HIMSS: Smartphone pilot gets thumbs up

LAS VEGAS—Mobile systems can allow for on-the-go availability, instant log-in, no required desk space or less time spent waiting for a shared computer, off-site use and the ability of physicians to use their own mobile devices, as well as greater acceptance of EHRs, Afzal ur Rehman, MD, PhD, CMIO, and Rebecca Kennis, clinical systems analyst at United Health Services, explained to a packed house Feb. 21 at the 2012 Healthcare Information and Management Systems Society (HIMSS) conference.

To take advantage of all these benefits, United Health, a four-hospital system in Binghamton, N.Y., piloted iCare four years ago. The system requires that each mobile device be registered to just one user and initial registration is done only on-site. Then, the user can essentially download patient information, including attending, group and team consensus, basic demographic data, medication lists, allergies, vital signs, labs, radiology reports, transcribed notes and billing with more features expected down the line.

Kennis said a short implementation timeline is important because “you don’t want to become frozen thinking about how the system has to be perfect. Get it out so you can get feedback from the pilot physicians.” The time from the initial thoughts to implementation was just eight months at United Health. The team developed iCare on its own, without vendor assistance, using the Apple platform.

iCare cost the organization about $50,000 and two full-time equivalents (FTEs)—one who performed front-end iPhone programming and one to do server management.

Residents and hospitalists make up just over half of iCare users but another 39 percent are attending physicians. Kennis said those attending are pulled in by the residents. Forty percent of users access problem lists, not just to review but also to add to the list. She said that of more than 65,000 bills submitted in 2011, the mobile billing supported by iCare has contributed to a significant decrease in lost charges.

Because iCare is not cumbersome, Rehman said that it provides mobile device use the way he thought physicians want it the most. And, with patient hand-off points being the weakest spot in the care continuum, the system provides an opportunity to prevent errors. The next three priorities for iCare, Rehman said, are getting health information exchange data flowing with other data, improve the sign-out process and implement computerized physician order entry.