The Wikipedia definition of BYOD (Bring Your Own Device) is: “the recent trend of employees bringing personally owned mobile devices to their place of work, and using those devices to access privileged company resources such as email, file servers, and databases. Some prefer the term Bring Your Own Technology (BYOT), because it is a broader description, which not only covers the hardware device(s), but also the software used on the device.” This phenomenon is not unique to healthcare. In one recent study, Cisco found that 95 percent of surveyed companies allow BYODs in the workplace. It also revealed that 76 percent said BYOD was both somewhat or extremely positive for their companies and challenging for their IT departments. Healthcare, however, because of regulatory issues including HIPAA as well as patient safety concerns, presents unique challenges in this regard. A recent HIMSS survey of hospital executives found that 85% of 130 hospitals embrace BYOD, 83% support the use of Apple iPads on the network, 58% currently or plan to use desktop virtualization solutions for hospital app use, 45% said they would use either home-grown or third-party apps, and 60% are supporting mobile EHR apps.
The majority of nurses, physicians, medical students and others use mobile devices for professional reasons, mainly as educational resources. Younger healthcare providers are using medical apps at a faster rate than older ones; however the vast majority of physicians use smart phones even without utilizing mobile apps, which present BYOD issues just the same. Mobile apps will become an increasing source of medical education, office and hospital management, and patient evaluation and treatment.
An excellent recent review of issues involved in BYOD highlights companies such as IBM and Sybase which address the issue with proprietary software support. Most medical offices and institutions cannot provide this kind of support. Other ways of dealing with the BYOD problem are necessary. Earlier this year, the West Wireless Health Institute established the West Wireless Health Council to address the issue of BYOD. The result has been the remarkable creation of a medical grade wireless open framework which essentially creates a utility out of wireless. The technology is in pilot testing and has the potential to solve the BYOD problem at no cost.
While BYOD presents many challenges unique to healthcare, the increasing importance of mobile devices is clear. Patient confidence in healthcare hinges significantly on the faith the public has in the security of healthcare IT tools of any sort. We must confront this big elephant in the room, and quickly. The rate of adoption of medical apps, the expansion of healthcare IT connectivity, and the rapidly increasing amount of data being produced mandate it.
I really love your analogy and it works on a couple of levels. First, health care workers bringing their own technology into play and second, patients doing the same. Understanding how to address these issues could be solved somewhat easily in the case of the worker because of the regulated oversight and the ability of employers to dictate. However, in the case of ‘free-range’ patients doing whatever they choose, it gets quite a bit less clear cut. One example of this and drawing on your analogy is in the case of tech support for the patient selected technology. Nurses have a really bad habit of performing tech support for medical devices and do not understand when to draw the line between helping patients with their health vs. providing tech support for medical devices. They do this because they care and because historically they are quite knowledgeable regarding the ins and outs of a closed ecosystem of a limited number of devices from major manufacturers and their associated software. Looking into the future (er, it’s already here), the rigorous policies and procedures that exist at the Enterprise Help Desk will have to be instituted in the physician’s office. Physicians are understandably hesitant to mess with the work flow of their office when it comes to telling their passionate nursing staff how to do their job lest they find themselves with an unhappy staff (often the key to a happy practice). This is by no means the only or even the most important obstacle that will have to be overcome in relation to the Elephant in the Room but it should help shed light on how big this elephant really is.
Your comments and insight are much appreciated, as always, Kevin. I do hope the procedures and policies would be executed in a more automated fashion then the help desk. I believe we can do it. Most importantly is, as you say, shedding light on the issue.