From The Editor | April 10, 2013

Mobile Carts Must Evolve Or Die

ken congdon

By Ken Congdon

By Ken Congdon, Editor In Chief,
Follow Me On Twitter @KenOnHIT

Commonly referred to as COWs (computers on wheels), mobile carts are a mainstay at most hospitals and the granddaddy of all mobile devices. However, healthcare mobility has come a long way over the past several years. Today’s high-speed smartphones and tablet computers are making data access at the point of care infinitely more portable. What does the progressing mobile health landscape mean for the future of COWs? Put simply, it means role changes and higher expectations.

EHR adoption is driving much of the demand for real-time electronic data access and entry at the patient bedside. Smartphones and tablet computers provide a convenient data access tool in many instances, but the small, touchscreen keyboards on these devices can make data entry and documentation a time-consuming and error-prone process. This is where COWs can provide hospitals and clinicians with significant workflow benefits. However, given that smartphones and tablets have introduced healthcare providers to a new world of mobile features and capabilities (e.g. apps, battery life, convenience/portability, etc.), the COW status quo may no longer be good enough.

“Clinicians continue to struggle completing real-time documentation,” says Todd Jackson, executive VP of sales for Stinger Medical. “Instead, many complete what I call ‘near-time’ documentation. This is where a nurse or physician enters data into the EHR after the appointment — either in an office or at a mobile cart or fixed workstation in the hall. The reason? Their mobile carts don’t facilitate real-time data entry at the patient bedside. Historically, many mobile cart and fixed-mount solutions weren’t really designed around clinician workflows. This needs to change.”

Power & App Enhancements Add Value To COWs

According to Jackson, mobile cart run time should be a primary area of focus. Where an iPad can run for more than 12 hours on a single battery charge, many mobile carts have historically provided somewhere between 5 and 8 hours of battery life per charge. Many COW vendors have responded to the increased power demands simply by offering larger battery options. However, bigger batteries can negatively impact the weight and mobility of the cart. Jackson touts a different approach.

“Increasing cart run time doesn’t mean you need a bigger battery,” says Jackson. “You simply need to reduce recharge time. Swappable power options are a great way to accomplish this. COWs with small backup batteries can allow users to replace a dead main battery while the cart is still running. This approach optimizes cart uptime without inhibiting maneuverability.”

Some mobile cart manufacturers have also started to incorporate app-type functionality into their solution offerings to enhance user convenience and provide added operational value. For example, Stinger Medical offers a CAST (Clinical Adoption Support Technology) app that allows IT personnel to connect directly with the wireless board on each cart and access important operational information about the device (e.g. utilization, location, trending info, etc.) via their smartphone, tablet, or PC. This tool provides IT with centralized and convenient point of management and control for a healthcare facility’s entire fleet of mobile carts.

Expanding The Role Of The Mobile Cart

Historically, COWs have been used primarily as a tool for point-of-care computer documentation. However, the future of mobile carts may be as a key component in other bedside technology applications — primarily telemedicine and patient engagement/education. Mobile carts provide a means to transport sophisticated videoconferencing equipment to the patient bedside, allowing physicians to conduct thorough examinations remotely. This is ideal when a hospital requires the opinion of specialists they may not have on their own staff. Likewise, with patient engagement becoming a huge focus among providers as part of Stage 2 Meaningful Use, the demand for patient education solutions is on the rise. Mobile carts provide a convenient way to bring computer-based patient education curriculum (e.g. videos, games, reference material, etc.) to the bedside. The more mobile carts can evolve to better meet the needs of these multiple applications, the more value they will provide to healthcare facilities, clinicians, and patients.