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Full Speed Ahead? For Mobile EHR Adoption, Not Yet

July 9, 2014
by Gabriel Perna
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While consumer-based mobile health applications explode in growth, clinical apps for tablets and smartphones are still maturing

Dr. Lee Peter Bee, D.O. is one of those people who just can’t run at half-speed.

Bee, an internal medicine doctor in Sesser, Ill., runs a six-employee independent medical clinic, Southern Illinois Medical Specialists. He is also a fellow with the American College of Osteopathic Internists, a trained chiropractor, who specializes in intervention pain management, and has a Masters degree in nutrition. He teaches students and second-year residents and works at an emergency room on the weekends.

“You can’t be everywhere and anywhere at the same time,” says Bee, who seems to try anyway.

Having worked at Fortune 500 companies including Apple and Canon before entering the medical field, Bee is fanatical about technology. He is a firm believer in the mobile revolution. Every single one of his employees was given a Windows 8 Surface RT tablet. Personally, he uses an iPad and has trained Siri, Apple’s homegrown voice-assistant application, to speak and understand medical terminology so he can verbally document on a patient. The Windows tablets have voice assistants as well.

Dr. Lee Peter Bee, D.O.

Bee says he has also become adept at using Practice Fusion’s (San Francisco) mobile electronic health record (EHR) app, and as his clinic switches over to a Kareo (Irvine, Calif.) system, its mobile EHR app as well. Moreover, he has set up intricate templates that help him complete detailed documentation notes on the app, and has it set up so it seamlessly and wirelessly integrates with the desktop application as well other clinical applications. To top it off, each room in his practice is equipped with dual-screens—mobile and desktop—so he can document and educate the patient simultaneously.

In other words, he doesn’t run his mobile EHR strategy at half-speed. “If you don’t do it well, it’s very dangerous,” warns Bee about mobile EHRs.


In a way, Bee’s experience reflects where healthcare stands with mobile EHR applications. While consumer mobile health (mHealth) revenue has exploded in growth, driven by consumer demand in wearable technologies as well as entries from multitudes of small and large players, clinical EHR applications on mobile devices remain a still-maturing segment. Those who are using EHRs on a mobile device are typically doing so with software that has limitations (something that even a tech super user like Bee admits) and doing so to compliment a desktop application.

Catholic Health Partners, a large health system with 23 acute-care facilities and 1,500 ambulatory providers in Ohio and Kentucky, certainly fits that profile. Stephen Beck, M.D., CMIO of the health system, says the organization has made investments into mobile EHR technology, but the applications are only used as viewers to compliment the desktop application.

“I’ve worked with several EHRs in the past, and the challenge around EHRs is that there is so much information to compile and to organize, it’s difficult to get all that information onto a small work space. If you look at a chart on a smartphone or a tablet, there is limited real estate to show the pertinent information on a single screen,” he says.

At Catholic Health Partners, clinicians can use the mobile app to review clinical information quickly and in front of the patient. However, a law in the State of Ohio requires two-factor authentication when electronic prescribing. This, Beck says, has required the organization to take a more cautious approach with the mobile EHR application. He says the health system plans on figuring out efficient ways to have the app move beyond its limitations.

The mobile EHR application market is so immature that the segment has not yet been reported on by KLAS Research, a well-known industry vendor research firm in Orem, Utah. Colin Buckley, strategic operations direct at KLAS, says this is because provider experience has been very thin in this area.

Colin Buckley

“We did a study last year on EHR usability, both on the hospital and ambulatory side. We talked with CMIO types and had them rate levels of functionality,” Buckley reports. “Most of what we asked about were meaningful use related functions, but we threw in mobile. We asked how they would rate EHR vendor support for mobile, and only half could even answer the question,” he notes. Those who would answer spoke of an immature form factor and only a few vendors stood out, he adds.


Other research efforts confirm that those like Beck and Bee, who are using mobile EHR applications, are clearly among a select group. The New York City-based research firm Black Book Rankings recently surveyed more than 20,000 EHR users. Of those, only 11 percent of the respondents were mobile EHR users.

Even then, respondents who reported using an app were sharply divided in user satisfaction. Large multispecialty clinics and group practices, hospital-based practice staffs, and other large healthcare organizations were more content with their mobile EHR apps, while most independent practices and solo physicians did not have as positive of an experience.