iPads and health care – health IT managers slow down physicians’ clinical adoption

Doctors are using iPads in huge numbers for personal life project management. 80% of doctors are excited about using them in clinical practice. But when it comes to clinical applications, don’t confuse physicians’ desire for mobility with their current use of iPads in everyday practice.

What’s surprising is the “why” behind that phenomenon. It’s not a lack of desire; to a large extent, it’s a hospital-based system that’s not listening to physician demand for seamless mobility that fits with real-life workflow.

This was the light-bulb-over-the-head finding of Gregg Malkary of Spyglass Consulting. Gregg recently complete 100 in-depth interviews with switched-on doctors to assess their views on iPads and tablet computing in clinical practice.

I spent an hour with Gregg on the phone yesterday getting into the nitty-gritty of his qualitative research. “Doctors are going mobile,” Gregg said, “But hospital IT doesn’t see the physician as their client and they want to play by the old paradigm – ‘we’ll tell you what we’ll provide, and you’ll adopt it.”

Gregg observes that hospital management did not anticipate that consumer electronics would move at the “lightning pace” it did, capturing physicians’ attention in their everyday lives. Gregg found that now that hospital senior management “want to use the same devices [like iPads], that ‘real client’ of the hospital IT staff” are motivating the IT managers to take a new look at the role of tablets in the doctor’s office. Hospital execs, for example, want to use their iPads as their primary device to access email.

When it comes to clinical practice for doctors, we envisioned a future where the physician could use natural language speech recognition, which could streamline workflow. “Bring up lab results for patient John Smith,” Gregg asserted wearing a physician hat, “and there it is — the pertinent information I need in front of me to use with the patient in the exam room.”

I see this as Nurse Siri of the EMR for the iPad.

For now, Nurse Siri is a vision: doctors are largely productive on a big screen monitor driving throughput, facing incentives and reimbursement that drive him/her toward that workflow paradigm.

This is also an indictment of big iron health IT vendors who aren’t working as closely with clinicians as they could to disrupt the EHR offering. It’s the smaller, newer, more nimble start-ups and developers, Gregg says, who are bringing new-new tools to the mobile clinician.

He forecasted business casualties among some of the long-time health IT players, noting that some key staff are “defecting” the companies moving to start-ups and other vendors who are more innovative.

Read the details of Spyglass’s study.

Health Populi’s Hot Points: Physicians are often blamed for being technology laggards, uninterested in keeping pace with technological change (except when driven by reimbursement). The iPad, beloved to its users, disrupts that stereotype. Clinicians want to use iPads and tablets to go truly mobile and turbocharge their productivity in the exam room.

Doctors work in an ecosystem like all other workers do. In their case, that ecosystem extends beyond his/her nurses, associates, administrative team, to the hospitals with whom they affiliate. When the health IT staff at those institutions aren’t closely collaborating with their physicians, it’s a recipe for lower productivity, less satisfaction, and inevitably, less than optimal patient care. This realization found in Spyglass’s study should wake up the hospital C-suite. What’s good for execs who want to access their email on tablets is even better for clinicians who want to use mobile tools in collaboration with patients.

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