More on Shiny New Toys

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 - Donald Levick-Portrait
Donald L. Levick, MD, Editor-at-large, CMIO Magazine

Tablets and smartphones continue to infiltrate our personal and professional lives. As a shiny new toy, a smartphone or tablet fulfills important criteria: easy access, affordability, user friendliness and unlimited uses.

In healthcare, the demand for these devices is very high. According to a 2011 CompTIA Survey, more than 50 percent of physicians use a smartphone for work purposes.

What are the most important tasks to be performed on a smartphone or tablet? Creation of full documentation (office visit notes, H&Ps, daily hospital progress notes)? Full access to diagnostic images for interpretation? Full CPOE capabilities? The jury is still out on the optimal use of these devices. Consequently, vendors are stuck trying to predict which functions clinicians truly need and will actually use.

At LVHN, we have piloted several applications for smartphones and tablets. We have an independent hospitalist group using smartphones for daily charge capture. Our main CIS vendor is still developing a tablet version of the software. Currently, we make the desktop version available through remote access. However, the native user interface is not "finger-friendly," and most clinicians have abandoned it after a short trial. Yet, the tablets are being used in some very interesting ways. Attendings are loading their lectures and key articles to provide lectures "on-demand" to students/residents, and then immediately email the associated references. It also serves as a wonderful reference tool with access to both internal and external evidence-based resources and medical calculators.

With the changing healthcare environment and convergence of technologies, I still question the true business case for smartphone and tablet access to clinical applications. As more hospitals evolve to 24-hour in-house coverage, how often will on-call physicians be called while at home and need to access clinical information. Many clinicians in hospitals already utilize carts on wheels or small laptops. In the ambulatory world, the evolution of extended office hours and nurse triage call centers are decreasing the need for on-call physicians to access clinical information away from the office.

I see great potential for tablets to function as teaching tools for both medical education and with patients. The capability to show patients their results, radiology studies and teaching aides is invaluable in the patient-centered medical home models. Integration of tablets with other devices (stethoscopes, imaging) and the capability to carry a multitude of textbooks and instant journal access should accelerate the revolution in medical education already occurring.

The future should provide a fascinating story for  these technologies, and the use-cases that drive development. I am interested in your opinions of where we are headed, and I'll continue to read about it… on my tablet, of course.