September 2014
By Tom Stibolt, MD, Mobile Musings Column Editor
Pundits continue to claim that physicians are becoming ever-more connected. According to a number of studies, the majority of us are using an electronic medical record (EMR), and the majority of that group is struggling to adapt. Many EMR’s can improve patient-doctor communication, but this only works for patients who are willing to use websites for this communication. Many of the current EMR systems support some form of mobile use, although the mobile applications are limited when compared to the desktop versions. My desktop currently employs two high-resolution monitors, which is impossible to duplicate on my mobile devices or tablet.
An area that holds some promise is remote monitoring and data gathering for patients with complex diseases. The technology allows monitoring of weight, activity, and other parameters. The hope is that this may be useful in preventing hospitalizations by allowing intervention before major problems occur. Video communication with patients is often a part of this and allows a remote office visit, which is useful for non-mobile patients. The technology is evolving with much of it requiring a trained technician at the patient end.
It is hoped that these new tools will reduce costs and improve diagnoses. However, this depends on the ability to share data across different systems, which currently is a major challenge. The U.S. government is promoting this, but it is not clear that even that will make data sharing very easy.
Marketers and developers are attempting to push the envelope in these areas. They note, however, that many physicians are skeptical. This seems a reasonable position to take. There is concern that data sharing may result in too much government intervention, loss of patients to other practices, and inappropriate data releases. The latter are happening at an alarming rate. Many physicians have come to feel displaced by outside powers whose interests are often at odds with theirs.
This is not to suggest in any way that physicians are against technology. At least two-thirds of us use technology regularly even outside of our EMR use. Studies also show that we have an interest in new technology that actually does improve patient care.
A recent survey of physician perceptions and behavior found that three-quarters of physicians use mobile applications. The most common use was medication reference, including drug interactions. This makes a lot of sense since these applications are ideal for use at the point of care. Other uses were much less common, including using mobile apps for diagnosis, accessing an EMR, viewing diagnostic images, prescribing, and writing notes.
The same survey asked what applications physicians were interested in having. Over half were interested in mobile access to their EMR system with smaller numbers interested in secure texting with patients or other staff, point of care access to drug, device or diagnostic information, patient scheduling, and remote monitoring.
I think all of these are possible, especially as mobile devices become more powerful, communications more reliable, and applications that are easy to use are available. Until then, I too remain skeptical.