Free Hospital EMR and EHR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to Hospital EMR and EHR for FREE!

Hospitals Using Tablets to Improve EMR Access

Posted on February 18, 2014 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Some high profile hospitals are turning to tablets as a way to give physicians better access to EMRs when they’re walking the halls.  Using tablets is seen as a way of working around desktops’ limitations in making better use of EMRs’ capabilities, according to MedPageToday.

For example, back in 2010, the University of Chicago School of Medicine issued tablets to all hundred 15 internal medicine residents. After a year, three quarters of residents reported tablets help them finish tasks more quickly and spend more time on direct patient care.

In another example, the Cleveland Clinic is pilot testing the use of tablets with a few sectors of its workforce, such as its rapid response teams. Using tablets, clinicians can look up patient data on the way to the patient was crashing and be better prepared when they arrive.

In yet another instance, the University Of Pittsburgh Medical Center is testing the use of Windows tablets with cardiologists. The medical center has developed special software allowing physicians to jump between different mobile apps without having to reenter patient information to do their work.

These are just examples of how hospitals can turn mobile devices into effective extensions of the EMR, said David Collins, senior director of mHIMSS, the mobile wing of HIMSS. “If you can spend $300 on a tablet and issue these to providers so that they’re more mobile, it’s really a minimal cost for the payoff,” Collins told MedPageToday. Although, John Lynn makes a pretty good counter argument for why IT admins prefer the more expensive Windows 8 tablets over iPads or Android tablets.

These are just a few early examples of how hospitals can use tablets to make access to patient data simpler. Over the next year or two expect to see far more examples of tablet use in hospitals, as it’s become increasingly clear that they can help enhance the use of clinical data, on the spot when clinicians need it.

Hospital Residents Question Value of iPad For Clinical Rounding

Posted on November 13, 2013 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Though the iPad has a sexy reputation — the Apple mystique is alive and well — it may not not necessarily the best tool to use for clinical rounding or education, according to a new study published in the Journal of Mobile Technology in Medicine. That being said, there’s a lot of issues with the study, as you’ll see below.

First, the study design. During the 2011-2012 academic year, researchers gave iPads to 102 medical and surgical residents at Riverside Methodist Hospital in Ohio. The tablets were 16 GB iPad2 models with wireless Internet capabilities, reports iHealthBeat. The iPads had Wi-Fi but no cellular network connectivity, which left many residents complaining about hit-or-miss connectivity.

At the end of the academic year, researchers surveyed the residents to learn how iPad use had worked for them. What they found out was that while the residents largely liked the iPads, they didn’t find them useful for clinical rounding. On the other hand, though the study doesn’t address this directly, they had reason to be uncomfortable.

Of the 102 residents, only 14.7 percent used the iPad on rounds, and a scant 7.8 percent said the tablet helped them document care more efficiently. But it should be noted that the iPads were running only VMware View, not an iPad-native care system, forcing the residents to cope with an interface designed for seated users on keyboards.

Meanwhile, almost 58 percent of respondents said that the iPad was useful for sourcing articles outside of the hospital and 52 percent said the iPad was valuable for research.

The medical residents also valued the iPad for making recommendations to a colleague (58.3 percent), facilitating patient care (45.8 percent), as an educational tool (41.7 percent) and to view results and use as a guide for evidence-based practice (38.9 percent). (Surgical residents were much less impressed, with, for example, only 6.7 percent agreeing that the tablet was a valuable educational tool.)

Despite its flaws, the study does make one important point — that it’s well past time for EMR vendors to create iPad-usable interfaces, rather than forcing residents to use some awkwardly hacked version of their desktop/laptop product. If this study is any indication, large numbers of residents like the iPad a great deal, but they’re not going to use it for documentation unless they have a good user experience.  Vendors, your move.

P.S. By the way, if you want to read about a case in which iPads are being used in daily rounds, check out this piece from drChrono that was highlighted on the Apple iPad website.

FCC Says Wireless Health Should Be “Routine” Within Five Years

Posted on September 28, 2012 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

This week, the FCC made an announcement which, I think, is likely to have far-reaching implications, including for providers, hospitals, wireless vendors and medical device makers. *So* much is going on in this announcement that I think I’ll have to parcel it out into a series, so stay tuned.

But let’s start with the basics. In the announcement, the FCC said that it plans to implement on the key recommendations made by an independent mHealth task force.

Perhaps the most dramatic news is that the FCC seems ready to push for making mHealth “a routine medical best practice” by 2017.  Despite doctors’ increasing reliance on mobile devices, that’s a tall order — or even a nearly impossible one depending on how comprehensive your definition of mHealth is.  Regardless, this looks like a watershed moment.

