Rise in physician tablet use means less than meets the eye

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Sixty-two percent of physicians--nearly double the number a year ago--now use computer tablets, according to FierceMobileHealthcare. That report makes it appear as if iPads and other tablets will inevitably take over medicine. In fact, Monique Levy, director of research for Manhattan Research, told eWeek that all physicians will eventually adopt these gadgets.

That would certainly affect healthcare, but perhaps not as much as one might expect.

For one thing, only half of the current tablet owners have ever used them at the point of care. That's still a lot of physicians, but they're mostly using their iPads to read medical news, access drug information and e-prescribe. In other words, they're doing the same stuff they used to do on PDAs and smartphones, only on a larger screen.

A smaller number of physicians are using tablets to view the information in electronic health records. The relative lack of uptake in this area reflects the fact that most EHRs are not designed for use on mobile devices. Of the major EHR vendors, only Allscripts has so far released an iPad-native application, although eClinicalWorks is expected to come out with one this summer. Epic is also said to be working on an iPad-native version but has not made any announcements.

The EHR incompatibility problem is compounded when physicians want to enter patient data. First, it is difficult to type on the iPad's onscreen keyboard. Second, some hospitals connect iPads to their systems via Citrix. Since that thin client application is designed for Windows, Citrix makes it hard for Apple OS users to navigate EHRs.

A December, 2011 Kaiser Health News and NPR article examines the situation at the University of California San Diego Health System (UCSD), which has received a HIMSS Analytics Stage 7 award for its advanced use of health IT. IPad use is widespread at UCSD, but only about 10 percent of the medical staff utilizes iPads in patient care.

Besides encountering the problems described above, UCSD physicians find it difficult to carry iPads around with them, since they don't fit in lab coat pockets. Also, they point out, wireless communication in the hospital is spotty, according to the Kaiser story.

"Are you ever more than four feet away from a computer in the hospital? Nope. So how is the tablet useful?" one hospitalist said. 

Of course, physicians' attitudes toward using tablets in patient care could change if a technological breakthrough makes it easier to enter data. Such a breakthrough might come in the field of natural language processing (NLP). More and more vendors are already imbedding NLP in their EHRs for various purposes. If these applications ever get good enough to parse dictation and put medical terms in the correct EHR fields automatically, tablets might become indispensable to physicians.

In the meantime, however, physicians are likely to remain skeptical about the clinical potential of tablets. In a recent Spyglass survey, 80 percent of doctors said they thought iPads had an "exciting future" in healthcare, but most doubted they were ready for clinical use.

So what does the big rise in physician tablet use mean? It indicates that these devices are very popular, especially among highly educated professionals such as doctors. It does not mean that their healthcare potential will be realized anytime soon. - Ken

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