iPad®, Notebook, Laptop, Netbook: What's Best for Doctors?

Neil Versel

Disclosures

April 19, 2012

In This Article

BYOD (Bring Your Own Device)

Clearly, some devices are more suited than others to certain medical specialties, practice settings, and individual physician styles.

According to a report from Spyglass Consulting, 83% of physicians surveyed said that desktop computers were their primary means of accessing "corporate assets" and patient data, regardless of whether they were in a hospital, in a medical office, or at home. "Physicians were found to be using mobile devices to access clinical information when they were outside of their normal working environment," the report said.

"Tablets really aren't that useful in primary care offices, "says Lyle Berkowitz, MD, medical director of clinical information systems for Northwestern Memorial Physicians Group in Chicago, and a practicing internist. With desktop computers available throughout the practice's offices, physicians already have convenient access to patient records, medical reference tools, and the general Internet.

However, hospital-based clinicians might like the convenience of a handheld computer when rounding, according to Berkowitz. The same goes for those who see patients at multiple offices or simply are on call.

Heritage Valley Health System in Beaver, Pennsylvania, has added radiofrequency identification tags to some of its iPads, so that mobile clinicians can touch the tag to a reader on a hospital PC and log into the main clinical information system at the same place they were on their tablets. Vice President and Chief Information Officer (CIO) David Carleton reported that physicians save 20 -30 minutes per day when doing their rounds because they don't have to fight for devices or keep logging back in every time they go to a different room.

Carleton said it is "pretty unique" to be able to switch almost seamlessly between a mobile and a desktop environment, but a portable display still has shortcomings. "To think that a doctor could gather everything on one screen may be unrealistic," Carleton Radiologists, for example, are used to having 3 screens at a typical workstation. At Heritage Valley Health System, the iPad functions somewhat like a paper chart, in that a physician uses it for quick review of the patient's status, whereas data entry mostly takes place on a traditional PC, according to Carleton.

Can Devices Interact?

Steven J. Davidson, MD, MBA, chairman of emergency medicine at Maimonides Medical Center in Brooklyn, New York, has experimented with several types of portable computers, including modern multimedia tablets and older Fujitsu "pen tablets" that let users write on the screen with a stylus. "They didn't support our workflows; they didn't support the environment," he reported.

"It's all about the tool and the individual," said Davidson, who also is the hospital's Chief Medical Information Officer. "I would like to get people thinking about the idea of workflow support and how the idea of workflow is unique to the practice," he added.

With this philosophy in mind, Maimonides, a large safety-net provider that generates 80% of its patient revenue from Medicare, Medicaid, and other government sources, is one of the growing number of healthcare institutions that supports a phenomenon called "bring your own device," or "BYOD." The BYOD model may cause headaches for CIOs and compliance officers, who have to accommodate diverse mobile devices and secure all data being sent across increasingly busy wireless networks, but this may be the price hospitals must pay to gain technology acceptance from clinicians who have resisted other forms of technology.

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