EHR Data Entry on Mobile Devices Challenges Clinicians

October 29, 2012

Here's a news flash that might cool down physicians' fever for the new iPad mini from Apple, which slips inside the pocket of a white lab coat: Clinicians in 70% of healthcare organizations look up electronic health records (EHRs) on smartphones and tablet computers, but they find it hard to enter data on the small screens of these hot devices, according to a new report from the research firm KLAS.

"Our physicians are accessing [the EHR] largely to view data," a representative of one organization told KLAS in a survey on mobile devices. "When the [iPad] keyboard pops up, it covers two thirds of the screen and makes it nearly impossible to efficiently document."

KLAS also heard this comment: "The iPads are more of a status symbol. We give the providers iPads, and they use them for everything but clinical documentation."

Likewise, physicians who are experimenting with mobile clinical applications have not yet graduated to e-prescribing, said a survey respondent. "They think it is okay, but when they can put in a prescription order, that is when the doctors will really like it."

These findings have a direct bearing on the healthcare potential of the iPad mini, set to debut in Apple retail stores on November 2. With a screen measuring 7.9 inches diagonally, the mini looks to edge the iPhone 5 and its 4-inch screen in ease of documentation. However, clinicians who are adverse to charting patient visits on the 9.7-inch iPad probably will be even more adverse using the junior version.

KLAS found Apple to be the 800-pound gorilla in the world of mobile healthcare computing. Ninety-four percent of the organizations surveyed support the Apple operating system (OS) compared with 49% supporting the Android OS and 44% supporting the Microsoft OS.

Ease of documentation for smartphones and tablets varies depending on what EHR system an organization is using, according to the survey. Systems from Allscripts and McKesson earned the highest marks in this regard — a 3 on a 5-point scale. Following behind were Cerner (2.9), Epic Systems (2.6), and Meditech (1.7).

The Question of Invisible Data

For clinicians who carry smartphones and tablets essentially to view patient data, the question becomes how much data they can see on the screen. The answer is not always to their satisfaction.

"Many providers expressed concern that mobile applications did not display all the important patient information needed," writes Erik Westerlind, the author of the KLAS report.

How different EHRs are configured on small screens makes a difference in how much information is visible. Systems from Epic and Cerner are tops here, according to KLAS. More than 80% of Epic and Cerner clients told KLAS that they were confident that all the important data were displayed. Such confidence scores for EHRs from Allscripts, GE Healthcare, McKesson, and Meditech were 50% or less.

The KLAS report is for sale on the company's Web site. The price is $980 for physicians, but survey data on individual vendors are free if physicians complete an online questionnaire about medical software, equipment, or computer services that they use.