It's 2 a.m. and 10-year-old Johnny's mom calls because he has an ear infection. She knows he's allergic to something, but she's not sure what.
In the past, Johnny might have suffered hours of pain and a perforated eardrum because his primary-care physician couldn't get to his charts and prescribe appropriate medication in a timely fashion, says pediatrician Barbara Morris, chief medical officer of Community Care Physicians, a 200-physician practice with locations throughout the Albany, N.Y., area.
Today, now that a growing number of physicians at the practice are equipped with Apple iPhones and iPads that connect to the Community Care's EHR, patients like Johnny get care and relief more quickly. And that's just the first of many benefits.
"It's an immediacy of clinical information," says Morris. "Sometimes it's a life and death [situation], sometimes it's convenience, sometimes it's being able to initiate a treatment."
Community Care is one of a growing number of practices, large and small, whose physicians are connecting to EHRs via mobile means — especially via media tablets. Physicians are warming up to iPads in particular, according to several studies, and because many are eager to use the devices to connect to their EHR systems, some observers are wondering whether the iPad will do more to encourage EHR adoption than any government stimulus or vendor promotion ever could.
But as with any new technology, there also are some limitations to mobile EHRs that will take time to work through. For physicians on the fence, here's some guidance on the benefits and limitations of the emerging mobile EHR.
The state of mobile EHRs
Mobile devices have come a long way. Today's smartphones, for example, allow a physician to do everything from download medical-reference apps to view high-resolution X-ray images quickly and easily.
But the introduction of Apple's iPad in April 2010 has done more to advance the concept of a truly mobile healthcare delivery system than any other device, software release, or technological development — including, perhaps, the Internet itself. The iPad's laptop-like screen size (10 inches), its phone-like portability (it's about 1.33 inches thick and weighs 1.3 pounds, depending on the version), and its powerful battery (up to 10 hours on one charge), seem to combine to make it a busy physician's dream gizmo.
Further explaining the iPad's success in mobile health has been sheer serendipity: Its release coincided almost exactly with the implementation of the final Stage 1 rules for the government's EHR incentives, which, in turn, spurred the adoption of EHRs.
According to our Physicians Practice 2012 Technology Survey, Sponsored by AT&T, taken by 1,369 physicians, practice managers, and other healthcare workers in the first quarter of this year, use of mobile technology, has risen substantially. More than half of all practices have a fully implemented EHR, and 63 percent of respondents said they use mobile devices for work purposes. Of those, nearly half (45 percent) use an iPad or other media tablet, and 82 percent use a smartphone.
All this has given rise to a new category of EHR — one that runs on a smartphone and/or media tablet — that most vendors are working on developing, if they don't have something already.
Most "mobile EHRs" are extensions of desktop-computer EHRs: They reside on mobile devices as "thin-client" applications (either as Web-based apps or apps that are native to the tablet's platform, such as Apple's iOS) that connect to the practice's EHR through the device's Web browser. While some EHR apps conform to a device's particular operating-system constraints so the EHR looks natural on a smaller screen, not all of them do.