Mobile solutions offer providers flexibility in managing care

Government, Employers, medical associations, payers, and many others are part of a nationwide momentum toward making electronic health records (EHRs) a reality. President Bush has cited the necessity to create EHRs, leading politicians of both parties have issued joint statements, and some states have accelerated activities. A number of initiatives by the Department of Health and Human Services (HHS), standards development organizations, and other groups are moving several issues ahead.

While this is happening, new technologies are demanding attention, such as mobile systems used by providers. The increase in mobile healthcare systems presents several promising new developments and the need for integration.

WHAT ARE MOBILE SYSTEMS?

Most of the systems fall within three categories. The first is Wi-Fi where a wireless area is created within a hospital, clinic, or practice that allows practitioners to be connected. The second is cell phone technology that allows both data and voice to be accessed and sent from mobile computing devices such as smart phones, laptops or tablets. This technology is dependent on the carrier's signal strength. High broadband connectivity in certain metropolitan areas enable a device to receive streaming video, for example. However, in most regions, this technology is still providing fairly slow connectivity.

The third technology allows synchronization of practitioners' own handheld devices (cell phones, smart phones, PDAs, etc.) in stations that integrate data. Such systems allow physicians to load patient data onto their mobile devices for a couple of hours and access and record data before putting the device back into the synchronizing station for uploading to a central site.

The move from general documentation applications to wireless patient tracking, asset tracking and wireless capture of data from medical devices requires the more advanced solutions.

EXPLORING SUCCESSFUL INSTALLATIONS

Mobile systems in healthcare represent a number of specific solutions. In the emergency department, for example, the workflow can be improved and return on investment can be significant. Charge capture applications also are reported to have a high ROI. Of course, being able to do bedside computing is beneficial and time-saving to many physicians. Among the application uses are:

In a 2005 Medical Records Institute survey of EHR trends and usage, almost 70% of the respondents state that the reason for implementing wireless/mobile systems is that doing so "enhances workflow or efficiency." This is followed by the perception that mobile systems improve patient safety, that mobile systems support the organization's IT strategy and that mobile systems help the IT image. The same survey shows that the use of wireless devices is steadily increasing in the 40% range and that tablets and PDA/smart phones also are on the rise.

Remote access has been the number-one reason for most physicians to begin using mobile systems. A particularly appealing application is patient flow monitoring, using RFID tracking techniques that allow management to know exactly how long patients wait and how they flow through the process during each visit.

The success of mobile systems depends on user acceptance. For many device users, the small screen is unbearable. In general, there seems to be a trade off between weight and size of the screen. If you're willing to carry a heavy tablet, you have a larger screen. If you want something light, then you have a screen that might be smaller than two-inches square.The same is true for the size of the keypad.

Integration of mobile applications into hospital information systems sometimes can be a problem. Smaller practices have an advantage in the fact that more vendors offer specific practice applications.

Electromagnetic compatibility programs enable mobile computing devices and patient devices/monitors to coexist without adversely affecting their performance. This increased awareness has diminished concerns about the safety of cell phone usage.