During this year, a large majority of small- to med-sized physician practices plan to buy tablets for in-office use.
The old expression, “Take two tablets and call me in the morning,” may be taking on new meaning for physicians. According to a recent survey by market research firm NPD Group, 76% of small- to mid-sized physician practices say they plan to purchase tablet computer devices during the coming year.
“You can do everything,” says Michael Hobaugh, MD, physician-in-chief at La Rabida Children’s Hospital in Chicago, who has been using an iPad for the last three years. “I have an app [on my iPad] that allows the device to emulate a PC on our internal network at La Rabida. And I can use any Internet connection anywhere to remote into the hospital on this device.”
Hobaugh admits that after he first purchased his iPad “it sat for about three or four months” until he decided it was time to “figure out how to get this thing functioning inside our network.” It took a couple of months, but Hobaugh now feels that he can work well with the device within the medical environment.
“It’s a new concept,” Hobaugh says. “All of these technological projects have that as their underpinning when it comes to rolling them out to physicians. So it took a little while [to adjust to using it], but I wouldn’t say [the learning curve] is exceptional in any way.”
Hobaugh says that La Rabida’s information technology staff helped get everything set up so that his iPad can navigate each of the hospital’s network drives, including imaging software for viewing x-rays and accessing its electronic medical record.
“It’s a little bit slow [for viewing x-rays], but not so slow that you can’t use it,” he says.
Hobaugh says that where the tablet devices work well is with button functionality for data entry; where all the responses are pre-written and a physician simply needs to select them.
Where it starts to become a challenge, he explains, is when fresh keystroke entry is required. While the keyboard is remarkable, the iPad doesn’t have the feel of a button keyboard. Nothing moves when you press it.
“The other thing is that when you utilize the keyboard, you lose half of your viewing area on the screen,” Hobaugh says. “Especially when you’re emulating the PC environment on the device, then it becomes tedious to re-size and reposition your working area on the screen so that you can see what you’re doing. A task involving a keystroke entry on a computer that would take me one minute would probably take me a minute and 45 seconds on the iPad. So it loses some efficiency.”
Hobaugh says he doesn’t use his iPad while making rounds, calling its large screen both a blessing and a curse. As with any physician, Hobaugh uses his hands extensively while making rounds and the device is about two inches too wide to fit inside his lab coat pocket.
“And then you set the iPad down to do your exam, and you walk out of the room without it,” he says.
That drawback hasn’t deterred the University of Chicago Medical Center, which recently issued iPads to more than 100 internal medicine and pediatrics residents. The iPad is slung over residents’ shoulders via a long strap that enables them to keep it at the ready.
“It looks a little cumbersome to me, but I suppose you get use to it,” Hobaugh says.
The device allows residents to readily share medical information with patients while cutting down on paperwork. However, for security reasons, no patient information is stored locally on the device, and layers of password protection are in place before access to information can be gained.
Hobaugh says the key to making tablet devices in medical practices work is the same as it is with all information technology projects. There needs to be a champion; someone who is savvy with the device, knows the kinds of software available for the device, and can educate colleagues on its usage.
But when done right, it can be a very useful tool for physicians.
"If I would have to bring one device with me somewhere, say I was traveling, the iPad would work very well for being able to get to everything I need to get to,” Hobaugh says.
Learning curveWorking out the bugsMaking the roundsNecessary planning“If you have three physicians, and none of them are particularly savvy in trying to get the device integrated and working well, they’ll need to bring someone in to help them integrate it into their network, and help them find apps to suit their needs,” he says.
Ed Rabinowitz recently wrote
a book about one family’s courageous battle against time and glioblastoma brain cancer.