Physician demand driving more EHRs to go mobile

Since initial rollouts, vendors are scrambling to develop smartphone and tablet applications that go beyond replicating the desktop record on smaller screens.

By — Posted June 17, 2013

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Vendors of electronic health records are making a push toward giving physicians what they want — a system with a mobile component.

Of the 710 vendors tracked by Black Book Research for a May 30 report, 36% say they have implemented or are working on implementing a mobile app that will give physicians on-the-go access to their patient records. Black Book said the vendors are reacting to physician demand.

The same report found 89% of primary care and internal medicine doctors using smartphones, and 51% of all physicians using tablets. Of those doctors shopping for a replacement EHR system, 100% told Black Book that a mobile app is a must-have feature.

“A mandate has been issued, and progressive vendors are reacting,” said Doug Brown, managing partner of Black Book Research, a technology market research firm in Clearwater, Fla.

Overall, 17% of vendors have a mobile app available now, according to Black Book. Brown said vendors who were most aggressive about getting their products ready for the federal meaningful use program are the ones most likely to offer, or to be developing, a mobile version. Thirty percent of vendors that have clients who already have received incentive money have developed a mobile app, and 22% of those with products eligible for meaningful use have developed an app, he said.

The research firm estimates that 48% of all EHR vendors with meaningful use clients will have a mobile app by the end of the year, Brown said in an email to American Medical News. The federal incentive program pays physicians up to $44,000 from Medicare or nearly $64,000 from Medicaid for the meaningful use of EHR systems.

Black Book published results from a survey of nearly 17,000 physicians in February that found many of the physicians who adopted systems intending to apply for the incentive funds may have rushed into a decision they later regretted, as 17% were making plans for a switch within the year. At that time, Brown said the push for meaningful use created an artificial market for immature EHR products, and that those vendors who wanted to survive needed to better address the needs and wants of their physician clients.

The May report followed up that contention with evidence that “a full 100% of practicing physicians participating in the follow-up poll expect EHR systems that allow access to patient data wherever physicians are providing or reviewing care,” Brown said.

The HIMSS Electronic Health Record Assn., a trade organization that represents EHR companies, declined to comment on the survey findings, saying it does not respond to market trends, especially as they relate to competitive activities.

Physicians want more out of devices

Black Book found that despite physicians' widespread use of mobile devices, fewer than 1% of doctors said they were maximizing use of them.

Smartphone owners are primarily using the devices to communicate with other staff members, and tablets are used primarily for online research, the survey found. Only 8% of office-based doctors are using smartphones for electronic prescribing, accessing tests, ordering tests and viewing results. But 83% said that if their EHRs offered mobile access to those features, they would use them.

While having mobile access is a must-have for those in the market for a new EHR system, physicians do not appear interested in replacing their desktop EHRs with mobile ones. Instead, they're looking to mobile features for specific tasks within the EHR.

“The vast majority of all survey respondents favored mobile applications that focus on the patient data and core parts of medical practice most needed when the physician is away from the office setting,” Brown said.

A 2012 survey of 152 tablet-using physicians published in December 2012 by CDW found that doctors spend an average of 31% of their total computing time on that device. The rest of the time was divided between desktops, laptops and smartphones.

Black Book also found that vendors who already were offering mobile access may have some tweaking to do to keep physicians using their systems. Many doctors reported that apps were difficult to navigate or were not optimized for the device they were using.

The biggest reported issue with mobile apps, at 95%, was the device's screen size. Eighty-eight percent of physicians said they also experienced difficulties with the ease of movement within the mobile chart. A chief mistake many app developers made initially was to replicate the desktop record onto the mobile app, which 83% of users said they did not like. Instead, doctors preferred simplified versions of the record on their mobile devices.

“The global application market is expected to grow 500% by the end of 2014, primarily because of the meaningful use incentive program, but the marketplace remains crowded, and overall physician usability and approval are the main factors that will keep vendors competitive,” the report said.

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Mobile access to EHRs a popular option

A survey by Black Book Rankings shows that these specialties anticipate the highest use of EHR applications on mobile devices:

Specialty Users
Hospitalist medicine 100%
General practice and family medicine 98%
Internal medicine 97%
Rheumatology 88%
Nephrology 87%

Source: Black Book Rankings

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External links

“CDW Tablet Poll,” CDW, December 2012 (link)

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