Mobile EHRs-An Overview

November 30, 2012

The mobile EHR age is upon us.  From Androids, to iPhones, to iPads, to other tablets and mobile devices, technology and the information that comes with it is increasingly becoming available anytime and anywhere.  A recent study from Pew Internet showed that 85% of Americans own a cell phone, and of that group, 53% own some kind of smartphone.  The healthcare industry is impacted heavily by this knowledge and there has been much pressure on software developers and healthcare organizations to create health-based applications and portals for patients as well as equip physicians and providers with mobile EHRs.  From the provider perspective, there are many potential benefits of mobile EHRs including easier documentation, more efficient use of time (especially with the patient), and more immediate access to important records which affect the course of treatment.  However, before these benefits are reaped, it is essential to identify which devices are suitable to house EHR software and the challenges associated with creating a usable platform that maintains confidentiality on a personal device.

Mobile EHR Devices
Electronic health records are robust.  Any software developer or EHR user can tell you how intricate and complex EHRs can be and how much highly confidential and personal information they store.  This begs the question, if it can be so difficult just to get EHRs up and running on desktop PCs attached to hospital servers, how is it possible to transfer all of this usability and information to a mobile/personal device?  There is no simple answer.  A recent KLAS study found that this issue is weighing on healthcare IT leaders.  The respondents (most of whom were C-level health IT execs) stated that security and management of mobile devices are amongst their top concerns.  With HIPAA laws and other confidentiality requirements, security is perhaps the most difficult aspect to navigate.  Encryption must be key.  While EHR vendors have some responsibility to develop products that offer security features, healthcare facilities must create and enforce strong security policies.

Beyond security, there is the issue of which devices can utilize EHRs and in what context.  A survey by Vitera Healthcare showed that 9 out of 10 physicians would like to be able to use EHRs on their mobile devices.  Furthermore, 72% of the respondents stated that they were already using smartphones, iPads, or other tablets for communication or medical research purposes and most wanted to expand their usage with EHRs.  Many challenges can arise when trying to bring an EHR to these devices.  For example, smartphones have issues with small screen and key size.  iPads and tablets are restricted to touch screen use.  This has prompted some software companies to focus on offering core aspects of the EHR for mobile devices such as reviewing charts and sending tasks rather than recreating all of the features of a desktop EHR.  However, some companies like Epic and Cerner have created voice-enabled applications in which the physician is able to capture notes and navigate software just by using his/her voice to offset this issue and bring more functionality to mobile devices.

Mobile EHR Benefits
Assuming that a physician has access to a mobile EHR, he/she can now see many benefits when providing care.  A mobile device eliminates the need for the physician to leave the room when seeing patients to bring up the EHR, which translates into more immediate access to relevant medical information and more face time with the patient.  This also can reduce errors as the physician is able to take notes and documentation in real time.  In addition, the mobile EHR solves the issue of physicians often working in multiple locations; they have the information they need with them at all times.  In addition, mobile EHRs coincide with the patient’s expectation for the physician to be on the cutting-edge of technology and have all the answers at his/her fingertips.  Overall, the mobile EHR offers a new level of efficiency and accuracy that has not been seen before.  Add this to the demand of physicians to enhance the devices they are already using for work, and the platform is a win-win.

As mobile devices become even more popular and functional, expect mobile EHRs to become commonplace.  It would not be surprising to see Meaningful Use requirements for mobile device implementation and security in the future.  While mobile device management will be yet another task for health IT leaders, the benefits seem to outweigh the challenges.