iPads Improve Resident Efficiency

Joe Barber Jr, PhD

March 12, 2012

March 12, 2012 — The use of mobile tablet computers was associated with improvements in perceived and actual efficiency among residents, according to the findings of a single-institution study.

Bhakti K. Patel, MD, from the Department of Pulmonary/Critical Care, University of Chicago, Illinois, and colleagues published their findings in a research letter published in the March 12 issue of the Archives of Internal Medicine.

The authors note that medical residents spend much of their time working on indirect care tasks such as updating patient medical charts. "Unfortunately, the implementation of electronic health records actually increases time in indirect care and the need for available computer workstations to advance care," the authors write. "These trends, coupled with the growing information needs for patient care, have led to more time spent locating a computer or working on the computer at the expense of time at the bedside or at conference."

More than three quarters (78%) of the surveyed residents reported that the use of iPads (Apple) improved their workflow efficiency, with an average savings of approximately an hour a day. In addition, 68% of the house staff reported that delays in patient care were avoided because of iPad usage.

The authors provided iPads to 115 medical residents with an explanation of how to use this device to access medical records, publications, and paging systems. The authors compared the efficiency of residents before and 4 months after providing iPads, and they examined the electronic medical record to assess all patient care orders placed in the first 24 hours after patient admission before and after iPad distribution.

Although there was no difference in the number of patient orders placed before and after iPads were deployed (16,770 vs 17,414 orders), more patient orders were placed before attending rounds at 7 am (38% vs 33%; P < .001), and before the departure of the postcall team (64% vs 56%; P < .001), after distributing iPads to residents. Moreover, more orders were placed within the first 2 hours after admission after the distribution of iPads (odds ratio, 1.06; 95% confidence interval, 1.00 - 1.12; P = .04).

The authors mention that mobile computing may have additional benefits beyond saving time. "In addition to enhancing efficiency of residents, the iPads may have facilitated greater continuity of patient care since the primary service was able to advance care for the patients they admitted and will follow before they execute a handoff," the authors write.

Study limitations include lack of generalizability and lack of data regarding whether orders were placed on iPads vs desktop computers.

“Despite these limitations, it seems that personal mobile computing can help improve perceived and actual resident efficiency in an era of increasing work compression," the authors conclude.

The study was supported by the Office of the Chairman of Medicine, the University of Chicago. The authors have disclosed no relevant financial relationships.

Arch Intern Med. 2012;172:436-438.

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