How Useful Are Point-of-Contact Apps?

A healthcare revolution. On its website, Apple is promoting the new iPad as 'transforming healthcare.' But is this true? Judging by the point-of-contact medical apps that Apple features in its App Store, I'd say so.  

Within the Appstore, there are a multitude of professional healthcare apps - the most intriguing to me being the point-of-contact apps. "With instant-on power and a full-day battery, iPad gives doctors the power to provide faster, better care anywhere. Apps on iPad connect securely to electronic health records, manage paperless prescriptions, and enhance patient interactions with visual examples and explanations," says Apple. That italicized bit is the important part.

First, let me explain point-of-contact (POC), if the term is not clear.  POC refers to direct interaction between the doctor and the patient for medical explanations, directions for medications, and so on. 

Apps can help patients at the POC by reinforcing their learning with visual aids. Consider the drawMD series of apps pictured to the left. With the app, doctors can show patients labeled photos as they explain issues, directions, and so on. The images can even be emailed so patients can refer to them later, reducing the chance they'll forget important information.

This POC example is only one possibility of which there are many. Apple showcases several different categories of programs, such as imaging apps for displaying X-Rays, EMR & Patient Monitoring apps to handle medical records, Education apps to keep professionals abreast of new research, and Reference apps for doctors to look up patient symptoms and treatments. 

Clearly, the iPad and other tablets will shape the ways in which doctors interact with patients from now on. Physicians will be able to carry a replacement for heavy books and radiological equipment in a one pound portable device, giving them greater flexibility and patient care quality.

Buried Under Stacks

If Electronic Health Records (EHRs) are being adopted at a record pace, then why are hospitals slow to abandon physical paperwork? Anoto, a digitizer of of healthcare processes, claims that paper is the preferred medium for healthcare professionals and 'will be for the foreseeable future.'

Why? What is driving this resistance to digital records? Respondents to a survey claim that this is all a part of the burden of the new Patient Protection and Affordable Care Act (PPACA). Employees responded that 75% of their time is spent working on or processing paperwork. While that is a tremendous statistic, I don't think it tells the whole story.

Employees are required to do this paperwork, so the resistance isn't against the digital medium itself. The resistance is against doing work twice. You read it yourself, employees spend 75% percent of their time working with physical copies, so when would they be able to input this data into the computer? If they were able to input digital files the first time, there would not be such a problem.

Now, the issue lies with how this data can be inputted digitally the first time. For those who work in an office with constant access to a computer, this is a non-issue. But, those who work directly with patients cannot jog back and forth between the patient and a computer. There are a couple of ways to tackle this problem.

Workstations on wheels (WOWs) are exactly what they sound like. These desktop computers are powered by batteries and are portable. Employees can drag WOWs around with them to patients and input data directly. The downsides are that these workstations are bulky and distracting. Employees may find it difficult to work on such a machine while they communicate with patients. This leads me to...

Tablets. If employees carried around tablets or smartphones that were synced with the hospital records, the problems associated with WOWs would vanish. These devices are smaller and thus less distracting. Data would be uploaded instantly to the EHR, drastically reducing time spent on paper work.

Of course, until a study backs up my suggestions, they are only theoretical.


Source: Healthcare Still Buried In Paperwork

Rising Demand for Healthcare Apps

At lunch the other day, I noticed my cousin futzing around with her iPhone and a prescription for medication. "What are you doing?" I ask. "I'm refilling a prescription," she replies. 

From her phone, she takes a photo of the script, which is uploaded to an app, and sent to the nearest CVS Pharmacy. She gets confirmation that the refill will be ready in an hour, right when we get out of lunch. 

This prescription app is a primitive step compared to the healthcare technology of the future.  As patients start to use these apps more often, they will begin to demand more services with this form factor. Scheduling appointments, paying doctors, ordering medication - all will be done through apps.  

Hospitals must have EHRs and infrastructure in place to meet the future demand for these portable apps. In areas were patients have a choice of quality healthcare providers, they will choose the most technically advanced. These create customer expectations that savvy healthcare management will meet.

Consumers have become increasingly dependent on mobile device over the last five years (disclosure: I'm writing this blog on an iPad). We [consumers] expect apps for most things in our lives now - healthcare will be no different.  

Healthcare in the Cloud

I’ve talked about Electronic Health Records (EHRs) in the past, but those posts were geared towards the hospital's benefit. In fact, you might be wondering: “How can EHRs benefit patients?” Funny that you ask, because I was just going to write a blog post on that very subject. 

Have you ever forgot to request a prescription refill? Waited anxiously for a child’s lab results? Made a long trip to the doctor’s just to have a form filled out? You can understand how bothersome these situations are, yet patients face these kinds of problems each day. Until now, there has been no easy solution. But, with the emergence of cheap cloud storage and the rise of high-speed internet, healthcare organizations may finally be able to offer a technological fix.

Imagine that you are a patient: wouldn’t you love to have total control and easy access to all of your health records? (Bear with me here.) You would be able to track all of your children's doctor appointments, order a new prescription, check lab results, and send health information to those who require it - all with the touch of a button. Electronic Health Records, with complementary apps, make those previously mentioned features possible.

