Most hospital IT administrators are presently dealing with Implementation of Stage 2 of Meaningful Use as well as planning for conversion to ICD-10 coding. Among more advanced institutions, the topic of the day is development of a mobile strategy. The vast majority of physicians and nurses are using their smartphones for professional purposes, mostly for reference purposes. I will discuss what I see as the most useful ways in which mobile health tools can improve processes and care.
1. A BYOD policy. According to Wiki,” Bring your own device (BYOD)…is a term that is frequently used to describe the policy of permitting employees to bring personally owned mobile devices (laptops, tablets, and smart phones) to their place of work and use those devices to access privileged company information and applications.” A BYOD policy is one which addresses security and privacy issues. Dr. John Halamka has written eloquently on the subject and I agree with his advice to make it a technology-based issue not a policy-based one.
2. A hospital app formulary. These apps range from reference apps to those which will be recommended to patients (and even perhaps ones added which are recommended by patients). The apps would be deemed to come from reliable sources. Operations (pertaining to coding, billing, personnel and room availability scheduling, etc), and patient education apps should also be included. Staff input in choosing apps is important.
3. Mobile patient management tools. Technology is rapidly evolving to assist providers in the hospital. There are robots utilizing telehealth conveying real-time video and information from ICU patients to physicians at remote locations within or outside the hospital. Technologies such as Patient Touch allow nurses at the bedside to transmit and receive digital health information via mobile devices or smartphones.
4. Mobile EHR. Although there are more than a few EHRs that have mobile platforms, most physicians are not utilizing mobile EHRs. However, when surveyed, 90% of physicians would like to use mobile EHRs. Although not specific to mobile EHRs, a significant finding of a recent study by the Pennsylvania Patient Safety Authority interestingly found that “of the 3,099 EHR-related events analyzed by the Authority, 2,763 (89 percent) were reported as “event, no harm,” meaning an error occurred but there was no harm to the patient. Ten percent of the reports (320) were reported as “unsafe conditions,” which also did not result in a harmful event. Fifteen reports involved temporary harm to the patient due to the following: entering the wrong medication, ignoring a documented allergy, failure to enter lab tests and failure to document.” It was interesting that privacy and security were not the areas sited as causes of problems. Mobile EHRs though, certainly carry these issues and will bring security to higher visibility as concerns after adoption.
5. Secure messaging. As part of Stage 2 of Meaningful Use, there needs to be secure messaging with patients. In addition, secure and HIPAA compliant messaging among providers and others in the hospital is warranted.
Hospitals present unique workplace issues and deserve special considerations regarding mobile technologies. IT personnel need to develop mobile strategies today.