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The iDoc?

September 3, 2010
by Joe Marion
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Lately, there has been a lot of press about handheld devices and how they will revolutionize healthcare. Call me the iDinosaur because I’m having a hard time seeing how anyone has yet to put together the right mix of tools to really make a handheld any more productive than the good old fashioned tablet PC!

Case in point: several months ago, a colleague eagerly acquired an iPad and proclaimed that printed media was a thing of the past. He could do all he needed to do with his iPad and didn’t need his laptop any longer. Interestingly enough, the last time I saw him, he was using his laptop. When I inquired about the iPad, he said it was for sale on eBay! It seems once the novelty wore off, it wasn’t as robust as he thought it was.

What are the primary things a handheld should offer a physician?

  • Ability to document patient encounters (notes, history, etc.)
  • Ability to order studies and tests (CPOE)
  • Ability to prescribe medications
  • Ability to access prior patient records and test results
  • Ability to search the web for specific disease or medication information
  • Ability to access reference material
  • Ability to communicate with other clinicians or the patient (email, instant messaging, etc.)
  • Ability to place/receive phone calls from staff, physicians, patients, and facilities

What technologies exist to enable the physician to do these things?

  • Textual information input in the form of dedicated keyboards or pseudo keyboards
  • Voice input in the form of voice and speech recognition applications for command and speech-to-text entry
  • Visual display of information through some form of screen
  • Content manipulation through various devices such as cursor movement devices or finger gestures on the display
  • Internet, Wi-Fi, and wireless connectivity
  • Bluetooth connectivity

So what’s lacking with the current lot of devices?

  • Smart phones offer an effective means for voice entry, Wi-Fi and wireless connectivity, and information interaction (cursor movement and finger gestures), but typically the form factor makes textual entry difficult, and viewing area is limited.
  • Tablet devices offer a good form factor in terms of a larger viewing area, along with similar capabilities to the smart phone, but may present a bulky approach to telephone conversations without something like Bluetooth technology.
  • Tablet PC’s can usually offer similar capabilities but in a bulkier form factor, and typically do not offer telephone service, or as sophisticated finger gesturing control.
  • Wearable PC’s were once the rage, but that idea seems to have faded, and I doubt many physicians would be attracked to the idea!

Perhaps the problem is packaging. The smart phone probably packs all the necessary capability, but is not the best form factor for effective entry and viewing of information. The tablet and tablet PC’s are better form factors for viewing and data entry, but they do not lend themselves to effective communication.

If one were to consider splitting functionality, it could provide the best of all worlds in terms of the “iDoc.” Wireless technology enables wireless keyboard and mice, and streaming technology enables wireless displays. Such technology is already creeping into consumer products with the latest trend by Google, Amazon, and others to create internet devices that can stream movies to one’s TV. LCD TV technology already allows internet connectivity for similar purposes, and along with wireless keyboard devices can enable interactivity over the internet from one’s favorite recliner.

So why not similar technology in the physician’s office? Why not a smart phone device that handles network connectivity and communication that can then stream to larger displays, handles telephone communication through Bluetooth, and accepts input from input devices such as a keyboard and mouse? This could perhaps enable proliferation of component devices such as displays and keyboards to be spread around facilities to enhance entry and visualization, while enabling the key device to mobile and self-sufficient when the physician is away from his/her office. With proximity sensing, the device could link and unlink from devices as the physician goes about their business.

I’m all for experimentation with today’s technology. But, perhaps in a few more years’ time, a whole new crop of consumer technology will be available to apply to healthcare’s needs and truly create the “iDoc.” As usual, I welcome your perspective.

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Comments

You are both right...and the recent revisions to the MU criteria back you up. Scribes are in and devices are out!

With that MU change, and what you both identify as weaknesses in the handheld tech world, it's going to be a long time before any device comes to the fore and entices docs at the bedside to ignore the scribe and take up with a new device.
Frank Poggio
The Kelzon Group

Joe,
Yes, absolutely agree with your observation! Have owned several Laptop PC's im my day - including the innovative IBM 701C Butterfly with the small form factor! Perhaps it's the lackluster nature of the PC companies - who can get excited about Dell, HP, IBM, etc. vs. an Apple or a Google?

I'm also enamored with perhaps the analogy of what happened in the IT market with computing power. We started with big, central iron, then went on the PC/distributed path, and now seem to be coming full circle with virtualization. Perhaps the same will happen with hand helds? Will everyone will learn to adapt, realize their inefficiency, and then return to some other form factor such as the tablet PC?

I guess time will tell.

Joe,
I'm in violent agreement with your overall reasoning. I see this iPad and Android device market success as largely evolutionary. Your comment,


"I'm having a hard time seeing how anyone has yet to put together the right mix of tools to really make a handheld any more productive than the good old fashioned tablet PC!"


seems to focus on the immaturity of the "tool mix", as though the platform evolution itself plays no significant role.

The old fashioned tablet PC (of which I've owned and used several) clearly didn't have the market splash. Do you agree with that? Why was that, or why do many folks have that impression?

Joe Marion

Founder and Principal, Healthcare Integration Strategies

Joe Marion

www.hisconsultant.com

Joe Marion is founder and Principal of Healthcare Integration Strategies, specializing in the...