iPads and tablets can fix many healthcare flaws, but only with well-designed apps
Doctors were one of the first professional groups to embrace the iPad when it launched nearly three years ago. Several doctors I interviewed at the time told me the same story -- that they saw the potential for the iPad to improve their work experience immediately. Within a few days of buying an iPad, all had brought it into their practice or hospital. A couple actually started taking their iPads to work on the same day that they bought them.
At the time, many healthcare IT professionals immediately saw the iPad as a giant red flag -- a mobile device that they neither owned nor managed. Many immediately assumed that the iPad was a giant potential compliance problem related to government regulations like HIPAA, the 1996 law that established clear privacy and security requirements for patient information. That fear wasn't entirely misplaced -- Apple didn't launch iOS 4, the first release to include enterprise security and management capabilities, until later that year.
Over the past three years, iOS has maintained its position as the preferred platform of healthcare professionals. Although sales numbers for the iPad mini haven't been published yet, it is expected to be popular with doctors -- mainly because it easily fits into standard lab coat pockets (companies have launched lab coats with pockets designed for full size iPads, but they haven't caught on with doctors).
Even with the management capabilities that Apple has built into iOS, many healthcare IT professionals are still wary of all consumer-oriented mobile devices -- tablets, smartphones, you name it. They aren't alone. Companies that develop software for the healthcare industry like electronic medical records (EMR) systems also seem wary of iOS and mobility in general. While some major healthcare developers like Epic have rolled out iPad-specific apps, others like have deliberately avoided mobile platforms entirely -- one company even said that it isn't interested in developing for mobile devices beyond Windows 8 and Windows RT devices.
On one hand, this has allowed independent developers and smaller healthcare software companies to make a name for themselves by delivering iPad-specific EMR products. Dr. Chrono is one great example -- the software designed specifically for iOS and Android devices and lets doctors manage their entire practice via those devices. MacPractice, a company that has developed EMR and practice management tools for Macs for years, has leveraged that experience in creating iOS tools -- including one called Clipboard that lets patients enter medical history and other information directly into their records -- that integrate extremely well with its desktop software.
On the other hand, larger institutions like hospitals or medical groups, generally already have EMR and other systems in place from the major vendors. Even without that investment, these entities generally need more functionality and scalability than apps aimed at individual doctors or small practices can offer.
The 2009 HITECH Act offers all healthcare providers major incentives to adopt ERM systems. Those incentives are tied to demonstrating compliance a series of meaningful use criteria by specific deadlines. That puts large-scale health organizations -- like medical groups and hospitals -- under the gun to select and implement scalable tools as quickly and efficiently as possible. The result is that support for the iPad or other mobile devices is seen as something that would be nice, but that isn't a major priority. If iPads are supported at all, it's typically through a virtual desktop (VDI) approach that delivers users a Windows application on their iPads -- an approach that may be effective but not one that takes advantage of iPad or tablet design and features.
Ironically, focusing on the iPad as an EMR client has the potential to deliver better care than some alternatives like the growing number of laptops in the exam room -- to say nothing about the unwieldy laptop carts that many hospitals rely on for in-room access to EMRs and related patient data like lab tests and scan results.
A recent op-ed piece in the New York Times illustrated how some EMR systems can lead doctors to unintended short cuts: copying and pasting notes rather than writing a new set of notes for each interaction with a patient and quickly checking off required boxes without fully performing every related diagnostic step or procedure. One way to handle this from a mobile perspective is to use the data leakage protection built into almost all mobile device management tools to disable a feature like copy and paste within an app.
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