The Curious Case of iPads in Healthcare

March 8, 2012
5 Comments
When it comes to adopting tablets in healthcare, there remains a disconnect between physicians and IT leaders
The Curious Case of iPads in Healthcare

A few weeks ago, I had a nice chat with Lane Cooper, editorial director of BizTechReports, an independent research and reporting agency, about why healthcare IT executives are hesitant to bring consumer-based tablets like Apple’s iPad into the fold. BizTechReports interviewed 100 executives and IT professionals within hospitals, and 66 percent of them said tablets like the iPad create governance challenges.

Cooper explained that tablets like the iPad go against the governance rules put in place by the Health Insurance Portability and Accountability Actof 1996 (HIPAA). HIPAA, Cooper says, wants data to be shared and protected securely. As he sees it, certain consumer technologies are not designed to support these governance rules and this is why tablets haven’t exactly been welcome with open arms by healthcare IT leaders. Cooper even asked a pertinent question, one which I think bears repeating:

Should the burden lie with regulations to support a consumer tool, or should the tools evolve to meet the requirements of these important legislative developments?

Another survey, highlighted by Healthcare Informatics Contributing Editor David Raths in his recent Top Ten Tech Trends feature, The BYOD Revolution, finds only 38 percent of healthcare CIOs have a policy in place that regulates the use of mobile devices, according to the Health Information and Management Society (HIMSS).

There are additional reasons why tablets and other consumer mobile devices aren’t the favorites of healthcare IT leaders. A similar survey from SpyGlass Consulting Group (Menlo Park, Calif.) claims 75 percent of the physician respondents say hospital IT directors are reluctant to support mobile devices because of security and cost reasons. There are also durability concerns, which Cooper outlined to me when we spoke. The governance issues, however, seem to weigh in importance over everything.

You might be asking, what’s the big deal? Well, the big deal is that physicians really like using tablets and have been bringing them to hospitals where they practice in increasing numbers. As a result, CIOs are having to come up with strategies to secure these devices in response.  This contrasts with earlier strategies in which CIOs distributed institutionally provided devices.

A survey last year from Waltham, Mass.-based QuantiaMed surveyed more than 3,700 physicians and found 30 percent said they already use a tablet, with 65 percent saying they are likely to use one in the coming few years. With this in mind, there are countless healthcare IT vendors trying to take advantage of physicians’ tablet fever. When I was at HIMSS12 a few weeks ago in Las Vegas, you could barely walk five feet without seeing a vendor shilling some kind of tablet-friendly product.

One company I spoke with, Motion Computing (Austin, Texas), makes tablets for the healthcare sector. Not surprisingly, Motion went out of their way to convince me their tablets are durable, easy to use, and most importantly, secure.

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BYOD

The West Wireless HEalth Institute has recently announced an initiative to provide a free small cell architecture which furnishes medical grade security to hospitals. It is agnostic to technologies and is treated as a utility. I would encourage all to look into this. David Lee Scher, MD

iPad and the case of Medication Reconciliation

Gabriel,
Great post and well researched. You captured much of the CIO's challenge of securing and managing these devices. The rate of adoption of this technology is unprecedented, as are several other aspects that you didn't touch on. The biggest issue is the state of existing applications, as well as the innovations in usability, mobility, and human-factor design for complex workflows where these new technologies excel, beyond simply their mobility.

The best example is covered in this blog post: http://www.healthcare-informatics.com/blogs/joe/medication-reconciliation-field-onions-part-2

The cliff-notes version is that Medication Reconciliation is one of the toughest problems in HCIT. This was recognized by the ONC who funded the development of the SHARPC grantee (Office of the National Coordinator's Strategic Health IT Advanced Research (SHARP) program) featured in the 91 second video in the blog above. If you are really impatient, jump 70 seconds in. You'll see an implementation of Medication Reconciliation, on the iPad. There are no comparably usable implementations on prior, non-tablet device technologies.

The story gets better. In our experience, the implementation, orientation and training characteristics are better for a variety of reasons.

The better Tablet technologies have multi-dimension attributes, mostly positive. In my experience, there is no distinction in relative interest between savvy physicians and IT managers, as well as executives eager to break down the barriers to safe and effective HCIT adoption.

Thanks Joe

Hi Joe,

Thanks for your comment and linking your blog, which was a fascinating take on the issue of medication reconciliation.The developments happening with medication reconciliation on tablets and other mobility devices are more proof that while things have come so far in terms of mobility, we have a long way to go. There are more challenges than just engineering ones, as you mentioned in one of the blogs you wrote. It's great to see industry leaders on both sides of the spectrum working to create solutions that are workable. I, like you seem to be, am optimistic that the barriers will be broken down sooner rather than later.

Thanks,
Gabe

The Curious Case of iPads in Healthcare

Both physicians and IT are right. It's one of perspective. IT's job is to make technology transparent and invisible to the physician and enable their workflow. The wild card is government regulation (i.e. HIPAA). If regulations create a situation where we have an immovable object meeting an irresistible force, then nothing positive will prevail. HOWEVER...physicians are slowly learning what IT already knew (see Seattle Children's article). It ultimately isn't about the device, but about the applications. Some applications simply aren't designed for a touch interface. If the functionality, user experience, etc. on an iPad is not positive, physicians will revert back and wait for either the application vendor or IT dept to provide a positive experience.

http://mobihealthnews.com/14752/ipad-setback-at-seattle-childrens-is-but-a-minor-growing-pain/

Thanks for your comment and I

Thanks for your comment and I agree, usability is a huge make-or-break facet of mobility in getting physicians to adopt.

Gabe