Benefits for patients are clear: convenience and simplicity. With the technology currently available, there is no excuse for shuffling loose, paper files around a desktop. Cloud computing can sync patient records across numerous systems, making matters simpler for both hospitals and patients. Annoyances of the past, wiped away with the swipe of a finger. 

Original Articles:

• Healthcare Cloud definitions should be based on NIST’s definitions
• Advanced EMRs reap advanced benefits

Rising Use of Mobile Devices in Healthcare

The rise of the smartphone and tablet markets has been the defining technological revolution of the past five years. What was once a niche product for the enterprise has become an ubiquitous consumer product, with nearly 42% of mobile users employing smartphones. How have healthcare institutions taken advantage of all the processing power of smartphones now at our fingertips?

Medical professionals have increasingly been using mobile devices (smartphones, tablets) when interacting with patients. A Healthcare IT news report stated that there were more than 1,000 medical apps available for the iPhone as of February 2010 (one month before the iPad was announced). Apple CEO Tim Cook recently announced that 80% of US hospitals have been using the iPad in some capacity to treat patients. Such uses include bedside care, health record input, and image viewing.

It is widely believed that this is the beginning of a transition to tablets or smartphones as a doctor's primary tool. It should be about about a decade for the transition is complete. The question for the time being is: how can hospital management justify this investment? I will discuss a few possibilities below.

1. Electronic Health Record (EHR) Compatibility. In a previous blog posed, I discussed the necessary conversion of regular print records to electronic ones. One of the main problems created by this necessity is the amount of work required to input new records into the computer. Under the old system, doctor's would take notes into their files and this information would later be input into a digital file. With an iPad acting as the file, the computer input would be already done. Many EHR companies have begun developing apps for this platform that could save many man-hours.

2. Higher Patient Satisfaction. Giving doctors, nurses, or PCAs access to a mobile device could greatly reduce the amount of patient wait-time. In many circumstances, patient treatments depend on the outcome of health tests that are reported by computer. If these results were immediate, patients could be treated at a much faster pace. Long wait time is a common complaint about hospitals and its elimination would help management achieve its goal of satisfying patients.

3. Increased Care through Better Patient Tracking. The portability of these devices creates unlimited possibilities for healthcare adoption. Rather than keeping patients at the hospital to be monitored, doctors can set up an app on a phone to track them remotely.

These are only three possibilities - there are no limits with what can be achieved with this new technology. Creative management will find new ways to boost hospital efficiency and patient satisfaction, increasing the quality of our health care.

See the original articles: "Docs using mobile apps at the point of care," "Steve Jobs' legacy will live on in healthcare,"and "ComScore report finds 42 percent of US mobile users have smartphones"

Challenges to Electronic Health Records

Hospitals have increasingly been making moves towards electronic health records (EHRs). But, as most people can relate, there is nothing simple about adding new technologies into your mix. We all shuffle contacts and documents from several different accounts across tablets, phones, computers and more. Things get complicated quickly.

Healthcare IT News reports that Healthcare organizations have been facing similar difficulties. Hospital CIOs find that EHR integration into existing systems is more difficult than initially perceived, even after costly investments into the software. Just as you find duplicates of the same contact with different information in your address books, hospitals find that EHRs for patients do not always match existing files.

This interoperability problem could lead to legal issues for these organizations in the future. Under the Affordable Care Act, hospitals with 'meaningful use' EHRs will receive financial incentive payments until 2015. After that, hospitals without these EHRs will face small financial penalties. It is in hospital management's best interest to sync EHRs with current software in order to receive current incentives and avoid future penalties.

An article from the Healthcare IT Guy website offers some interesting solutions to this EHR fragmentation problem. Persistent Links are the most interesting option. Persistent links identify and match patients by issuing unique identifications to each one. The technology eliminates the fragmentation issue by working across several different hospital databases.

I am not a healthcare technology expert, but these problems and solutions are quite interesting. Hospital management must effecitvely navigate through politics and fast-paced technological change while maintaining the quality of patient care. Proposed solutions will require large investments and managers must be prepared to weigh their benefits.


See original articles:

Healthcare IT News: Interoperability Still a Barrier  

Healthcare IT Guy: Techniques for Matching Patient Records

A Note On My Sources

You might be wondering how I, a business student, have any idea about the technology needs of hospitals. Let me just say: I don't. But, I found some interesting people who do. They also happen to blog about it. 

My Sources: 

1) The Health Care IT Guy:

This blog is written by Sahid, an 'internationally recognized enterprise software analyst' who specializes in Healthcare. He's worked at several healthcare companies in the past, providing him with the necessary experience to blog on the subject. 

2) Healthcare and Technology: 

This blog is written by a Registered Nurse who has had experience in many different technology roles. She offers the perspective of an insider with clinical experience and a tech focus, which should be helpful for my blog. 

3) Healthcare IT News: 

Unlike the previous two blogs, Healthcare IT News is organized as an online newspaper. Multiple authors contribute the blog, offering a more objective point of view when compared with my other two sources.

These three sources should extend sufficient material for me to blog about. I often visit other tech news sites in addition to those listed above. These sites, such as Engadget, BBC Tech News, and NYT Technology, can increase the breadth of the information I will be analyzing.