Tuesday, August 11, 2009

Smartphones for Health Care

Software Advice is an online consultancy currently offering an advisory service to connect software buyers and vendors in the health care sector (among others). They recently conducted a survey to determine which smartphone is emerging as the device of choice in U.S. health care markets. Although the survey is not scientific, the results are interesting. There were 700 emails sent out to invite participation, while only just over 10% responded (n=71). (There was no option to indicate that the respondent did not own a smartphone.)

Here is the breakdown of respondents by profession:
22 Physician
9 Student
6 Nurse
16 Healthcare IT professional
2 Administrative support
16 Other

While health care service providers including physicians and nurses preferred the iPhone, personnel in administrative support (n=2) chose the Blackberry - a result consistent with anecdotal observations from my informants in the health care sector. This may be because the Blackberry offers superior infrastructure for large enterprise functions including management and security (the BlackBerry Enterprise Server), while the iPhone delivers attractive software applications and facilities for reference and research. (See the debate on Computerworld Mobile and Wireless.)

Especially interesting is the apparently predominant use of smartphones for email communication and note taking in spite of the strong expectation that such devices should be used for medical imaging, patient records (EHRs) and e-prescribing. These results, although unscientific, suggest that smartphone systems are inadequately integrated in institutional information systems, and that the infrastructures required for EHR functions including health information exchange (HIE) generally remain unavailable.

Related to the question of smartphone choice is scenario analysis of future IT infrastructures for health care service delivery in the U.S. and around the globe. In my opinion, the emergence of cloud computing and web-based services will shift the focus of this debate away from the characteristics of access devices and software - to the design of national and international infrastructures with sustained public investment. This paradigm shift in the next five years would invalidate current definitions of "meaningful use" of HIT at the individual practitioner level of analysis and render irrelevant CCHIT certification policies and procedures. (See a Chilmark research presentation entitled "What's Really Going On? or PHRs, Platforms, & Consumer Trends" .)

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