An occasional topic of conversation around the dinner table at my house concerns the value of the smartphone. Per Wikipedia, a smartphone can be described as “a high-end mobile phone that combines the functions of a personal digital assistant (PDA) and a mobile phone. Today’s models typically also serve as portable media players and camera phones with high-resolution touchscreens, web browsers that can access and properly display standard web pages rather than only mobile-optimized sites, GPS navigation, Wi-Fi and mobile broadband access.”
I made the leap up the mobile phone IQ scale several years ago. Today, in my capacity as the medical officer for our company, I find the 24/7 access to information both a blessing and a curse. Connectivity permits me to stay on top of things and when necessary to quickly involve multiple people in the “conversation.” The steady chatter of inbound messages, however, can be distracting.
My wife has refused to make the jump. Also a physician, she represents an odd dichotomy with respect to technology. Not only is the smartphone an absent accessory in her world, to this day she does not have an email address. In spite of this apparent technology deficit, she has used voice recognition with the Acumen nEHR for the past couple of years and managed to be one of the first physicians to collect the year 1 meaningful use incentive. (Where the check went remains a mystery to me, but it clearly was not used to purchase technology.)
Physician smartphone use was recently in the news. According to Jackson and Coker the vast majority of physicians possess a smartphone today. They cite a study by Bulletin Healthcare from April which ranked mobile device use by specialty as follows:
- Emergency Room Physicians – 40 percent
- Cardiologists – 33 percent
- Urologists – 31 percent
- Nephrologists – 31 percent
- Dermatologists – 30 percent
- Gastroenterologists – 30 percent
- Psychiatrists – 28 percent
- Optometrists – 28 percent
- Radiologists – 24 percent
- Rheumatologists – 22 percent
- Endocrinologists – 21 percent
- Oncologists – 20 percent
- Clinical Pathologists – 16 percent
Increasingly we are seeing a wide variety of smartphone apps designed for the medical profession. The opportunities here seem limitless. Beneath the surface, however, lie a couple of growing concerns.
The FDA recently made a splash by announcing their intention to provide oversight for certain mobile medical apps. Of additional interest is the challenge posed by the HIPAA privacy and security rules. As these devices become increasingly sophisticated they will contain PHI at rest. Device security varies significantly across the industry. This can become an issue when a device originally intended for personal use becomes a platform for business, particularly when that business is healthcare. Lost or stolen devices previously created a minor headache. If the missing device contains your patients’ PHI the consequences can be substantially more challenging.
John Halamka is a physician and the CIO for the Beth Israel Deaconess Medical Center and for Harvard Medical School. John blogs about his experience in this capacity and he recently described the challenges his organization faces as personal devices increasingly enter his network. He points to a trend that has been cleverly anointed elsewhere as BYOD (bring your own device).
Increasingly companies are seeing device utilization driven by the end-user experience. Employees (and customers) are selecting devices based on features and functions as well as service coverage, creating a transition from the classic “push” strategy to a “pull” strategy stimulated in part by BYOD. It will be interesting to watch as this trend expands into healthcare.
The smartphone debate at my home typically ends in a draw. (Unless our children are home. In which case, my wife is out numbered.) I would have a very difficult time abandoning the smartphone. But it is, of course, a double-edged sword and on occasion I am tempted to test my phone’s buoyancy.
If you are a smartphone user, please leave a comment and let us know your favorite medical-related apps, or if you are on my wife’s side of the debate, what keeps you from making the leap.
Randy Gertner says
The Up To Date app is amazing—tens of thousands of pages of medical text in my palm. We recently went over seas, and could not use the smart phone. We were much happier and engaged—it was nice to get rid of it for a week. I would love to snap a photo of a patients access or foot ulcer, and click “send to acumen record.” I can do this to deposit a check into my banking account—just take a pic and send. I like the free epocrates app. There is a feature to delete the contents of the phone remotely if it is lost. Great post Terry—I don’t know the answer but just some random thoughts. Love it or hate it, it is here to stay.