With new technologies erupting across the IT landscape, physician mobility is expected to leap forward in the coming years. But healthcare IT leaders and industry experts say thoughtful strategies and clear vision will be needed to make the mobile future a successful one for all those involved.
Mark Musco, M.D., remembers clearly what life was like in the pre-mobile-computing days for physicians. “It must have been in 2005 or 2006,” he recalls. “I was at a party with a bunch of friends from college, and two friends had Palm PDAs, and they were checking their e-mails, and I looked at them doing that with longing. And I realized in that moment how owning a mobile device would allow me to be connected to my practice, but also be with my family, or be at the park, or anywhere else-in other words, how it could untether me from a fixed workstation.” Not long after that, Musco began using his BlackBerry for some functions, and then switched to an iPhone just under two years ago.
And if Musco glimpsed the future of physician mobility several years ago, he's also someone who, in his role as CMIO of the Walnut Creek, Calif.-based Muir Medical Group IPA, has been charged with helping his 700-plus physician colleagues create the environment they want in order to facilitate the anytime-anywhere computing capabilities they need these days. So Musco, a family physician who practices two days a week in a three-doctor practice in nearby San Ramon, also spends two days a week at the Muir corporate headquarters, working with Tina Buop, the organization's CIO of clinical integration, and others, to help move everyone towards the new world of mobile computing. (The fifth day every week Musco devotes to managing a mix of administrative and personal activities.)
Musco himself currently performs many tasks in a mobile fashion-“coordinating care, taking calls, updating a patient's status with another provider-a lot of that I'm doing is via text-messaging now,” he notes. He also texts fellow physicians briefly regarding patients before receiving documents within the IPA's electronic health record (EHR) or a fax. Meanwhile, within his own three-doctor, one-physician assistant office practice, “All the people with direct patient care responsibilities are mobile,” using tablets for core clinical documentation and other functions, he notes.
As CMIO, what is he seeing? “The physicians have a few major concerns,” Musco says. “Number one, they're often driven by total cost. Number two, the physicians are very excited about instantaneous provider connectivity to ancillary services and other providers in the community; so basically, they want to be connected to a community of doctors collaborating and coordinating care on an e-community kind of platform.” The third and fourth levels of priority, he says, are “ease of use” of any platforms and devices “relative to their particular clinical needs”; and making sure that “the instrument that they're going to deploy in their office is going to help them meet evolving mandates or requirements, such as related to meaningful use, healthcare reform, or managed care needs.”
THERE'S GOING TO BE AN ENTIRE GENERATION OF ADOPTERS WHO NEVER KNOW WHAT IT'S LIKE TO HOST THEIR OWN SERVERS, BUT WHO INSTEAD WILL BE LOGGING INTO WEB-BASED, HOSTED SERVICES. - MARK MUSCO, M.D.
What's patently clear, Musco says, is that in a collaborative environment such as exists in IPA-based organizations like Muir, “The idea of maintaining something yourself in clunky servers in your office is going by the boards.” Instead, he says, “There's going to be an entire generation of adopters who never know what it's like to host their own servers, but who instead will be logging into Web-based, hosted services.”
MANAGING A SWIRLING MIX
Nationwide, CIOs, CMIOs, other healthcare leaders, and physicians in practice are all struggling over questions around physician mobility, as policy, regulatory, industry, technological, and societal developments continue to swirl forward in a heady mix of change. Far more than even a few years ago, there now exists the technical capability to provide physicians with unprecedented capabilities in mobile computing. But just because something is technically capable of being done, does that mean it should be facilitated? CIOs, CMIOs, and other healthcare IT leaders are faced with an almost bewildering array of choices to make, knowing that choosing correctly could boost physician productivity and potentially optimize reimbursement, while also enhancing patient safety and care quality and boosting patient and family satisfaction.
But no one can have everything; and the same industry and policy factors that could potentially support increased physician computing mobility are also weighed down by issues of cost, implementation scheduling, prioritization, and return-on-investment value. How to decide?