At the Mayo Clinic, iPhones and iPads are the standard

A CT scan on the Mayo Clinic's iPad app for health providers. Credit: Mayo Clinic

The Mayo Clinic has rolled out several mobile apps to let doctors to look up medical records, find detailed contact info about colleagues, and tap into expert advice from them. The apps have now been installed on more than 15,000 devices and doctors credit them with saving tons of time.

Every single one of those devices is an iPhone or iPad. That's because, while Mayo makes patient-facing apps for both Android and iOS, its internal apps are iOS only.

"We stopped the conversation pretty early," explains Mark Henderson, the chair of Mayo's IT division. In 2009, when Mayo was just starting its mobile move, iOS was the clear front-runner in the mobile space. "We worked internally with the security group for a comfort level. At the time there were ways to manage the devices, and encryption was where we wanted it. It was the front leader." 

It also helps that a lot of doctors were already carrying iPhones. "They requested access to this, it's not something we dreamed up. It's something they were begging for," says Henderson.

Troy Newman, an IT specialist who oversees app development for Mayo, adds that the clinic was accustomed to running on a single platform -- Windows -- and wanted its mobile initiative to be similarly standardized.

"All our developers know how to do Windows development, so we made the same kind of same decision for iOS. We wanted a platform where we could get developers up to speed and train them to develop apps."

Finding that expertise hasn't always been easy.

"Our team's pretty small," says Newman. "As we've grown, it has been difficult to find people with the right skills who want to work in Rochester, Minnesota."

"We've tried external sourcing for some projects," says IT chair Henderson. "It's worked OK, but it's been a little difficult because a lot of apps have to tap into proprietary internal systems." In the end, the clinic's IT staff spent as much time helping external developers as it would have taken to do the job themselves. 

Data security and privacy is a big deal in health care, which is regulated by HIPAA and other laws, so Mayo made sure the apps don't store any data locally. "One of the biggest and best decisions we made was the fact that we don't store any patient info on device," says Newman. "All access is pulled down in real time. Once you hit the home button on the app, the data is off the device."

Mayo also uses AirWatch to enforce logon security and for managing the devices.

Apart from security, the biggest challenge was getting the apps to connect to the disparate back-end systems the organization uses, including a "mish-mash" of different directory systems (including one homegrown) and at least three different electronic medical record (EMR) systems.

"Our EMR system is either GE-based or Cerner, and 2 different versions of Cerner," says Henderson. "It's really hard work to do -- not all vendor apps out there make it easy to access data, and some don't even allow it. It does take a talented set of people to do it." 

Next up, Mayo is looking to extend mobile apps to the nursing staff to let them communicate more quickly with doctors and other nurses, and to be alerted when test results are available. 

They are also looking to update the apps with more modern capabilities -- "We'll have a model now where users won't have to VPN in externally," says Newman -- and to allow the medical records app to update (not just read) records.

The organization is also reconsidering how many PCs it needs to maintain. "We have 25,000 desktop computers dedicated to the viewing and entry of medical records and content," says Henderson. "In the future, I think we'll see the decline of desktop devices, and add to the mobile space....It really does beg the question of whether we need those desktops all over."

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