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Ask health IT experts about the penetration of mobile devices in healthcare, and most will say the medical field is lagging behind other industries in using the technology.
Mobile in healthcare is "vastly underdeveloped. I think we're five or six years behind every other industry," said Karen Clark, CIO at OrthoTennessee, headquartered in Knoxville, Tenn. And Indranil Ganguly, vice president and CIO at JFK Health System, based in Edison, N.J., described the mobile landscape as disorganized. "I think it's very disjointed," he said. "I think we're struggling with basics. … We're struggling with the fact that, for most of the users, mobile is a consumer device."
Ganguly explained that mobile devices in healthcare are mainly being used as an endpoint to receive information. "It's clunky, it's not easy to use and we've got a long way to go," he said.
For an industry that prides itself on advanced medical care, it may seem odd that mobile technology is underutilized. The reason, however, may not simply be that hospitals are slow adopters.
Indranil GangulyCIO, JFK Health System
Clark traced the problems with health IT mobile efforts in healthcare to the HITECH Act -- a law that encourages adoption of electronic health records (EHRs) and supports health IT in the U.S. When the HITECH Act was signed into law, it brought requirements for certification of EHR software. EHR vendors had to pour their resources into meeting those certification requirements and, therefore, didn't pay much attention to mobile.
"[If the vendors] didn't meet these certification requirements, they lost their certification, which meant they were out of business. So all of the focus was there," Clark explained. "Mobile was sort of a stepchild because that wasn't required."
CIOs envision seamless mobility
Clark and others do see a rosier future for mobile devices in healthcare facilities for both physicians and patients. "It should be invisible," she noted. And that's a good thing: Mobile device use in healthcare will become so engrained that people won't even notice it.
Clark used the example of purchasing an airplane ticket: She opens a flight app on her phone and buys her ticket. The app reminds her when it's time to check in for her flight. She chooses her seat, lets the airline know how many bags she's bringing along and decides to pay for a seat upgrade. "I can't remember the last time I bought a plane ticket any way other than on my phone," she added. "At no point did I think once about the device I was using. The technology had become invisible so that all I was thinking about was the task at hand."
Hospitals see many benefits in mobile devices
Some healthcare organizations have succeeded in using mobile devices for improved customer service and patient safety.
"We have apps that, for instance, schedule an appointment with your doc," said Ed McCallister, senior vice president and CIO at the University of Pittsburgh Medical Center. "As you're travelling to that appointment with your doc, you can actually leverage the map app to see the directions … and see what your wait time could be once you arrive."
University of Colorado Health (UCHealth), based in Aurora, uses mobile in a different way and for a different purpose. "The [laboratory staff] carry both an iPod to get to the [medical record] charts or workflows that they need, and they also carry a wireless printer," said Ed Horowitz, senior multimedia developer of clinical informatics at UCHealth. This way, when clinicians conduct blood draws, for example, they can quickly print out and stick ID labels on the vials.
"It becomes a patient safety aspect," Horowitz added. "You're not printing out a handful of labels and trying to guess who the patient is and make sure the right label is on the right vial."
Ganguly sees mobility in healthcare one day becoming as seamless as the experience a user has with Amazon. "You can go into your phone and order what you need, and [Amazon is] intuitive in pushing things it thinks you need out to you," he explained. "That's stuff we have to get better at in healthcare. If the banking institutions can get there with that level of comfort, I believe we can, too. But we have to dot our i's and cross our t's and make sure we can deliver it in a secure way."
Future mobile experience for physicians
On a physician's mobile wish list, expect to see more seamless integration with EHRs. "That's where we have to get with the EHR," Clark said, "so [clinicians] can think about examining and treating the patient, and the technology fades into the background, and they're just not even thinking about it."
But it's not simply about providing access to the EHR and health information; it's also about providing that access anywhere, whether inside or outside the healthcare organization, Clark said. She believes this kind of access will provide great value to physicians by allowing them to move around the hospital, which can be a challenge with more traditional methods of accessing EHRs via laptops or at workstations.
Karen ClarkCIO, OrthoTennessee
"[Clinicians] want to be able to move freely," she said, "talk with the patient, show the patient her X-ray, say, 'Okay, well, let's go ahead and order this for you and make this appointment for you to make it easy.' Nobody wants to carry around a 4.5-pound laptop all day."
But mobile should also allow physicians to do their job outside the walls of the hospital, Clark added. "If [a clinician is] sitting on the sidelines at their child's soccer game and they want to securely answer a few messages or sign off on some documents … that really helps providers with work-life balance," she said.
Watch for improved patient engagement
Furthermore, mobile will allow healthcare organizations to provide a more valuable experience to patients and consumers -- a benefit largely missing in healthcare, said Marc Probst, CIO at Intermountain Healthcare, based in Salt Lake City. He pointed out that technology has been implemented in many hospitals to improve workflow and processes, but little has been done to provide technology for a better patient experience during care.
Mobile should be the best way for patients to interface with their health system, Ganguly said. "For my patients," he explained, "if they have a problem, they should be able to go to the JFK [Health] app … and basically speak to it and say, 'Listen, I'm not feeling well.'"
On the back end of this voice exchange, there should be a decision support engine that will provide patients with options on how to receive care. Ganguly explained: "'It sounds like you might have a fever, but would you like to talk to a nurse?' In which case, you could have a nurse practitioner summoned if you have a telehealth portal, or … the system will know who I am. So it should say, 'Well, you know, your primary care physician has an opening tomorrow morning at 9, would you like us to book it for you?' Or, 'The urgent care center down the street is open now; it's going to be a $25 copay, but they only have a 10-minute wait. Would you like us to put you on the list?'"
"You can get to the point," Ganguly said, "where you're keeping people out of the hospital because you're directing them to the right point of care."
This type of mobile interaction, Probst added, "will give huge value to our patients, members and community."
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