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Smart Phones Finding Voice in Health Care
Health Data Management Magazine, February 2006
"It's awesome to carry only one device," says Diamond, also a clinical assistant professor at the University of Washington School of Medicine, Seattle. "When I was using a cell phone and PDA, I sometimes wouldn't have both devices with me, so I either couldn't make calls or get the information I needed."
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Like many early smart phone adopters, however, Diamond isn't using his device to enter patient data or access complex clinical software or the Internet. "Data transmission speeds are slow and the memory capabilities are too limited," he says.
Smart phones, which have been on the market just over two years, are designed to be converged devices that provide the application functionality of PDAs with the voice capabilities of cell phones. They run on a variety of nationwide mobile phone networks, and some models are embedded with technology that enables them to be used over Wi-Fi networks.
Converged devices always generate a buzz when they hit the marketplace, and smart phones are no exception. However, like many first-generation technologies, the devices still have a ways to go before they match the hype.
"There are some kinks-including limited battery life-that need to be worked out before smart phones are widely adopted," says Lynne Bishop, an analyst at Forrester Research, Cambridge, Mass. "But they are still in their first generation, so users have some legitimate gripes about their limitations."
But there are encouraging signs for smart phones, Bishop believes. Adoption has been slow, but that can be expected because of the limited amount of health care applications for smart phones. However, clinicians have been more eager than general consumers to use the mobile devices because they are well suited for care delivery, Bishop says.
"There are many productivity and patient care benefits that can be gained by using smart phones in health care," she says. "We're still in the early phases of their use. But as more application vendors make their software available on smart phones and wireless infrastructures are upgraded and extended, this is the way medicine will go."
Early kinks
A plethora of clinical software vendors recently have designed applications that can be stored on smart phones.
The problem is that the devices have very limited memory compared with more established mobile hardware. For example, the Treo 650 has only 32 MB of memory, while Palm's LifeDrive PDA has 4 GB.
Diamond, who's using an earlier version of the Treo, quickly ran out of memory for his smart phone. He stores some reference applications on a flash card, which fits in the SD card slot on his smart phone. But limited memory is preventing him from purchasing more clinical reference applications for the device, he says.
Some smart phone applications don't require data to be stored on the devices. Many of these systems are designed to mobilize legacy software that runs on local area networks. But provider organizations often must make expensive upgrades to their infrastructures to ensure that they have the Wi-Fi signal strength or necessary connectivity to mobile phone networks to support these applications on smart phones, says Bishop, the consultant.
The price tag for such upgrades often is too high for small hospitals or group practices. As a result, smart phone adoption has been mostly limited to physicians who practice at large facilities that can afford such infrastructure, she adds.
Northeast Medical Center Hospital decided that smart phones could be worth the costs of infrastructure upgrades. The Humble, Texas-based hospital enhanced its mobile phone network coverage in part for a smart phone pilot study.
About 30 of the hospital's 300 physicians are using smart phones to access the organization's main clinical information system, from Reston, Va.-based QuadraMed Corp.
Northeast Medical Center is using software from Boston-based PatientKeeper Inc. to provide mobile access to the system. The I.T. department purchased the smart phones, but requires physicians to pay for data and voice services, which are provided by Sprint Corp., Overland Park, Kan.
Norman M. Sorgen, M.D., uses a Treo 650 smart phone to access patient data, including radiology reports, while making rounds in the hospital or doing everyday tasks-such as waiting in line at his bank-before heading to work. He also uses it to call colleagues if they have any treatment questions.
The hospital's I.T. staff had to talk Sorgen into switching to the Treo from his Palm PDA. But he now says his new device provides a lot more functionality.
"I can use my smart phone at the hospital, but it also enables me to access data while I'm not there," he says. "Now when I'm at a ballgame or at a friend's house, I can pull up patient data quickly and quietly."
Northeast Medical Center is playing to smart phone strengths-providing anytime, anywhere access to discrete bits of read-only data. Some industry observers question whether smart phones are suitable for more complex functions such as data entry.
"Smart phones are excellent devices for fairly singular applications, such as charge capture, or to look up lab data or other clinical information," says Bill Crounse, health care industry director for the health care and life sciences division at Microsoft Corp., Redmond, Wash.
Microsoft's Windows Mobile operating system runs on smart phones from a variety of hardware vendors. "But smart phones are never going to be the device for physicians to use for data entry while rounding. They need a bigger screen for that. Smart phones are good for delivering specific data to the point of care."
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