Mobile devices at point of care

There has been a fascinating trend resulting in use of more mobile devices at the Point of Care. Many of the major electronic medical record vendors offer iPad and also iPhone/iPod Touch applications that allow users to access information in a corporate EMR system. This allows users at home or at work to quickly obtain information about patients without having to use a desktop or laptop computer. The fact that the iPad/iPhone/iPod Touch turn on instantly makes their use an advantage. This capability theoretically helps avoid mistakes by allowing a healthcare worker to know more about a patient when asked to make a decision. A number of anecdotal examples of decision makers helped by access to detailed information about complex patients have been circulated. Additionally, the iPad, with a 10-inch screen has proven suitable for reviewing radiology images and detailed medical reports. Currently, EMR access software for the iPad has been developed by Cerner, Epic, Allscripts, GE Healthcare, Greenway Medical, and likely other vendors.

Users of these devices also see great potential in using the iPad to educate patients on their conditions and treatment. A company called 3D4Medical offers a free iPad application to create vivid and accurate animations of various common medical conditions. Many of the animations have been created by various physicians who, although developing them originally for their own use, have made them available to anyone using the software. At this point, there are only three lung related images but I would expect others to be developed over time. At present, users need to work directly with 3D4Medical to develop images. Current users of the application who have helped develop images believe the animated and detailed images make their points better than hand drawn images.

Despite all the possible benefits, many hospital and healthcare technologists are still trying to sort out where the iPad and other mobile devices fit into their medical bags. Information security and protecting patient privacy are important issues for devices that can easily be taken. Physicians’ personal devices are especially likely to be removed regularly from the hospital. Although this provides easy access to medical records at home or at a restaurant, it also opens up the possibility that the device will be left behind on a restaurant table.

Mobile platform security is fairly easy to deal with. Strict password policies and the ability to remotely wipe the memory of a device that's lost or stolen can alleviate many security concerns as long as these capabilities are implemented. Other issues, however, are challenging the widespread use of mobile devices in medical settings, including the lack of native support for many non-Windows devices, the inability to disinfect mobile devices, and device overload, with physicians simply toting around too many devices. For hospital owned devices, the risk of the devices being stolen and replacement costs are hurdles at present to widespread use.

All of these features have won the iPad many fans in healthcare, but that doesn't necessarily mean it's going to be a standard-issue device. There is some stiff competition in Windows-powered tablets, including medical-grade devices like the Panasonic Toughbook H1 designed for healthcare environments. There are also alternatives like the Samsung Galaxy Tab, Motorola Xoom, and Research In Motion PlayBook, all smaller tablets that have been promoted as being small enough to fit in a lab coat pocket. In any case, much will be happening with mobile devices over the next several years.

This column begins the second decade of this series. Where is the party?