Monday, October 10, 2011

Brave New world of iPad Computing

After all of the discussion  and political debate about EHRs; the pros and cons, the deadlines, the training, the difficulty that so many doctors seem to have adapting their practice to a model that incorporates an electronic health record, and use of the computer during the patient visit, the world has changed once again. Enter the iPad.

In many physicians’ offices, patients arrive to find an iPad waiting for them where they can fill in current problems, allergies, symptoms, and medications with the touch of a finger. When the nurse takes the patient to an examining room to check vitals, that information is also recorded on an iPad. All of this data is instantaneously transferred to the doctor’s iPad and is available during the office visit. When the office visit is over, the doctor dictates notes directly into an iPad. The full set of patient data is then automatically stored in the patient’s electronic health record. Annoying issues of eye contact and personal communication with doctors who use desktop systems that can become a barrier to communication go away. The 1.3 pound iPad sits between the provider and the patient, can be seen by both individuals and does not become a diversion. 

iPads are also easy to use and maintain and do not require the learning curve or the overhead of larger computer systems that doctors have resisted for so long. Implementing an iPad-based electronic health record qualifies doctors for the stimulus money allocated by the 2009 Stimulus Package as long as they adhere to the meaningful use definitions. The Electronic Health Record software for the iPad is supplied by the familiar players:  Allscripts, Prima, Meditouch and Eclipse and other vendors who have been developing EHR software for years and have hopefully worked the bugs out of their systems.

In the brave new world of using IPads, physicians and hospitalists also take them right to the patient’s bedside where they can view the patient’s chart together and determine next steps. Doctors who make house calls to home-bound patients are using iPads loaded up with the patients’ electronic health records, x-rays, lab tests, and procedures, that they can share and discuss. IPads are even used today in emergency departments to track movement of patients and staff and record orders.

There is a downside to using an iPad that contains extensive patient data and can be carried in a pocket. Privacy of health information is serious. It is important that the data is encrypted, and that iPad users are diligent about insuring that their iPad is with them at all times, so it cannot be stolen. 

Did Steve Jobs ever envision that the iPad would become an important device in the delivery of healthcare? One can only wonder.

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