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Technology-Driven Healthcare Part 2: Mobile Computing

July 22, 2014
by John DeGaspari
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Next steps toward a mobile computing strategy at Seattle Children’s Hospital

How important is mobile computing in healthcare delivery? At Seattle Children’s Hospital, a 323-bed facility in Seattle, Wash., a mobile computing platform has largely freed clinicians from stationary computer workstations, and the hospital encourages its clinical end users—or “partners”—to experiment with new applications that may eventually be incorporated into their workflows. (Part 1 of this article examined how telemedicine is driving change in healthcare delivery.)

Wes Wright, senior vice president and CIO of Seattle Children’s Hospital, is a proponent of using mobile computing devices in the hospital’s virtualized computing environment. The hospital is taking delivery of 200 Surface Pro 3 tablet computers as part of its laptop replacement cycle. Eventually the hospital will bring in about 1,000 Surface Pro 3 tablets as replacements for up to 70 percent of its laptop computers, he says. At the same time, the hospital is working with Microsoft, based in nearby Redmond, Wash., and with Santa Clara, Calif.-based Citrix, to upgrade its virtualized desktop operating system to the Windows 8 operating system, which Wright says smooth the way for touch-enabled devices.

Dennis Schmuland, M.D., chief health strategy officer at Microsoft, says mobile computing is playing an important role as healthcare delivery increasingly emphasizes team-based care. In his view, the primary purpose of healthcare IT has changed over the last decade, from capturing and presenting clinical information and insights to providers, the prevailing decision-makers, to team-based caregivers. The original IT infrastructure, which he terms “provider-centered piecework,” is changing as well to support that new care model, he says.

As the industry enters an era of frugality, with a growing emphasis on managing chronic disease and the continuum-based payment model, technology is increasingly focused on improving health outcomes and the experience of care for more patients more securely, in less time and at a lower cost, Schmuland says. This requires patient-centered teamwork, with highly mobile, collaborative, virtual care teams that incorporate multiple organizations and disciplines. “Team collaboration can make a huge difference between rapid recovery and readmission or a life-threatening complication,” he says. In his opinion, these collaborative teams will find innovative ways to keep down costs, drive down wait times and inefficiencies, and free up time for patient care.

‘A Sandbox for Innovation’

Seattle Children’s Hospital already had experience with the Surface Pro tablets before it placed its most recent order. It had deployed about 150 to 200 of the Surface Pro 2, the previous generation of tablets, which are used primarily for administrative tasks. Wright says his decision to use the Surface Pro 3 as a laptop replacement was based on the latest version’s larger screen size, along with its lighter weight, and improved keyboard.

Wright notes that Seattle Children’s Hospital has a large virtualized environment with about 5,500 zero-client devices. “That is my predominant clinical environment right now,” he says. He is confident that any applications that currently run on the laptop computers will also run on the Surface Pro 3 tablets. Most of the people who use a laptop now have a Windows 7 virtual desktop on top of their laptop, he explains. “They are operating in a virtualized desktop environment, were all of the applications are tested to run together, without interfering with each other,” he says.

Wright says the virtualized desktop environment allows him to be “device agnostic from an application testing perspective, because I’m giving whoever hooks up with my network a full-up operating system, with the applications embedded within that operating system.” That environment supports the use of a variety of devices, whether Mac, Android or the Surface Pro devices, he says.

He calls the operating system on the Surface Pro 3 a “sandbox for innovation.” Some possibilities for development are handwriting recognition, creating video and statistical packages for research, he says. “I’m hoping that by just getting that form factor into their hands, they will start to figure out ways to make their workflows more efficient,” he says.

Wright says that for security, every Surface Pro 3 will employ BitLocker hard disk encryption. In addition, he says, corporate data that resides in the virtualized environment stays in the virtualized environment. “All of the data stays in the data center,” he says. He adds that he is in favor of a “Bring Your Own Device (BYOD) policy, noting that if end users want access to corporate data for their work-related tasks, they will need to access it through the virtualized environment.

Looking ahead, Wright says the virtualized desktop model will serve well in the future, which will see growth in the mobile healthcare arena.

Upgrading the Operating System

As a next step, Wright says, the hospital is working with Microsoft and Citrix to upgrade the virtualized environment to Windows 8. That will allow Seattle Children’s to deploy a touch-enabled operating system with any touch-enabled device.

Wright notes that Seattle Children’s is currently on an older version of Citrix, which has resulted in some relatively minor performance issues that detract from the user experience. “You generally get one shot at getting it right when you are implementing a new technology; and if it is not right it is branded as bad, and you are never going to get another shot at it,” he says. He says that virtualization in the Windows 8 environment is a lot simpler than it was in the older Windows operating system..