The agency has already taken several steps that advance wireless healthcare networking, including:

*  Medical Body Area Networks:  The FCC recently released an order allocating spectrum for Medical Body Area Networks, networks of small sensors attached to a patient that continuously report results.

*  Medical Micropower Networks:  Last year, the FCC adopted rules enabling a next generation of  wireless medical devices used to restore functioning to paralyzed limbs. The MMN is an ultra-low-power wideband network consisting of transmitters, which are implanted in the body to take the place of damaged nerves.

FDA/FCC Partnership:  Since 2010, the FCC has been working in partnership with the FDA to help bring communications-related medical devices quickly and safely to market.

But this is just the beginning, folks. As you’ll see over following installments, the FCC is taking on not only the broad policy goal of “mHealth by 2017” but taking several steps that should help to lay the groundwork to make this happen.

Are they enough?  Let’s talk about it. I’ll get into what some of the proposals are, and how much impact they’re likely to have, in coming HospitalEMRandEHR.com articles.  So don’t turn that channel!

Survey: Virtually All Docs Want Mobile EMRs

Posted on August 21, 2012 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Here’s news that shouldn’t come as a surprise:  a new study has concluded that nine out of ten doctors would like to be able to use an EMR on their mobile device. The survey was conducted by a vendor, which arguably suggests that the study reflects its agenda, but if you’re like me you’ve been hearing the same thing from doctors almost daily.

By the way, to be clear, plenty of physicians are already accessing EMRs via mobile devices. The thing is, most access the EMR through some kludgy solution like a Citrix client,  which leaves much to be desired in the way of flexibility and usability.  So getting a “real” client onto the key devices is a hot item.

The survey, which was conduced by Sage Software successor Vitera Healthcare, reached out to 240 Vitera customers, most of whom were office-based physicians.  In the study, which was reported by Information Week, 72 percent of respondents said they used mobile devices in healthcare.  However, they mostly used their tablets and smartphones to do medical research or communicate with other staff members  — in fact, only six percent were using the devices to connect to EMRs or do e-prescribing.

What stood out most of all in this research was that 91 percent of physician respondents said they’d be interested in a mobile EMR solution. Features they like the best include ability to review and update patient charts and order prescriptions, along with documenting patient encounters.  In other words, they want to be able to do virtually everything they can do from a desktop.

Not surprisingly, Vitera is working on its own mobile EMR solution, designed for use on iPads (though usable on iPhones).  eClinicalworks is expected to launch an iPad-native EMR shortly.

It’s a lock that over the next few months, other vendors will take the same steps. The question is how usable these iPad and Android clients will be.  We’ll soon find out though!

Connecting Mobile With Desktop A Chore

Posted on July 31, 2012 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Readers, I’m guessing  you’ve seen the same stats I have, which suggest that doctors are crazy about tablet use, as well as smartphones.  And we’d probably all agree that using both for clinical tasks makes sense in a lot of environments.

The thing is, few doctors are actually using these devices in day to day practice management, according to a recent study.  A survey of 1,190 physicians published in June found that 75 percent of doctors use their desktop for practice management tasks, according to American Medical News.  The study was published by little blue book directory and its parent company Sharecare.

Truthfully, doctors have a perfectly reasonable motive for doing so: they need the greater power and larger screens desktop computers provide. Not only that, they get to use their hospitals’ EMR in its original form, rather than through a Citrix or other client awkwardly shoehorned onto an iPad or Android tablet.

So, what to do to make the transition between these devices more seamless — and mobile devices better integrated into the mix? In a piece by Healthcare IT News‘ Michelle McNickle, whose work, like John, I’m beginning to find addicting, chief scientist at M.Modal Juergen Fritsch outlines some key steps in bridging the “mobile-desktop divide.” Here’s a few ideas on what needs fixing:

Inadequate apps:  Many of the apps physicians use most often aren’t available for tablets or the iPhone. Workarounds exist, but they’re crude.

Speech recognition is critical:  Doctors are already used to dictating into cellphones to do clinical documentation, so making tablets documentation friendly is very important.

Create a hybrid strategy: Don’t demand that physicians go all-mobile in one swoop, Fritsch suggests. Combine multiple devices and make the experience as similar as possible from device to device.

Educate doctors on the latest offerings:  Doctors who used the initial round of apps and interfaces on mobile devices were probably irritated, as they were fairly cumbersome. CIOs and CMOs should make sure they educate physicians on current offerings, which will probably appeal to them much more.

