Array of Options
A dizzying range of communications technology is available to working hospitalists, typically accessed through personal digital assistants (PDAs), smartphones, computer tablets, pocket PCs, and laptops.
The Palm Pilot, introduced in 1996, is a well-known example of this technology, as are the Palm Treo and BlackBerry. PDAs combine the functions of cell phones, video phones, cameras, video recorders, media players, Web browsers, reference tools, bar code scanners, and global positioning system (GPS) devices—all in a palm-size package.
Hardware and supporting software vary in terms of ease of use, in particular, the ability to interface with the Web or the hospital, practice, or employer network the physician needs to connect with.
The technology is evolving rapidly. But anomalies abound, such as dependence on the fax machine as a staple of communication with attending physicians. Through all of these changes, hospitalists are responsible for learning what works and how best to take advantage of the technology to make their jobs easier.
Hospitalists also vary tremendously in terms of their comfort levels and openness to new technology.
“There is a considerable gap between those of us who ‘Palm’ and those who don’t,” says Timothy Hartzog, MD, pediatric hospitalist at Medical University of South Carolina (MUSC) in Charleston and a medical technology consultant. “Physicians want their patient data in different ways. Some want it printed out or in a paper chart.”
—Steven Liu, MD, of Emory University Medical Center in Atlanta
But implementation of technology, such as hospital electronic health records or computerized physician order entry, inevitably changes their relationships with information technology and patient information.
Some hospitalists, like Dr. Deruelle, are interested in what communication technology can bring their work and how to adapt it to their needs. Others, like Dr. Hartzog, medical director of Information Technology at MUSC, have taken added responsibilities for technology within their institutions.
And a few, such as Steven Liu, MD, of Emory University Medical Center in Atlanta, have taken their interest in computer technology a step further. In 1999, Dr. Liu founded Ingenious Med, an Atlanta software company that offers a suite of inpatient practice management applications to working hospitalists.
“Often the hospitalist is already on the forefront of technology,” Dr. Liu says. “The demographic is typically younger and techno-savvy. They may get tapped by their hospitals to help customize the electronic health record to make sure it satisfies the needs of clinicians. Conversely, if an electronic project does not involve strong physician feedback and collaboration, physicians can be the Achilles’ heel impeding successful implementation. Even though they are the ones who stand to gain most from the potential efficiency, physicians will not adopt technology that does not fit their workflow.”