Hospital records going mobile
Source: Jim Fuquay
Cardiologist Dr. Jose Soler demonstrates an app on an iPad to review the medical tests of one of his patients recently at Northwest Medical Center in Margate, Fla. / Emily Michot/MCT ― Miami Herald
If a patient of Arlington, Texas, physician Ignacio Nunez shows up at the emergency room when the doctor is not at the hospital, he doesn't have to wait long to start investigating what might be wrong.
The obstetrician/gynecologist can call up an expectant mother's medical records on his iPhone, or even watch the fetus's heartbeat on the device once the woman is connected to a hospital monitor, wherever he might be at the time.
"Maybe I made my rounds in the morning, but at 2 p.m. a nurse calls and says, 'We don't like the way an EKG looks.' I can see it. I don't even have to leave my house," he said.
By linking mobile devices such as smartphones and tablet computers to hospitals' electronic medical records, "we're trying to extend the physician beyond the hospital," said Luis Saldana, associate chief medical information officer for Texas Health Resources.
Russ Hinz, director of electronic health record clinical adoption and transformation, is the link between technology and the clinical staff with Aurora Healthcare, which includes Aurora BayCare Medical Center in Green Bay.
System-wide he sees an infusion of mobile devices ― a trend he expects to continue growing.
"This is a burgeoning area for heath care and on a daily basis I'm getting a lot of requests and seeing the use of a variety of notepads, iPads, hand-held devices and smartphones," said Hinz who works out of Milwaukee. "As an industry, this is where the future is. … Physicians and others are looking to improve their efficiency and by having mobile devices, that's clearly the next step. "
Bellin Health in Green Bay is in the process of migrating to an electronic medical records system called Epic.
Epic "is developing applications specifically for mobile devices for iPhones, iPads and Android smartphones as well," said Troy Schiesl, director of information and services with Bellin. "We have a hardware assessment team that is looking at all the technology right now."
About half of the health system is converted to the new system. The hospital is expected to be converted in summer 2012, Schiesl said.
"We're working with our physicians … and we're going to hold a hardware fair for them at the end of (August) to give them an opportunity to look at the hardware and show them the pros and cons," he said.
Schiesl said getting the right information to caregivers is the thrust behind technological advancements.
"That's the key, whether that's putting more devices in the right places or extending the use of mobile devices," he said. "We see it as a positive being able to provide those solutions. It's something we're going to see continue to grow and grow faster over the next two years."
At Huguley Memorial Medical Center in Fort Worth, Texas, physicians have been able to view selected patient medical records, such as test results, on smartphones for about six months, said Tammy Collier, chief nursing officer.
"What we see physicians doing is preparing themselves with very current information," Collier said. "They have so much more information available at their fingertips."
Mobile access is also a way to draw more value out of the big investments hospitals have made in electronic records in recent years. According to consultant Accenture, North American hospital systems spent $7.4 billion in 2010. And the 2009 stimulus act promised $50 billion over five years to help move government and private health care providers to electronic records.
Texas Health Resources says it has spent $200 million-plus on electronic records system wide.
That's a lot of money, but "one of the problems is making it easy to use," said Brian Dolan, editor and co-founder of MobiHealthNews, an online newsletter that covers mobile technology in the health care industry. "If you make it easier to access through technology," physicians and patients can make greater use of the data available, he said.
While many physicians have desktop or laptop computers in their offices, and hospitals have desktop computers at nursing stations or physician quarters, putting information on a mobile device seems to make a difference, some say.
"It's just the way doctors use tablets. There's more of a willingness to share with the patient," Dolan said. "The collaborative nature is more of a game-changer."
Aurora's Hinz said functionality of applications is improving on a daily basis and that ensuring confidentiality and security are paramount as mobile technology becomes more prevalent in the medical setting.
"We are being very vigilant on the security and confidentiality side while at the same time giving the flexibility in mobility these devices afford us," he said. "Security and confidentiality are our top concern."
Nunez said that while he owns both an iPhone and an iPad, he finds the tablet computer too large for his daily work. And with an iPhone, he said, "I can find the medical record, look up information and do it while I'm talking" to a patient, doctor or nurse.
While mobile medical information today is focused on distributing existing electronic health records, future uses will likely include creating medical data as well.
"The next trend, with chronic diseases, will be leveraging this technology in the home," said Bruce Brandes, chief strategist for AirStrip, a San Antonio software company that developed the app Nunez uses.
"We will capture information and distribute it, via online alerts, to a physician."
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