To put in my own quibble, my sense from researching the matter is that the biggest force holding back mobile use is simply getting EMR vendors to create native clients for tablets and phones. Even if they’re not fully-featured, they should at least be cleanly usable.  What do you think?

Health IT Can Change Delivery Models From The Outside In

Posted on July 2, 2012 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

As we all mull over the implications of the recent Supreme Court decision affirming the key pillar of the health reform law, transformation is definitely in the air.  Hey, if nothing else, we’ve got a presidential election on the way, and it’s likely there will be big changes — either yanking back parts of PPACA or expanding it significantly — when the new POTUS steps in.

This is a great time for the health IT world to assert its place in the system and change the way care is delivered. Of course, I don’t have anything like the space to cover this topic in full  but a few ideas that I think have high potential include:

* Hospital At Home:  This Johns Hopkins model delivers care at home to patients who could use hospital-level care but aren’t likely to deteriorate. It can lower costs by almost one-third and reduce complications, researchers say. Let’s step up and bring sophisticated mhealth apps and remote monitoring to power this further.

*Medical Body Area Networks: With the approval of specifically-dedicated spectrum for MBANs, the FCC has kicked off what should be a revolution in health monitoring, both for consumers interested in self-care and for clinicians. Where can we take it this year?  For example, will consumers wear their network, connected to a receiver in their car, and transmit their own data as they come into an ED for care?  The mind boggles.

* Prescribe An App: This is an area which is juuust getting a foothold in American medicine — though as the linked article notes, the Department of Health in England has created a list of 500 apps for primary care docs to prescribe to patients. The practice can only grow here as evidence helps us sift out the best apps.

*Patient Portals:  Yeah, so what, they’re required under Meaningful Use anyway. So why am I listing them here? Because a nice interspersing of the above technologies with a robust,  user-friendly portal has nearly unlimited potential for medical collaboration:  video visits, telemedicine, mobile visits and check-ins and so on. Although, John also wrote about some of the challenges of patient portals recently on EMR and EHR.

Of course, I’ve said nothing about EMRs themselves, which obviously lie at the center of this Web.  But for a reason. I’m taking the position that in most cases, given the incredible mhealth explosion, care delivery change is going to push in from outside the hospital rather from within. Am I wrong there?

Are iPads Good For Healthcare? A Few Video Viewpoints

Posted on April 17, 2012 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Within, say, six months of its introduction, bloggers were already waxing rhapsodic over the potential of the iPad to transform the practice of medicine.

Many industry observers still do see the iPad as one of the defining moments in health IT, and many clinicians couldn’t be parted from their iPad with a crowbar.

But these days, as news of iOS security issues become more widespread, hospitals struggle with integrating iPads into their infrastructure and doctors grow weary of the iPad’s awkward data entry format, the elegant device is making some enemies as well as friends. OK, not enemies, exactly, but for some clinicians and IT leaders that early thrill is gone.

Given how perceptions of the device are shifting, I thought it’d be interesting to take a look at three takes on the iPad today. The first is from a hospital CIO, the second an interview with a doctor an Israeli hospital, and the third with a US physician. Check them out; there’s an interesting range of perspectives here.

At Mayo Clinic, Patients Getting Loaded iPads That Guide Them Through Stay

Posted on April 5, 2012 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Today, we give you a short case study on how the Mayo Clinic is using content- and app-loaded iPads to move the patient smoothly and happily through their experience there.

I don’t know about  you, but these kind of applications really excite me. The patient shown here isn’t just being given an iPad to meander about with, he’s been supplied a tool filled with useful information that better orients him to his process at the hospital.

“The iPad is a nice way to navigate through some of those resources and keep track on a daily basis that you’re doing the things you need to do to make sure you’re doing the things that you should be,” heart patient Randy Sterner tells the interviewer, who seems to find the app easy to use.  (“It made him feel like a part of the process,” notes Sterner’s wife.)

Among the things the iPad app does is allow Sterner to report on, say, levels of pain he feels or exercise he has done. These reports are broadcast instantly to the healthcare team working on his case.

The iPad app in question was created by a team led by Dr. David Cook, who hoped to meet a need that wasn’t being met.  I say, bravo. This seems like a wonderful idea.

Billing App For Doctors Should Catch Hospitals’ Eye

Posted on April 2, 2012 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Today, I’m going to do something I seldom do — talk about a specific app and what it represents in terms of trends.  The product, SwiftPayMD, is interesting not only because it seems to be solving an important problem, but also because it may be one of the early entrants in a new category of mobile software.

