Handheld Juggernaut

What is clear is that the appealing form factor of the iPad is engaging more physicians more enthusiastically than have many other types of computing devices in the past. And, given the hyper-competitive nature of the general mobile device market, it's virtually certain that competitors to Apple will move forward with potential rivals to the iPad, so, as with all the other devices being tested and deployed in healthcare right now, the phrase “stay tuned” seems to apply rather well in this instance.

“The huge amount of text messages flying back and forth has been noteworthy,” Baker says. “We got a report from Voalté last week that our 100 phones are generating 15,000 messages a week.” Indeed, given that “the average age of our nurses is 46 or 47,” Baker admits to some surprise at the level of enthusiasm of his nursing staff for this new technology on handheld mobile devices.

On the other hand, he notes, secure, encrypted texting is a great way for nurses to communicate short, routine messages to each other, because it is less interruptive of their patient care workflow than phone-calling, and it works very well.

A THOUSAND FLOWERS BLOOMING-IN DIFFERENT GARDENS

Given the dizzying range of variables and considerations involved, it's no wonder that IT leaders at different patient care organizations are approaching the whole area of handheld mobile devices in strikingly diverse ways. For example:

The multi-hospital University of Pennsylvania Health System (Penn Medicine), Philadelphia: Vice President and CIO Michael Restuccia and Associate CIO and Chief Technology Officer Brian Wells have hewed to a middle-of-the-road approach. They are allowing clinicians to bring in their own BlackBerrys and iPhones, but are requiring that the IS department be able to configure individuals' devices to remotely shut them down if they are lost or stolen. In addition, they are disallowing any kind of saving of data to the devices themselves, as well as demanding that any approved device be a self-locking mechanism. At present, Penn supports BlackBerrys and iPhones, and is testing out iPads. It is waiting for the next generation of Android devices (with enterprise capabilities) to come out in order to authorize anything Android-related.

Emory Health System, Atlanta: Technical Analyst Jason Stanaland is helping clinicians replace pagers with BlackBerrys and iPhones, using a pager replacement communications solution from the Eden Prairie, Minn.-based AmCom.

Community Care Physicians, Latham, N.Y.: At this 200-provider, 35-site multispecialty group organization, Chief Technology Officer Sumeet Murarka and Chief Medical Officer Barbara Morris, M.D., have facilitated the use of the Chicago-based Allscripts' core electronic medical record (EMR) on the iPhone for their physicians. In fact, Morris was the first U.S. physician to work within the Allscripts iPhone EMR app when it came out last summer. Their policy continues to be to distribute security-configured iPhones and other handheld mobile devices to physicians, rather than encouraging physicians to bring in their own individual devices. Murarka and Morris are also testing the iPad for potential suitability.

The 485-bed UPMC Mercy Hospital, Pittsburgh: At one of the 20 hospitals that make up the University of Pittsburgh Medical Center health system, CIO Bruce Haviland, working with Bill Fera, M.D., a UPMC physician informaticist, has deployed fully secured BlackBerry Curves for nurses on patient floors. Using a system of drop-down menus, nurses are successfully sending brief, time-sensitive yet routine “quick-text” messages to one another. The program, launched several months ago, has been very effective and very well received by the nurses, Haviland says. The hospital is allowing individual physicians to bring whatever handheld mobile device they wish into the hospital. However, those devices are restricted to the general, unsecured Wi-Fi access that any individual, including guests, would have, and are carefully kept out of any potential contact with the hospital's Citrix server. Meanwhile, as at countless hospitals nationwide, Fera and other clinical informaticists are testing out the potential of the iPad for physician use; but Fera and Haviland don't see a large organizational role for iPads at this point in time.

Oregon Health and Science University, Portland: Chief Health Information Officer Thomas Yackel, M.D., helped his organization become one of the first two in the country (the other being the Swedish Healthcare System in Seattle) to deploy the Verona, Wis.-based Epic Healthcare Systems' Haiku (EMR for mobile devices) on the iPhone. Yackel reports that physicians are not only looking up results via Haiku on their iPhones, they are also doing some secure messaging within the application. In addition, the physicians are taking steps towards some limited clinical documentation, such as reviewing and co-signing residents' notes.