Doctors and iPads

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Category : Medical Rants

Let me state my bias upfront – iPads help and will help physicians greatly.  Of course, whenever new technology enters our universe, the luddites find all the problems.  The early adopters (I just replaced my original iPad with the new version) find all the potential.  As I have written about previously, this likely represents the affect heuristic.

Bob Wachter wrote this piece urging appropriate use of technology – Digital Distractions: Time for a Diet

In a commentary accompanying the case, the impossibly energetic John Halamka, ED doctor and Harvard Med School’s Chief Information Officer, described all of the things that his hospital, Beth Israel Deaconess Medical Center, is considering to address this issue. It’s not easy: whereas the hospital owns the Electronic Health Record and can manage access to it, the vast majority of mobile devices in the hospital today – at BI and everywhere else – are the personal property of the users. So Halamka is testing various policies to place some digital distance between the personal and professional, including blocking personal email and certain social networking sites while on duty. He’s even investigating the possibility of issuing docs and nurses hospital-owned mobile devices at the start of shifts, collecting them at the end.

On the other hand, iPads particularly are receiving kudos, but clearly physicians have not all figured out how to balance their gadgets for patient benefit.  This article presents a balanced view – Mobile devices offer advantages, challenges

This week I will have an EHR application installed on my iPad.  This application, which many colleagues and residents already use, should save me much time on rounds.  Currently, when we want to review the labs we have to find a computer (not always easy in a busy hospital), log on (rarely fast) and then search through many lab tests.  The iPad application makes lab retrieval simple.

So during my morning pre-rounding ritual, while the students and residents are presenting to me, I can look along at the lab results.  This is very efficient. 

Residents and faculty who already use the application rave at the efficiency.  A recent Archives of Internal Medicine article supports these anecdotes:

Concerned that residents were spending more time at the computer screens and not with patients, the University of Chicago department of Internal Medicine began giving each of its 115 internal medicine residents an iPad and accessories in 2010. In a research letter published in the Archives of Internal Medicine on March 12, Christopher Chapman, MD, ACP Associate Member, chief resident at University of Chicago reported finding 78% of residents said they are more efficient on the ward with the iPad; 70% say it saves them at least one hour per day; and roughly half say it allows them to attend more conferences.

iPads make sense for physicians because the size is reasonable, and the device is multifunctional.  We will have articles, reference books and patient information all available while rounding.  

But iPads represent change, and of course some physicians will resist any change.  But this change I predict will quickly spread amongst physicians.

Comments (3)

OK, I'll bite, what is you EHR app?

Patient Keeper for the inpatient.
We will have Wand for the outpatient.

My mom recently spent a week at an internal ward at the hospital (Pneumonia). The had computers (not mobiles; desktops mounted on trollies). I assume that's efficient for the Drs. But one thing that I noticed was that while in the past the patient or family could glance at the chart that was hanging on the bed or a nearby cabinet and see what was going on with the patient (something that helped my in the past notice that a nurse was going to put dangerous eye drops to the wrong eye…), now the information is hidden. Technology could be used to make the relevant information immediately also available to families and even the patient on *their* iPads or iPhones.

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