In other hospitals, a field trip can help. “We will take IT staff out on the wards,” Dr. Feldman explains. “Come observe the process you’re automating. When they come back, they’re very sobered.”
Dr. Misra, the Johns Hopkins intern, notes that mobile devices are perfect hosts for checklists. Their ease of use can even be viewed as a potential motivator to ensure that those checklists are completed, particularly for younger physicians who have either grown up with or started their careers with more exposure to technology than previous generations.
“The biggest strength of touchscreen technology is it’s interactive,” Dr. Misra says. “It’s fun to use, much more fun than checking off boxes on a piece of paper or on a computer screen.
“It’s portable, it’s lightweight, it’s where you are.”
The virtually limitless boundaries for touchscreen technology to replace functions in the hospitalist’s workflow is, of course, limited in one glaring respect: privacy. The security of devices, applications, or peripherals must be paramount to their effectiveness, Dr. Feldman says, adding patient information must “remain sacrosanct.”
At BIDMC, digital security is accomplished in part via a bifurcated wireless network that allows physicians access to a secure connection while simultaneously and transparently maintaining a free wireless network for patients and visitors. Not all hospitals can afford the infrastructure necessary for such a setup. And even for health systems that have separate wireless systems, the connectivity cuts both ways, says Mike Stinson, vice president of marketing for Motion in Computing, an Austin, Texas, firm that produces tablet computers for multiple industries, including healthcare.
“Are you willing to have every file on your personal system viewable and accessible by the IT guys so they can make sure you don’t have access to something you shouldn’t have access to?” Stinson asks. “It seems easy and appealing, but there are larger issues.”
Stinson says the privacy and safety concerns of the technology can be addressed. Even potential fears regarding the sterility of the equipment might be simply solved. To wit, a column in the Journal of Surgical Radiology in January found that the device worked well when put in an X-ray cassette sealed off with a hemostat.1
Dr. Nathanson, an ED physician who has worked closely with hospitalists at BIDMC in the past, says it’s clear to him that making the technology easy enough to use in a medical setting is no longer the hurdle. It’s the systemic timidity of physicians who are slow to endorse and incorporate cutting-edge technology into entrenched work patterns.
“In medicine, it tends to take a long time,” he says. “The adoption of technology in medicine can be very challenging. If nothing else, we’re very early in the process.” TH
Richard Quinn is a freelance writer based in New Jersey.
- Wodajo, FM. The iPad in the hospital and operating room. Journal of Surgical Radiology website. Available at: www.surgisphere.com/SurgRad/issues/volume-2/1-january-2011—pages-1-112/152-column-the-ipad-in-the-hospital-and-operating-room.html. Accessed Jan. 3, 2011.