mHealth Congress: Providers share experiences with mobile EHR deployment
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| Source: ChartZoom.com |
“We see the commercial arm of mobility flying ahead ... and healthcare is just beginning to take advantage of that,” said William H. Morris, MD, vice chairman of clinical informatics at the Cleveland Clinic.
Mobile health (mHealth) tools allow providers to view longitudinal data on patients, communicate with colleagues and push important notifications to patients. Access, ease, ubiquity, function and scale are all good reasons to go mobile, Morris said, and “collapsing multiple needs into one device” can reduce cost.
However, barriers exist at the technological, organizational and financial levels. For instance, Cleveland Clinic had to build an architecture on top of its proprietary EHR system to liberate data for integration. Additionally, Cleveland Clinic is still working out a governance structure to guide clinical use of mHealth tools and, the facility recently invested in iPhones that could soon be obsolete as the new version is being released in October.
Working on a mobile EHR deployment project utilizing laptops and aircards for providers of home healthcare, Philip Chuang, PhD, saw firsthand how disastrous mismanaged mobile initiatives can be. It took too long for providers to get their computers going during home visits so they simply didn’t use them. Chuang estimated that 60 percent of what could have gone wrong did go wrong during the three-year initiative.
“Some of it was the vendor and some of it was us making bad choices,” he said. “When we looked at the cost to fix all of the system’s issues and finish the rollout, it was a big number. We didn’t know if it was the right horse to bet on.”
Now, the director of information services at Sutter, a system that sprawls across Northern California, is overseeing a mobile EHR deployment project utilizing tablets. Chuang and his colleagues chose tablets because they provide immediate access, they’re easy to use and are more appropriate for data entry than smartphones.
The team also carefully considered minute details of tablet configuration. They chose a seven-inch model because the 10-inch can’t be held in a single hand or stuffed into a pocket; decided that bluetooth keyboards would be a wise investment to keep productivity up while maintaining clinician comfort; and decided to install local apps on the devices rather than relying on remote options that could lose connectivity in areas with spotty reception.
Despite the careful planning, certain aspects of Sutter’s initiative aren’t going as planned. Testing the system is an ongoing part of the deployment and training providers to use the mobile application has taken longer than expected. “There’s a presumption that a mobile app is always easy to use and that’s what our vendor sold us on,” Chuang said. “That didn’t turn out to be true.”
There are two takeaways for providers considering the transition to mobile EHRs.
First, have a goal in mind. “You’ve heard this refrain that putting EHRs on a mobile device is not a solution,” Chuang said. Speaking from experience, he knows this is true: the project to put EHRs into laptops failed in part because the organization didn’t have a concrete idea of what it was trying to accomplish.
Second, learn from those like Sutter and Cleveland Clinic that have already been there and done that. Valuable lessons can be learned from their successes and failures. Consistently ranked among the top healthcare innovators, Cleveland Clinic is a good place to look for guidance. “When you’re up in front, you’ve got a lot of people running after you,” Morris said.