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The Droid Will See You Now

March 16, 2010
by daphne
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As one of the last holdouts on the planet, apparently, I bought my first smartphone this week. A Motorola Droid 2.0, on the Google Android platform and using Verizon’s 3G network, this phone does everything except cook dinner for me. The 3.7" Touch Screen and 480x854 WVGA display is brilliant and crisp, it has a slider keyboard, advanced voice recognition technology for all its functions, and if choose to I can download a whole slew of apps to its 16 gigabyte memory card. Oh, and it’s blazing fast.

How did I live without this? After a short romp through the wow factor, my writer side kicked in and I thought, “Now I know why one of our Top Tech Trends is smart phones.” As Kate Gamble explained so well in her HCI wireless story, “Trend: Smartphones,” 70 percent of physicians now carry these devices. And physicians’ expectations are skewing towards “I want my clinical data, and I want it now.” My Droid screen is so big and crisp it would be easy to even use it for quick imaging reviews. EMR vendors are taking note, and many are already offering smartphone applications. And some hospitals are indeed offering a variety of smartphone access to clinical data.

Of course, as with all healthcare technology, it’s not about the technology. A smart phone is a golden opportunity for CIOs to use a very cool IT tool to enable better care, access and communication. It’s also an opportunity to get on the wrong track by not having a clear, well-defined strategic plan for their use. No matter how you look at it, smart phones are not going away: you’d have to pry mine out of my cold dead hands. Smart CIOs better have this top of mind if they want to keep their doctors happy— or even keep them.

Now, if I can just download an app to write my next story…

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Comments

A note at looking a physician's desktops, and the broader significance of your topic, trends (and implications) on accessing health information:

Physician Desktops:  My doctors, my dentist, and the doctors of my kids often encourage me to look over their shoulders at what they're seeing on the computer (the eChart.) It's often very telling.

For example, one GI physician is clearly not seeing the growth issues for one of my kids, even when the treating physicians are in the same AMC and/or group practice. It was clearly an implementation decision. One with clinical consequences. Things will definitely improve with ARRA Certified interoperability through CCD documents.

Accessing Health Information:  In your example, let's hypothetically refer to your Dr as Dr Josh. It would appear that Dr Josh would need to be very conscientious if you had relevant results in TDS, SCC, IBEX, Cerner, IDX, GE-PACS, McKesson, Epic, and QuadraMed.
 
Conscientious, here is a code word for slow and taking a productivity hit.  At just one minute on average per icon to complete a review, the arrangement shown in the photo means taking ten minutes per visit, just to poll the availble sources.  He had better know where to look; that means either you tell him, or he follows up things he knows about.

 
Again, information access will definitely improve tremendously when Dr. Josh can see, in a single screen on any of those systems, the CCD documents being interoperability shared about you. Then, a quick check on any system he's already logged in to (authenticated with) will assure that he's got all of your documented information. 
 
Counter to some of the negative response about the goverments' ARRA posture, here is a concrete example of where technology can simultanously improve physician productivity and improve quality and safety, in terms of reliable, efficient access to information.  Objectively, this would be an improvement over the situation captured by the camera in Daphne's Droid (photo above). 

And, of course, Dr Josh and perhaps you will be able access those same documents on your Droid, and Kate on her iPad.

 
Concluding Thoughts:  I think you and Kate are doing a real service elaborating these issues for us all. It's also a great example of where the government's leadership with driving interoperability is making a positive difference.  Further, it's a great of example of where vendor leadership (both the EHRA and it's members) are pushing for stronger interoperability standards (e.g. CDA Infrastructure), so that care coordination improvement initiatives (e.g. medication reconciliation) are strongly supported, as are Patient and Family Engagement, Quality, Public Health, Security and Privacy.

Daphne!

Welcome to the land of the living! After a few short months with my iPhone, I honestly don't know how/why I waited as long as I did to give up my old red Samsung Sync. Like you, I was seduced by the cool factor at first, but now have come to rely on it to be more efficient - both in my professional and personal life.

And if you're wondering which apps are the live withouts? Just send a single Tweet and ask your Twitter followers for advice, which they will be happy to provide! Oh, and make sure you send it from your smartphone - I recommend Echofon for Twitter!

G.

Thanks Joe, that was my thought exactly as I was staring at it"Wow, he has to look through all of this? Good thing there's nothing really wrong with me!" Drives home the importance of interoperability and physican portals in one quick picture.

Daphne,
You hit it right...thay are great tools, but Joe hit the most important piece, which is the software that drives the PDA is even more critical. Overloading the doc's PDA with to much info is worse than too little. And if it doesn't mimic his/her work flow he'll just keep it in his pocket when he's at the bedside. Just because the data is accessible doesn't mean it needs to be seen.

Thanks guys, I am going to follow those tips. And Joe, you're right, adoption is closer to 100 percent, I was looking at a number from maybe a year ago. Anyway, here's one of the first things I did with it: I was at my doctor's, in a hospital-based setting, sitting in the exam room alone waiting for him. I'm always very nosy about what's on the computer, so I grabbed the mouse to check it out, and thought it was so cool that Cerner, Epic, Centricity, IDX, etc were all there. So I took a picture and sent it to myself!
 

Daphne,
The 70% penetration of smart phones figure might have been true months (or years) past, pending on the polling method.  Amongst physicians who show up at meetings and conferences I attend, the number is much closer to 100%.

I think Frank Poggio's comment here sums it up well:


it blows the docs mind too see how easy it is and realize they will not have to learn a new device.  [Sounds like it may be comparable to your experience, Daphne!]

Gwen's advise is solid.  The range of HCIT apps for the iPhone, as well as utilities like the citrix client or VNC allow these smart phones to connect very broadly today.  The smart phones are just the final common pathway for lots of trends, including cloud computing, ubiquitous connectivity, improved user experience, and the final moves toward self-serve (and away from paper.)  This Internet thing really does change everything!

Great post Daphne (and thanks for the shout-out to my article!). It sounds like you've caught the bug and you're on your way to making the smartphone a tool that works for you.
I think the biggest factor with smartphones in health IT is the fact that they have the potential to make it easier for clinicians to access patient data. That's what this whole thing is supposed to be about.
You'll have to keep me posted on your progress... I just might convert myself!

daphne

Twitter @Daphne Lsawrence

Daphne Lawrence is senior associate editor at Healthcare Informatics magazine, covering the...