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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?
Tina Buop, Muir's CIO, is clear in her mind about all of this. “As a CIO, I'm constantly prioritizing in four key categories,” she says. “Number one, are we up, are we available, are we secure?” In other words, core maintenance, operations, and availability. The other categories are new projects and product development; implementation, training and adoption activity; and work that supports the vision and mission of the IPA's board. What is key about all the developments taking place around physician computing facilitation at Muir, she says, is that “We're constantly evaluating whether what's being requested is aligned with what the board is envisioning. So if you want an iPad, that's great, but would you like an iPad, or a new bidirectional interface for the lab?”
The key, in other words, is IT prioritization and governance. At Muir, that translates into an EHR physician advisory committee of 13 doctors, which meets at least three times a year, with Musco as chairman and Buop facilitating.
Among the questions she, Musco, and their colleagues at Muir are continuously trying to answer are the same ones their colleagues nationwide are looking at these days.
Among those are:
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What strategies make sense from the organizational standpoint of a medical group, hospital, or integrated health system leadership level?
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How can strategizing around mobility be successfully harmonized with overall clinical IT strategy development?
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What kinds of analysis and trend-watching can be brought to bear, both in terms of the mobile, web, and infrastructure technologies themselves, and in terms of the policy, regulatory and reimbursement developments taking place that will in effect mandate certain clinical computing requirements?
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How can the vendor development elements be managed, and can vendors move forward to more optimally partner with patient care organizations going forward?
While there are no simple answers to any of these questions, all those interviewed for this article agree that one of the numerous pressing challenges of the next few years for CIOs and CMIOs at all types of patient care organizations will be to figure out how best to facilitate mobile computing for physicians in ways that make sense for all the stakeholder groups involved, without breaking one's organization's bank or vaulting off a tech-fad cliff.
EXAMINING USABILITY
One thing is patently clear: physicians are becoming mobile very quickly-perhaps more quickly than many in the industry might have anticipated even a few years ago. This fact is documented in a recent survey conducted by QuantiaMD, a Waltham, Mass.-based mobile and online physician community. In the survey of 3,798 physicians, conducted online in May, more than 80 percent of doctors surveyed said they own a mobile device capable of downloading applications-a percentage far higher than that among the general public. For more details on the QuantiaMD survey, including results made available exclusively to Healthcare Informatics, see “Mobile Device Adoption Speeding Forward” (sidebar, p. 14).
The data on accelerating mobile-device adoption is obviously very clear. But one researcher who has done recent work in this area cautions that there is a flip side to the current wave of interest in mobile computing among physicians, and that has to do with the mobile applications currently being developed. Fran Turisco, a researcher in the Waltham, Mass.-based Global Institute for Emerging Healthcare Practices, a division of the Falls Church, Va.-based CSC, has been examining usage of mobile apps in healthcare. “What's interesting,” says Turisco, “is that while there are something like 17,000 mobile health, or ‘mHealth,’ apps out there, and they range from free-of-charge to some expensive, very sophisticated solutions, what we're seeing is that in many cases, physicians and other clinicians are trying out mobile apps, but not sticking with them very long.” She cites a recent industry survey that found that only 26 percent of mHealth apps retain end-user loyalty beyond about 10 uses.