The product,  which runs on the iPhone/iPad, is made by a startup called Iconic Data. Iconic describes SwiftPayMD as a “mobile revenue cycle management app” which lets doctors submit diagnosis and billing codes directly to their office while still at their local hospital.

Hmmm. A mobile revenue cycle management app. What, you mean a product that acknowledges that doctors on the move need not only to access, review and enter clinical data, but also to keep the money coming in?  It’s astounding!  It’s revolutionary!  It’s…a no-brainer.

While I admit I didn’t find any major studies on the subject, it does look as if the app developers and (slow moving) firms on the revenue cycle management side are starting to get it that if you’re going to document, read data and diagnose on the road, you might as well bill for your time too.

A Google search on the words “mobile revenue cycle management” doesn’t turn up a lot that’s on  point, though it does seem that there’s a few small providers in this space, including one focused on anesthesiology.  But my guess is that this will change dramatically within the next six months. The idea just makes sense.

In summary, I guess I’m saying that we’re looking at something really important here. While I haven’t tested SwiftPayMD — and thus, can’t begin to predict whether it will be a major player — the idea is almost certain to catch fire.

Now, I’m tossing the ball to you, hospitals. Is this an opportunity for you?  Should hospital IT departments supply branded apps which allow doctors to collect money faster (and perhaps their own institutions as well)?  Seems like a good idea to me.

Software to Software Interoperability and Software to Device Interoperability

Posted on March 26, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’ve been having the discussion for a long time about interoperability of healthcare data. Although, maybe I should say the discussion has been around lack of interoperability of healthcare data. However, I think we sometimes get confused in the discussion because there are a lot of different ways to share healthcare data. From the hospital point of view this becomes even more complex. Here’s a look at some of the various ways that we could and in many cases should share data.

Software to Software – When someone is talking about healthcare interoperability, they are usually talking about software to software data sharing. Some of the most common examples in healthcare include EHR to HIE, EHR to EHR, or even within modules of the same EHR or HIS system. You can also expand this to include Lab to EHR, Radiology to EHR, ED to EHR, Pharmacy to EHR, etc. In all of these cases, it’s one piece of software sharing data with another piece of software.

One of the biggest challenges with this sharing of data is that even when these software systems are the same software it can be hard to share the information in a ways that’s useful for the receiving system. Sure, we could just transfer some PDF files which are easily viewable and can be easily digested by the receiving system. The sending system and receiving system both understand the PDF format and can easily create, send and receive the file in a way that both know.

Unfortunately, a PDF file listing your drug history isn’t nearly as useful as an XML or other data driven file that contains each of the elements of your drug history including things like drug name, strength, date prescribed, data filled, etc etc etc. The challenge is not creating a file like this. That’s quite academic. The pain point is communicating to the new system the format of the file that you created so that the receiving system can ingest that file into that software in a proper manner.

There are plenty of more points on why software to software exchange is a challenge. However, we’re going to see more and more software to software exchange in healthcare going forward. We’re literally just at the beginning of this revolution.

Device to Software – Another common place for healthcare data exchange is from a medical device to software. Some of the most common examples are the blood pressure cuff and thermometers that are connected directly to an EHR software. Things like EKG’s are also becoming more and more common. In the hospital there are an amazing number of high end clinical devices that also integrate their data with software.

From my experience, these device to software integrations are pretty straightforward. The device manufacturers set the standard and there are relatively few medical device manufacturers out there. Usually it’s a one (device) to many (EHR and HIS software) which makes things easier. Although, we’ll see how this changes as more and more medical devices are built on top of various smart phones and tablets like the iPhone and iPad.

Software to Device – The exchange of data from software to a device is less common. Yes, I am excluding devices like a smart phone which to me are just an extension of the software. A better example is something like Cisco’s unified messaging system where you can have data from your EHR or HIS system sent to your Cisco VoIP phone. It’s pretty amazing technology and I hope we get to see more and more Software to Device integrations in healthcare.

Device to Device – I actually can’t think of any device to device connections that I know of today. I imagine there are some out there, but I can’t think of any that are really popular. With that said, I can see the day where devices are talking to devices. A simple example could be a medical device talking with your Smart TV. Your device could know it’s time to take another reading and so it could display that to you on your Smart TV. You could have the option to respond on the TV and the TV could talk to the device.

In some implementations, we already have a device talking to your smart phone. This will become even more common once we have things like near field communication (NFC) in all smart phones. Depending on how this is implemented, it could be considered a device to software connection, but could also land in the device to device.

Theses examples might not be a good description of what type of device to device integration we could see going forward in healthcare. I’m confident that creative minds will come up with some really fantastic device to device integrations in the future.