A Fertile Field: Mobile Access to the EMR

Michael Rose

The technological soil is well prepared for growth in mobile electronic medical records that promise physicians new freedom, greater productivity, and quick decision-making

By Michael Rose
Senior Marketing Manager
GE Healthcare

Walk into a doctor’s office today and you’ll see people quietly reading magazines – on their smartphones and tablets. The “take information anywhere” revolution is here, and it goes well beyond the waiting room. It reaches into doctors’ practices, especially if those doctors make rounds at hospitals.

Yes, we’re about to see the ultimate in convenient patient information come to fruition: The mobile electronic medical record (EMR). One could say the soil is tilled and fertilized and awaits only the planting. Studies indicate that a substantial majority of doctors already own devices able to accommodate a mobile EMR. For example:

• In a 2011 study by QuantiaMD, more than 80 percent of physicians survey owned a mobile device capable of downloading applications.1

• In a 2012 study of physicians’ digital behavior, 45 percent of respondents owned an iPad and 10.1 percent used another brand of tablet, and that 52.4 percent were iPhone users 25 percent more used other smartphones.2

Clearly, the hardware is in place. What remains is for EMR vendors to deliver mobile applications that “play” well on the devices doctors prefer. Some already exist, and more are in development.

Variety of benefits
Mobile healthcare is not a new concept, and clinicians see benefits in it beyond mere convenience.

In one 2010 study, physicians said mobile health could:

• Expedite decision making (56 percent of respondents)
• Shorten the time required for administrative tasks (39 percent)
• Increase collaboration among physicians (36 percent)
• Allow more time with patients (26 percent)3

Meanwhile, healthcare trends favor mobile EMR adoption. The application holds promise to enhance clinical efficiency and care quality – an advantage as compensation models shift toward rewarding outcomes. And its adoption could help physicians comply with Meaningful Use requirements and qualify for federal incentives for EMR investments.

Steady evolution
The question is how quickly mobile EMR applications will arrive. The concept has already come a considerable distance. The obstacles have been not in wireless technology itself, but in giving physicians practical devices to use at the point of care.

The first iteration was the WOW – “workstation on wheels” (formerly called COW – “computer on wheels” until patients thought staff were talking about them). WOWs were essentially laptops on carts with batteries rolled from room to room. The wireless access itself worked fairly well, but the units were costly and hard to maneuver around cramped patient rooms. There was also the issue of availability – WOWs were shared by multiple clinicians on the floor (who often forgot to plug the WOW back in to recharge the battery).

Next came hand-carried laptop computers, ruggedized against damage from the inevitable bumping and dropping. These are still in use and are much more convenient, but they’re relatively heavy – some clinicians complain of arm fatigue from carrying them all day.

Tablets and smartphones largely solved the portability problems – some newer physician lab coats even include pockets designed just for tablets. Now the challenge is to make the EMR usable on the much smaller screens. EMR vendors’ first attempt was to use an emulator – essentially a kind of middleware – to shrink the display to fit the device. That was unsatisfactory for tablets and altogether unworkable on smartphones.

The answer lies in native applications – software designed specifically for the device and operating system on which it will run. Such applications are designed to make the EMR manageable even on a small screen. For example, instead of a single home screen containing all functions, the device would provide separate pages for a patient list, lab results, communications from other providers, alerts, and so on, providing fingertip access to essential information. Ideally, the native application provides touchscreen functionality and minimizes typing.

The point of entry for the mobile EMR is the read-only application. It allows easier access to clinical data at the point of care or remotely, contributing to better physician workflow, greater efficiency, and potentially higher-quality care. Bidirectional EMRs are more difficult to deploy and require more training. Still, one study predicted rapid growth leading to adoption by up to 75 percent of hospitals by 2014.4

Mobile web applications such as the New England Journal of Medicine and Best Practice Guidelines from the Institute of Medicine provide a valuable complement to the mobile EMR, providing point-of care access to, for example, the latest treatment regimens or surgical procedure checklists.

Today, mobile EMR and web applications provide additional tools which help physicians provide safe, cost-effective, better-quality care. In the very near future, these seeds will bear fruit, and the emergence of native mobile EMR applications will give powerful information in forms they can use conveniently on the same mobile devices they use to help run their practices and their lives. We are starting to see the sprouts emerge from the ground!

1 Modahl M, “Tablets Set to Change Medical Practice” ©2011, Quantia Communications Inc.
2 The Joint Survey of Physician Digital Behavior, ON24 and MedData Group, reported in Healthcare InformationWeek April 20, 2012.
3 Price Waterhouse Coopers Health Research Institute Physician Survey 2010.
4 mHealth in The Enterprise, ©2010, Chilmark Research.


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