7 things to consider when choosing mobile devices
■ A practical look at information technology issues and usage
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For physicians who want a mobile device, what's the best choice -- a smartphone or a tablet? Or both? Or something else? Experts say the answer depends on how a physician is planning to use the device, and where.
Frost & Sullivan, a business consulting firm, published a white paper that looks at the decision-making process of adopting one or more major wireless devices -- smartphones, tablets, push-to-talk and machine-to-machine (M2M) monitoring tools, such as home monitoring instruments that send data to an electronic medical record. The paper, which received financial support from Sprint, says the decision can be broken down into seven criteria: functionality, usability, security, network connectivity, durability, application availability and price.
"Using these criteria to finalize device selection can result in choices that help address three of health care's greatest challenges: controlling costs, delivering high-quality and easily accessible patient care, and complying with government and industry regulations," wrote the authors of the report.
So how do physicians assess the seven criteria?
Functionality. Doctors need to define their mobile device requirements in terms of what they want to accomplish, which should include projections three to five years out, according to the authors of the Frost & Sullivan report. Knowing the planned uses of the device may help determine which features would be most effective. If a doctor wants to use an instrument device for patient education at the bedside, for example, he or she needs to think about which device would be easiest to use and most effective with the patient.
Usability. "How you interact with your device is going to go a long way towards how happy you are," said Bob Kernen, vice president of products for service and technology vendor, HCPlexus. He used the example of touch screens versus hard keyboards. Most devices are touch screen, which is great, he said. But "if you have big ol' meat hooks like me, you may like the tactile quality of a hard keyboard." Keyboard attachments are available for tablets, or a physician who doesn't want to use a touch-screen keyboard might prefer a small laptop.
Usability also includes how easy the device is to carry. Whether the physician is solely in an office or a hospital environment, or divides time between the two, will have some bearing on the decision. The Frost & Sullivan report found push-to-talk devices (think walkie-talkie functions on a cellphone) would be more useful in a hospital than in an office.
"If a physician has a purely office-based practice and there is a computer in each room with Internet access, a smartphone with simple clinical tools and apps may suffice," said Kevin Moynahan, MD, deputy dean for education and associate professor of medicine at the University of Arizona College of Medicine in Tucson. The medical school is starting to hand out Apple iPads to all of its incoming students, because it believes they will continue to use them after school and residency.
Dr. Moynahan said that although smartphones will remain a part of medicine because of their size and convenience, the screen size presents a challenge when it comes to clinical care and research. The tablet makes sense for those who travel from one location to another -- such as students and residents who rotate through many types of practice settings.
Security. Physicians are obligated to protect patient information. Therefore, how well a device can be secured should be an important consideration. According to the Frost & Sullivan report, the instrument should have strong encryption and authentication capabilities. For large deployments in hospitals, the report recommends tools that can be managed from a central location. This would allow the device to be locked down, or wiped clean of its data, remotely. Ideally, the instrument would be integrated easily with existing IT infrastructures. All mobile products promise some level of security, so physicians should research the security functions of each device under consideration to see if they are comfortable with what is offered.
Network connectivity. Mobile device users must decide what kind of network they need to run the instruments they plan to adopt and ensure that the networks are reliable.
Harry Greenspun, MD, senior adviser of health care transformation and technology at Deloitte's Center for Health Solutions, said one of the reasons physicians still use pagers is that hospitals have a very challenging telecommunications environment.
If it's necessary for a physician's mobile device to be synced with the hospital's health IT system, he or she may want to consider whatever tool is being provided by the hospital or supported by it. If hospital infrastructure isn't a consideration for office-based physicians, there are other issues to consider, such as choosing the appropriate mobile partners.
Selecting the appropriate mobile partners, such as carriers, software application vendors and systems integrators, is just as crucial as the device a physician chooses, said Jeanine Sterling, senior industry analyst of mobile and wireless communications at Frost & Sullivan. A powerful instrument with many uses becomes less desirable if it's linked to a slow, unreliable network.
Durability. Not only do the mobile devices have to sustain drops or falls, they also need to handle regular disinfecting. Many third-party vendors provide rugged cases for several instruments. The cost of the cases needs to be considered when looking at the total expense of ownership.
Availability of applications. "If your doctor's electronic medical record system provider has an iPad app, then that is the device you are likely to see in the office," said Michael Griffith, associate director of BioCommunications at the University of Arizona College of Medicine.
The report said physicians need to consider how many apps are available for the device. It also warns that instruments with few available applications could be discontinued due to lack of viability.
Dr. Greenspun said activity at the federal level may play a role in what applications a physician wants to adopt. The FDA, for example, recently published proposed guidelines for when a mobile application developer should seek FDA approval for use of apps as a medical device.
Price. Although price continues to be a barrier for many IT purchases when it comes to mobile devices, there often are ways to save money. Signing long-term service contracts can lead to better pricing.
"If you follow these criteria ... they should lead you naturally to the specific brand or brands that will work best for you," Sterling said. For most physicians, that will mean decisions on more than one instrument.
"The expectation is that more than one wireless device type will be the norm within the physician's office environment," she said. "We can easily envision smartphones, tablets and M2M remote monitoring solutions all being used to address different caregiver and patient needs."