Not only are hospital, health system, and medical group CIOs and clinical informaticists deploying handheld mobile devices across their enterprises as clinical computing tools; clinicians, especially physicians, are increasingly bringing their own BlackBerrys, iPhones, iPads, Android devices, and other handhelds, into patient care organizations for their personal clinical use. Not surprisingly, the challenges-as well as the opportunities-are multilayered and complex, and include the strategic planning, infrastructure, clinician preference, clinician workflow, and security issues involved in the emerging mobile handheld revolution.
The diversity of approaches among CIOs and other healthcare IT leaders on such issues is striking, and underscores the need for flexibility and nimbleness going forward.
Denis Baker, vice president and CIO of the 805-bed Sarasota (Fla.) Memorial Hospital, believes strongly in the future of handheld mobile computing. Last year, he agreed to let his hospital be the alpha site for the testing and refinement of the concept that became the Voalté One product from the Sarasota-based Voalté. The product, which has been live on two of 12 patient care floors and in all of the hospital's critical care units since last July, has been deployed on iPhones and enthusiastically adopted by nurses, who send and receive secure, encrypted text messages and receive critical care alerts throughout the day. [For examples of how hospitals around the nation are deploying handheld devices, see sidebar on p.12.]
Will Apple's new device be a “game-changer” for physicians?
One of the most intriguing questions of the day is this: Will Apple's new iPad find a special niche use in healthcare? It's a question that is strongly dividing physicians and other clinicians. Some physicians were among the first to rush out to buy the iPad the moment it came out this spring, and many of them are thrilled with its form factor and functionality. Others are a bit more skeptical about its potential as a “game-changer” for clinical computing. There does seem, however, to be a broad consensus that the iPad is yet one more device that is adding to the appeal of clinical computing for a group of healthcare professionals who were once more likely than not to resist the Information Age. Thanks to newer devices that are making computing more user-friendly, even fun, these same healthcare professionals are becoming more and more engaged.
Some CMIOs in particular are enraptured with their iPads. “I love it!” exclaims William F. Bria, M.D., CMIO for the Tampa-based Shriners Hospitals for Children. “I was afraid it would be a big iPhone,” says Bria, who is also president of the Association of Medical Directors of Information Systems (AMDIS), “but it's not. The larger display size, combined with the engineering of the weight and feel-what's happened is that they've broken through to a usability experience. And the extra screen size and touch interface together really change the game.”
Joe Bormel, M.D., chief medical officer and vice president at the Reston, Va.-based QuadraMed, agrees. The iPad, Bormel says, is significant because it is moving medical minds forward towards a full-fledged embrace of clinical computing, as no other device has yet done. “We've gone from ‘Over my dead body will I touch technology,’ to this,” he enthuses.
Adds Bormel: because physicians are rushing out to buy iPads, if CIOs can configure system security correctly (at the server level), “there's not that issue of beating up the vendor to get support for it.” As a result, he says, physicians will pay their own way to bring such devices into the patient care setting, bringing advantages both in terms of physician preference and in terms of economics, as long as the security can be worked out.
Lyle Berkowitz, M.D., medical director, clinical information systems at Northwestern Memorial Physicians Group in Chicago, takes a slightly more cautious view. “Will the iPad create a more efficient or effective environment?” Berkowitz asks. “Like most technologies, it has the potential to do so; and I think we'll see both success and failures. I think the successes will mostly relate to the easy, quick access to an application in an environment that requires mobility, such as inpatient floors, the emergency department, and home care, as compared to the more stable setting of an outpatient office.”