Despite the growing availability of unified communications systems, clinicians are cobbling together a variety of mobile devices to suit their needs, according to a study released last month. The continued dependence on paper-based systems and lack of standardized tools and processes are impeding efforts by physicians and nurses to effectively communicate with colleagues and patients, the report says.
"Healthcare Without Bounds: Trends in Mobile Communications," released by The Spyglass Consulting Group, was based on over 100 in-depth telephone interviews with physicians and nurses and examined how mobile communication devices could improve clinician mobility and responsiveness, enhance patient safety, and reduce communications costs.
"Clinicians interviewed do not believe there is an ideal mobile communications device," says Gregg Malkary, managing director of Spyglass. Sixty-seven percent of clinicians interviewed carry two or more mobile communications devices (mobile phones, pagers, etc.), allowing them to communicate with specific networks of people or perform certain job functions. One physician reported simultaneously carrying six mobile devices on a utility belt, each for a different use.
Respondents were interviewed over a four-month period beginning in July. On the whole, they said they lacked the "tools to filter, manage and prioritize communications" and reported their communications workflow "tended to be an ad hoc manual process involving handwritten notes and verbal communications that are frequently illegible and incomplete."
Pager use still dominates (used by 81 percent of physicians, 53 percent nurses), because of low cost and excellent in-building reception, followed up smartphones (59 percent physicians, 63 percent nurses) and VoIP (19 percent physicians, 41 percent nurses). Many purchased their mobile communications devices themselves but wanted a more sophisticated communications device capable of unified messaging, accessing reference materials, on-line directory service, and clinical applets, but "there is no killer application driving physicians to purchase any particular type or brand of device."
Seventy percent of clinicians interviewed believed their organizations lacked the appropriate infrastructure, whether cellular coverage or WiFi, to support efficient mobile communications. Other reported roadblocks, including systems integration with existing hospital information systems, lack of technical support, and security and privacy issues.
An assistant medical information officer at an academic medical center in California explained, "My IT department will not let my WiFi-enabled smartphone access the hospital's information system for fear that my device could introduce vulnerabilities or viruses into the network."
Mobile computing has grown significantly over the years through the use of standalone knowledge-based applications, with a large number of physicians independently purchasing their own handheld devices, used primarily for drug reference databases, reference manuals and medical calculators. But according to hospital administrators interviewed, obstacles to mobile computing usage include physician adoption, funding, protection of patient information, and the complexity of integrating mobile devices with legacy-based systems.
The Spyglass conclusion wasn't overly rosy either: Mobile communications solutions themselves still need to evolve and clinicians still need more compelling financial incentives from payers and their own institutions to spur greater adoption of new mobile technologies..
"Healthcare organizations are having a difficult time calculating the ROI for mobile communications solutions, because many of the derived benefits are considered soft, including improved communications, enhanced patient safety, and reduced risk of medical errors," says Malkary.