Apple has gained a well-deserved reputation for disrupting industries. Witness the impact of the iPod on the music industry, the iPhone on the cellphone industry, and the iPad on the computer industry. Apple’s announcement this past June that iOS 8 (the next release of its mobile operating system) will include tools to manage personal health information has many analysts, journalists, and other pundits debating whether the company can have the same disruptive impact on the health sector that it has had other industries.
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Perhaps one of the Steve Jobs’ greatest legacies is the iPhone and the app ecosystem that it supports. Rather than trying to define and develop every bit of functionality that an iPhone has to offer, Apple handed the opportunity to do so to hundreds of other organizations, large and small. Apple gave up some control in exchange for unprecedented growth in market share and, ultimately, stock price. Imagine for a moment if a similar approach was applied to the design of EMRs and other eHealth applications. Might the same level of innovation and user adoption result? A team led by Harvard University seems to think so and was awarded $15M by the U.S. Office of the National Coordinator for Health IT to turn their ideas into reality.
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One my favourite bloggers is Dr. John Halamk, a practicing emergency room physician, CIO of Beth Israel Deaconess Medical Center, Chairman of the New England Healthcare Exchange Network (NEHEN), Co-Chair of the HIT Standards Committee, and a prolific blogger (I have no idea where he finds the time!). In his most recent blog post, Dr. Halamka notes that “Clinicians have been adopting iPhones, iPads, and iPod Touches so fast that they have become the most popular mobile devices at Beth Israel Deaconess”. In this blog post, he describes how they are using a special case at Beth Israel Deaconess that can be disinfected so that these devices can be used in surgery. According to Dr. Halamka, they can even use an iphone with gloves on!
Despite attempts by some to portray physicians as luddites unwilling to use IT in the practice of medicine, a recent survey by QuantiaMD offers some hard data to refute this belief. QuanitaMD is an online physician-to-physician learning collaborative where, according to the company, 1 in 6 U.S. physicians engage, share, and learn from experts and each other.
According to the recently conducted QuantiaMD survey, more than 80% of physicians responding to the survey indicated that they own a mobile device that is capable of downloading applications (including but not limited to smartphones and tablets). This level of adoption is higher than the general population and demonstrates, in my view, a clear physician willingness to use technology when it fits into their workflow (which is highly mobile). Interesting findings from the survey include:
- 44% of physicians who do not yet have a mobile device intend to purchase one in 2011.
- 30% of physicians surveyed indicated that they use a tablet device. Interestingly, 2/3’s of these tablet users employ their tablet in a clinical setting.
- Despite claims that younger doctors are more apt to embrace new technologies than older physicians, the QuanitaMD study shows that interest in tablets holds steady across years of practice and is, according to the survey report, “as high for physicians with 30 years or more of practice as it is for those with 10 years or less”.
- Approximately 2/3’s of survey respondent state they are likely to select an Apple product. 60% of smartphone users indicate that they have an iPhone while nearly all tablet users have an iPad.
How do physician want to use their mobile? According to the QuanitaMD survey, their top interest is access to EMR data. Other desired uses devices for “peer to peer activities” include receiving treatment protocols alerts, and sharing and discussing cases with other physicians. Desired activities that involve patients include e-prescribing, sharing patient education materials, and receiving alerts when patients need follow-up treatment.
A close to home example of how mobile technology can be used for patient care is the Ottawa Hospital’s massive rollout of iPads and other Apple mobile devices. According to recent articles and anecdotal feedback from sources at the Ottawa Hospitals, the clinical community is enthusiastically embracing these new devices.
The Hospital of Central Connecticut has launched a free iPhone application that provides information regarding the wait times in their emergency rooms.
The iPhone app complements an existing wait time application on the hospital’s web site. The articles note that “Doctors say the system works in two ways, giving patients a sense of what to expect – or a nudge to visit the location with the shorter wait”.
So, when can I expect to find the Ontario equivalent in the iTunes application store?
I have been eagerly following the discussion leading up to and following the iPad annoucement. I have envisioned just such a device since held my first iPOD Touch (since replaced by an iPhone). At the time I thought “great device but Iwish that it had a larger screen”.
I think that the iPad is a new category of device meant for people who already have a computer (either desktop or laptop) and a mobile device (smartphone or otherwise) and is looking for a lightweight device for basic functions (email, web browsing, light work processing). The iPad will be what netbook tried to be … an inexpensive, lightweight, light duty computer. It will NOT replace either an iPhone or a laptop and, hence, doesn’t need some of the same functionality.
My plan is to buy a Wi-Fi only iPad and tether to my iPhone when not in Wi-Fi range. I think that Apple will need to think about better integration between iPhone and iPad. I will always carry my iPhone but won’t always take my iPad. Hence, some means of easily sharing data and connections is required.
As Mark can readily attest, I have been a vocal proponent of what I refer to as “Personal eHealth” applications. Since there is no more personal IT device than a mobile phone, I was intrigued to find that there many eHealth applications on the Apple App Store. Check out:
Mark, what do you think of the $139 EMR application for physicians?
As you well know Mike, the US HIMSS show is in full swing in Chicago. After glossing over the usual PR stuff, I came across an announcement that screams convergence to me. Allscripts-Misys, one of the larger US EMR players, has released an application called Allscripts Remote on the iPhone for viewing patient data. Highlights taken directly from the article include:
- Doctors with an iPhone or iPod Touch will be able to view patients’ electronic health records using a new application available on Apple Inc.’s App Store.
- …physicians will be able to help patients no matter where they are. A doctor called for an emergency in the middle of the night, for example, would be able to access a patient’s health records immediately on his iPhone so he could talk with emergency room staff.
- …fax a patient’s medical summary to the emergency room, complete with any notes the doctor deemed vital to include.
- The software includes e-prescribing to a patient’s regular pharmacy.
- But doctors will be able to make use of Allscripts Remote only if their hospital or clinic already uses Allscripts’ main software product lines, Enterprise or Professional editions of Allscripts’ Electronics Health Records.
Interesting model and nice vendor lock mentioned in the last bullet. Do you think this tethered PHR will work. Docs need an iPhone and your practice or clinic has to use Allscripts EMR software. The relatively closed ecosystem model has worked for Apple so far, do you think this is a good model…both from a business and care perspective?