An introduction to mobile health technology

As mobile health technology gains steam, physicians are increasingly using smartphones, tablet PCs such as the iPad and other mobile devices to view and update patient records, fill prescriptions and even email patients.

This video provides an introduction to the most popular mobile health technology devices being used in today's health care settings and describes the types of mobile health applications that physicians are using. The video was recorded as the introduction to a workshop on mobile devices in health care.

Let us know what you think about the video; email Brian Eastwood, Site Editor.

Read the full transcript from this video below:  
An introduction to mobile health technology

Brian Eastwood: Hi. This is Brian Eastwood, Site Editor for I'm joined by Don Fluckinger, our Features Writer. Don covers many technologies in the health care space, including the rapidly growing mobile health market. Here we'll be discussing some of the key benefits and challenges associated with using smartphones and tabloid PCs in a health care setting. This video is an introduction to a workshop on mobile computing health care strategies. The webcast and article that follow were built upon the topics we discuss here. Thanks very much for joining me, Don.

Don Fluckinger: Well, thanks for having me, Brian.

Brian Eastwood: So, first off, what specific smartphones and tabloid PCs are most popular among physicians today?

Don Fluckinger: Well, no doubt, hands down, the iPhone and iPad are dominant. Obviously, the iPad's pretty much the only one out right now. There are some competitors, but the iPad had such an early market lead that it's 99% or some fraction close. On the smartphone side, we've heard that a third of all physicians in this country carry iPhones, and the ones that did not have iPhones was because AT&T didn't cover their hospital or their home quite well.

So, they begrudgingly went to Blackberry or Droid phones that are also popular right now. It seems like from what we've heard anecdotally that physicians are either carrying iPhones or they want to. And with Verizon now getting into the iPhone market, it could be an even bigger slice of the pie that Apple will hold with the iPhone.

Brian Eastwood: So, the iPhone's clearly dominant, but are there any devices that you see coming on the market that could challenge it or that will make a big play into the health care space?

Don Fluckinger: It will be interesting to see how the Android phones catch up to the iPhones because in the consumer market, the Android phones are catching up to the iPhone and, in some places, exceeding iPhone sales. As software developers develop medical apps for both consumers and the clinical side of the hospital environment, the Android phones could catch up.

Also, you have the Blackberry and the associated Research In Motion Playbook, the tablet, that goes with the Blackberry phone. Blackberries seem to be more popular among the business side of the hospital: The back office, the administrators, and so on and so forth. But if they integrate that Playbook with the right medical apps, that could be a contender, too, down the road.

Brian Eastwood: Speaking of medical apps, what are the most appropriate clinical applications that are best suited for use on these mobile devices?

Don Fluckinger: Well, for smartphones, the electronic medical record is--to be able to port that to a physician's smartphone--is a great thing. Then the physician here, she can. . .the classic anecdote we hear when interviewing medical authorities is, you can change a patient's prescription while at your kid's soccer game. You can answer simple questions from patients or nurses or other people who are involved in your patient's care that come up when you're not in the office. Some physicians also like to work at home, and the smartphone is the most obvious thing to do that, and you can access all of the patient's data through the electronic medical record.

There are other things like sharing of lab results and porting other things to mobile devices like that. On the tablets, with the iPads and the Research In Motion Playbook and the Android devices, another very popular thing is imaging as well as reference books. A physician might want to show a patient a diagram of their knee or a hip that may be getting replaced. This is what your hip looks like, and here's a CAT scan we took, and this is what a normal hip looks like.

So, you can use those tablets to do demonstrations like that, and it's much more patient-friendly than having a laptop and holding it up and saying, "Hey, look at this." Getting hit in the face with a keyboard kind of thing.

Brian Eastwood: Or the x-ray that's always backward. “I'm sorry.” It seems like there's a lot of really good applications for it, but it also sounds like there's a lot of sensitive data that's being displayed on these devices, if a physician's working from home, being accessed outside of the hospital environment. What kind of concerns do IT departments have when physicians and nurses and other clinicians are using these mobile devices?

Don Fluckinger: Well, that's interesting because, as you know, iOS as an operating system -- as well as the Android operating system -- is designed for cell phones. It's very simple and it's not as robust as a Windows or other operating system that IT directors have experience locking down security. You don't want to lose any patient data. That's a serious breach of federal regulations. So, if I'm a physician and I drop my cell phone, and there's patient data on the cell phone, that's a breach. My employer could get in trouble for that. I could get in trouble for that.

So, that's the huge concern, and the answer seems to be web access for data that is not stored locally, as well as virtualization.  Citrix and other vendors have figured out how to port the Windows desktop or virtual machines to the tablet PCs, and in some cases a smartphone. So, work-arounds like that double up on occasion and so on and so forth to protect that patient data from falling into unauthorized hands.

Brian Eastwood: With all these different tablet devices coming onto the market, each with their own pros and cons, ultimately what will it take for one particular device to dominate the tablet market in health care?

Don Fluckinger: That's a fascinating question because Apple, for all of the good things it does with the iPad and taking over the market, really doesn't cater to the business environment, meaning that one CIO I talked to railed at me for not being able to buy more than one iPad at a time at the Apple store. He said, "I wanted to get 50 iPads. What'd I have to do? I had to go to Target."

There's also questions about being able to keep them clean, which, in an infection-controlled environment, you use some pretty strong solvents, and those are two questions. If Apple came out with a ruggedized health care iPad, I'm sure Apple would just take over, but they don't really seem interested in that. The HP Slate, which runs Windows, is ruggedized, and so that takes care of one of the components of the problem.

Motorola's Xoom, that tablet, Motorola has a lot of experience with other ruggedized devices. Their EDAs can take the abuse of these solvents that nurses must apply to it several times a shift for infection-control purposes. So, the Motorola Xoom is very interesting. The Blackberry and its integration is interesting, and the iPad, of course, is the clear victor. That's the one that all the nurses and physicians want right now.

The big question that nobody's been able to answer, that I think is going to be a huge issue, is ergonomics. OSHA steps in after injuries are reported, and if a nurse or physician or somebody employed by a hospital gets hurt and they have to use an iPad, and they think the iPad is the reason they got hurt and can prove it, then OSHA steps in and makes the employer take care of the ergonomic issue. Who is going to solve the tablet ergonomic issues that will happen? How will they do it, and who can solve it the most quickly?

I think if you can answer that question, you can figure out which tablet is going to win out. Just from my armchair view as a reporter and not a CIO myself, it really looks like Apple is not trying to win health care. The company that tries to win health care, or the third party vendor that can adapt the iPad to all of the regulatory issues that come with health care work, that's who is going to win.

Brian Eastwood: It sounds like it's going to be a very interesting few years for health IT professionals as they incorporate the mobile devices that their physicians and clinicians want to use. Thanks very much, Don, for providing your perspective.

Don Fluckinger: Thanks for having me.

Brian Eastwood: And thank you for joining us. We hope you found this informative.

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