Thursday, November 4, 2010

Ipads in the ER

Okay, so I am  a huge Apple fan but I haven't jumped on the Ipad wagon yet. I am still waiting for a better Iphone 4 to come out so I can upgrade my phone. However, I think this is a great idea. However, I feel that we should also have a Plan B when technology fails.


Much as consumers have loved Apple’s iPad since it hit the market in April, busy physicians have been prominent among its early professional adopters. John D. Halamka, Chief Information Officer at Beth Israel Deaconess Medical Center in Boston (BIDMC), bought one as soon as they came out and blogged about their usefulness in daily rounds.
“The Emergency Department is the perfect place for an iPad because all our ED workflows are web-based, wireless and iPad compatible,” he told me. “Since June, I’ve seen increasing numbers of clinicians use the iPad because of its light weight, its battery life, and the easy of keeping it clean.” The last is no small factor, when you consider how cluttered and grimy the standard hospital workstation can become.
Clinical web based applications that physicians normally had to access via the workstation can now be accessed from the patient’s bedside. According to Halamka’s colleague Larry Nathanson, “The EKGs look better onscreen than on paper,” he wrote in a guest post for Halamka’s blog in April. “It was great having all of the clinical information right at the bedside to discuss with the patient. The only problem was that the increase in efficiency was offset by the patients and family who wanted to gawk at it.”
Doctors in the ER are on their feet for hours at a time, which is exhausting. Having a tool that is light, and more importantly lasts for 10 hours without a recharge, is what has helped transform more than a few ERs around the country. Extra bedside time with the patient is no small thing in these days when doctors are already overworked. But when you add in the quick updates to records and notes a doctor can make on the fly when the nurse grabs him or her in between floors, the increase in efficiency is significant.
Web-based electronic health records and other existing clinical software that can be accessed via the iPad’s Safari browser are the most useful applications. But as you would expect there are also apps being developed especially for MD iPad users. “The most popular application is the medication reference tool ePocrates,” according to Halamka, which works on both iPhones and iPads. Also, Nuance Dragon Dictation voice recognition software, which was developed for the iPod and iPad, is something clinicians find very valuable as well.
But BIDMC at least is not limiting itself to just what’s available from app developers. According to Halamka, “Our programmers are planning to build a few iPad native applications that enrich the user experience over the standard web browser access to our electronic health records.”

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