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And they had developed a few apps, but they were all siloed, and weren’t connected yet to the clinical information system. They had a Citrix view into the clinical information system, but the mobile apps that they had created weren’t yet integrated into their clinical system. So for example, there might be a dose calculator or an image viewer—but the apps weren’t integrated into the overall clinical information suite.
And that’s where things are going. And that’s what the paper said, which is that these tools are cool and neat, but the longevity of use comes from the integration, so that summaries can be created for physicians and patients, for example. So that’s where we’re at right now, is that we’ve got thousands of apps doing different things—but those apps have to be integrated into core clinical information system development for truly accountable care and sustainability of use.
Given that the physicians in particular are bringing devices in and dragging senior IT leadership forward, doesn’t that mean CIOs and CMIOs really need to develop strategic plans around mobility, and quickly?
Yes, and you don’t have forever to develop those plans; you need to do one in a three-or-four-month planning process. And you need to develop a vision, direction, and ground rules.
And if a patient care organization is going to develop its own apps, do you have any thoughts?
Yes, one of the things that’s important to understand is that the FDA [Food and Drug Administration] is putting out advice on the use of medical devices and what is a medical device. And so things like ultrasound apps that are mobile, those are all things that go for approval. And some apps may actually require FDA approval; so those are things to consider.
And many organizations are developing very cool applications, especially physicians and other clinicians.
Yes, that’s right. And the whole thing about mHealth is, it’s been around a long time. I actually did a research report back in 2001 for the California Health Care Foundation, and referenced that report in this white paper. For this report, we looked at those types of applications that really are making the most of the smart mobility platform. So the things that are listed in here, and the things we describe, are things like using the camera, the GPS, the video capability, the high-level processing, such as search engine capabilities; and now, this is all available to you on this little teeny device that you can stick into your pocket or purse.
And the vendors are creating software development kits (SDKs) for development. So for example, Apple has an SDK that helps you develop an application to run on their operating system; so it makes it easy. One statistic we cited, which is probably already out of date, is that there are 17,000 healthcare apps already being used; and it’s amazing to me that 43 percent of those are for clinicians.
And we tried to look at the organizations that are making the most of these applications. And we put interesting examples in the tables and in the ‘Case In Point’ section. The other thing I think that’s particularly interesting now compared to a decade ago is that mHealth now covers the whole spectrum of healthcare—wellness, care monitoring, clinical decision support; and it covers life sciences, population health, and health plans. So health plans are using mHealth to help people make the best choices. So it’s one of those technologies that’s not just for care delivery, but that covers everything. And smart people, whether it’s clinicians, engineers, whatever, are coming up with really clever ways of taking platforms, taking connectivity, and creating these solutions that I believe are making a big difference.
How would you summarize your advice to healthcare IT leaders?
I would say, do it quickly, involve all the stakeholder groups, make sure you cover all the bases, and get everyone onto the same page, and then off you go. And if you do that, you’re going to get it about 80 percent of it right. And then you go and do your first couple of projects, and then you go back and tighten things up. And the good thing about a lot of these projects is that you’re not going to be working on them for three years—you’ll be focused on specific issues like reducing readmissions or monitoring diabetics. It won’t be an “ENTERPRISE-WIDE CLINICAL INFORMATION SYSTEM IMPLEMENTATION,” in capital letters.
