From The Editor | February 8, 2012

iPads Clinically Challenged

Ken Congdon, Editor In Chief of Health IT Outcomes

By Ken Congdon, Editor In Chief, Health IT Outcomes

There’s no doubt that iPad business is booming in healthcare. A 2011 poll of more than 5,000 doctors conducted by the Physicians Consulting Network revealed that 27% of primary care and specialty physicians own an Apple iPad or similar device and use it on the job — a rate five times higher than the general population. A similar study by Manhattan Research showed that 30% of physicians already own an iPad or other tablet, with another 28% planning to purchase one within the next six months.

While definitely popular in medical circles, it appears iPads aren't being widely used for clinical applications. This evidence comes courtesy of a recent study by Spyglass Consulting Group titled Healthcare Without Bounds: Point Of Care Computing for Physicians 2012. According to this study of 100 “early adopter” physicians (70% of which own iPads), the vast majority (83%) still use desktop computers as their primary device for accessing corporate assets and patient data when they are at the hospital, in the office, or at home. The primary reasons cited for this tendency include mobile security concerns and a lack of clinical software innovation for the iPad platform.

For example, 75% of physicians interviewed reported that hospital IT personnel was resistant to supporting personal mobile devices on the corporate network. Hospital IT believes personal devices are insecure, less reliable, and more expensive to deploy, support, and maintain than desktop computers.

However, mobile security concerns paled in comparison to the clinical software shortcomings for iPad. “Significant software innovation will be required to realize the vision of anytime, anywhere clinical computing,” says Gregg Malkary, managing director of Spyglass Consulting Group. “Clinical applications must be rewritten and optimized to take advantage of the native capabilities of the Apple iPad and other mobile devices including gesture—based computing, natural language speech recognition, unified communications, and video conferencing.”

Where Are The iPad—Native EHRs?
While countless medical apps have emerged for the iPad since its introduction, clinical apps —particularly EHR apps —are scarce. The reason for this is not so much a technology barrier as it is reluctance on the part of EHR vendors to redesign their applications from the ground up for use on the iPad or a similar device. The current form factor of the iPad is also a drawback when it comes to EHR interaction. For example, the iPad’s on—screen keyboard is ill—suited for the extensive data entry that is often necessary to modify the patient record or complete an order, and voice recognition software still isn’t sophisticated enough to sort medical terms into discrete fields in an EHR.

That being said, a select few EHR vendors are beginning to develop apps or modified versions of their software specifically for use on iPads and other mobile devices. For example, Allscripts’ Sunrise Mobile MD II can be used on an iPhone or iPad and incorporates speech recognition from Nuance and M*Modal. The product allows physicians rounding in the hospital to view clinical data in EHRs, capture charges, send secure messages, and document notes.

Dr. Chrono’s iPad Patient Care Platform is an iPad—native EHR focused on ambulatory care. The Dr. Chrono iPad app includes features such as practice management, medical billing, and EHR access. It also allows physicians to document notes and prescribe electronically using speech—to—text recognition from M*Modal.

Greenway Medical Technologies’ PrimeMOBILE is a mobile EHR application that provides complete access of ambulatory data housed in the company’s core PrimeSUITE EHR platform via an iPhone or iPad for a low monthly cost. The app provides two—way integration with patients and peers to streamline patient care and the financial management of a medical practice. In other words, charges and notes can be immediately captured on the iPad and uploaded to PrimeSUITE for automated review and posting, helping to streamline workflow.

Epic and other EHR giants are also rumored to be working on iPad extensions of their EHR platforms, but, for the most part, these apps are slow to market and lacking in sophistication. Without increased emphasis on software redesign, iPads will continue to be leveraged more to manage business workflow or accessing reference content in medical circles, rather than as a tool for complete clinical support.