Rx for iPads: More healthcare IT support needed

Survey shows IT groups are leery, doctors lack access to clinical apps, data

Plenty of doctors are using Apple iPads, but not many of the tablet computers are outfitted with enterprise network and data access, according to a new survey from Spyglass Consulting Group.

Many hospital IT groups remain leery of iPads accessing confidential patient information, and 75% of the survey respondents say they've received no IT help for their iPads. The vast majority of the 100 respondents (medical professionals, mostly tech savvy doctors) say they're not using the tablet with any clinical applications or data.

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That is changing as early adopters, such as Ottawa Hospital in Ontario, show the way. The hospital has deployed 3,000 iPads for physicians, with an upgraded Wi-Fi network from Aruba Networks, and a major investment in native iOS applications. And this week AT&T announced its AT&T Developer Center ForHealth, which combines a mobility infrastructure, cloud services, developer portal and APIs to speed writing mobile apps, for healthcare staff and patients, that can pull together patient and clinical information from a variety of stand-alone systems. [For additional details, see AT&T's press release.]

The Spyglass interviews were conducted this past summer, and are part of a fuller report, "Point-of-Care Computing for Physicians 2012," written by Spyglass founder and principal, Gregg Malkary. The full report is for sale, available from Spyglass.

Despite the explosive popularity of the iPad in the enterprise, reflected in the survey sample's enthusiasm for iPad, 80% of the interviewees say the iPad is not yet ready to "transform" patient healthcare delivery.

The reason, says Malkary, is that the range of needed tools are missing. Those include enterprise healthcare applications that so far have not been revamped with the iPad in mind. As a result, many in healthcare rely on existing Citrix-based virtualization infrastructures to access Windows-based clinical applications and data from mobile devices, according to Malkary.

"But to do that, you have to dial out over the guest network to get back into the hospital network: You're not natively on the hospital's network," he says.

The survey also showed that most of the doctors favor 19-inch and bigger monitors for navigating these data-crammed applications, which usually means working with a desktop PC or a big laptop. They use mobile devices of any kind "when we don't have access to a desktop," according to the Spyglass survey. Malkary says software vendors serving healthcare have yet to create streamlined interfaces that are effective on smaller displays.

"The healthcare IT software vendors need to step up," he says. "Their applications are still for desktops and large screens. These need to be transformed."

A chronic complaint of the survey participants is being unable to access a consolidated electronic medical record, which by definition pulls data from multiple clinical applications and databases. Often, they say, they have to access each clinical system separately, in effect creating the consolidated record in their head. It's complicated still further by the fact that patients today often are likely to have connections to numerous providers: doctors at different hospitals or clinics, pharmacies, laboratories, etc.

These are not iPad-specific, or even tablet-specific, issues, Malkary acknowledges. But they add to the complexities of supporting mobile access to patient data.

Most of the respondents, 3 out of 4, say they're on their own with their iPads, lacking any help from their IT group.

That resistance is changing. Ottawa Hospital was faced with implementing a computerized physician order entry (dubbed CPOE) system, which would have required a PC at every bedside. That was not only a logistical challenge but a usability challenge: Instead of logging into the system, doctors were far more likely to simply scribble an order and hand it to a nurse to enter, defeating the whole purpose of CPOE.

The first iPad instantly provided an alternative, says Dale Potter, the hospital's CIO. After testing a couple of tablets for two days, doctors were clamoring for it; his IT technical staff, though unfamiliar with iOS, concluded it was viable. The board of directors eventually weighed on, affirming that CPOE was a hospital priority that should be achieved quickly.

That meant a major IT refocus: The Wi-Fi network had to be upgraded, the hospital had to invest in native iOS application development (a combination of experienced outside coders and new hires with iOS expertise), and coming up to speed on mobile device management, which Potter calls a "massive topic."

The iPad, and attendant infrastructure, is making possible a return to more engaged bedside care for physicians. "Now, they all have iPads, and they go to the bedside with the patient and the family," Potter says. "The physicians review [iPad] data with them, and talk to them. It's much more engaged care."

John Cox covers wireless networking and mobile computing for Network World. : http://twitter.com/johnwcoxnwwjohn_cox@nww.comhttp://www.networkworld.com/community/blog/2989/feed

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