This content is part of the Essential Guide: Guide: Securing patient data while promoting BYOD in healthcare
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New iPad EHR app emphasizes mobility while acknowledging device's limitations

ADP AdvancedMD's new iPad application won't solve the problems that come from typing on the device's on-screen keyboard. Vendor: That's the point.

Apple's iPad offers physicians a new way of accessing patient information from wherever the data is needed -- whether it's at the point of care or in mobile settings outside the office or hospital -- but does it offer the functionality to be a doctor’s primary electronic health record (EHR) interface?

The latest entrant into the iPad EHR market is betting not. ADP AdvancedMD says its new release, which is ONC-certified for meaningful use and includes a beta iPad application, isn't intended to replace physicians' desktop computers, but instead will function as a way to augment full systems that also utilize desktop or laptop computers.

Robert Carlin, M.D., a solo practitioner in West Islip, N.Y. who tested AdvancedMD's new iPad EHR, said  being able to access patient information while away from his desktop system has been a major advantage.

Remote access allows him to bring all his notes with him when checking in on patients in the hospital. He is able to access all his previous notes, see problem lists and view patients' full allergy and medication information. He said this enhances safety, as it allows him to make sure his patients are receiving the right treatment.

"You can see the total history," Carlin said. "You have everything here."

Despite the benefits that come with remote access, Carlin admits he still needs to enter new notes when he gets back to the office at a desktop with a physical keyboard. Even with its mobile functionality, some physicians -- including Carlin -- find data entry using the iPad's on-screen keyboard difficult.

Steven ZoBell, ADP AdvancedMD's vice president of product development, said the new iPad EHR doesn't seek to solve this problem. Instead, it positions the application as a part of a broader EHR solution that operates on mobile devices and desktops.  It is intended to be a tool that gives flexibility in terms of accessing patient information and not function as the EHR itself.

"If we were to build an iPad-only solution, we'd be missing the mark," ZoBell said.

This use of mobile devices as a complementary tool rather than as a primary EHR interface is gaining momentum. More and more, vendors are releasing products that help physicians get the most out of their EHR without necessarily trying to replace a desktop computer.

For example, Epion Health recently launched an application for tablets running on the Android operating system that allows physicians to gather more information about their patients and provide educational opportunities.

The app enables patients to complete health screenings and watch videos about their condition on a tablet while they wait for their appointment to begin. Physicians can then view the information submitted by the patient on their own tablet. The data can be fed into a physicians' full EHR and used to identify patient risk factors. It also has drug reference guides, dosage calculators, and other resources for doctors.

Epion's CEO Joe Blewitt said physicians like the system because it centralizes information. Rather than hunting through stacks of paper records or going to several different resources to determine appropriate drug treatments, physicians can access this information on their tablet.

While the system may complement many of the uses of traditional EHR systems, it does not have all the functionalities physicians would expect from full systems. The Epion application is part of the trend of vendors seeking to make the most of the mobility offered by new devices without necessarily trying to provide a complete system on a tablet.

Of course, remote access to patient data raises security questions. ZoBell said many physicians run into HIPAA compliance problems without even realizing it, particularly if they are operating in a bring-your-own-device (BYOD) setting. Applications may cache data, which can then be compromised when users bring their iPad home and sync it with their computer. If that computer lacks security software the problem is even worse.

The new AdvancedMD EHR application doesn't cache data, ZoBell said. This allows doctors to use the iPad during the course of patient care and then take it home with them for personal use without worrying about transporting any potentially sensitive patient data with them.

Data entry on the iPad is just part of the transition to EHR systems that isn't straightforward to Carlin, who has noticed some disruption to his workflow in general with electronic workflows. After using paper charts for 20 years, he struggles with typing and now must spend extra time entering data. However, the ability to access patients' records from anywhere outweigh these drawbacks, he said.

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