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Mobile Tech: One App at a Time
December 1, 2007
Executives at Columbia, Md.-based Howard County General Hospital used a variety of criteria to select a wireless bedside specimen collection system last year.
They spent several months evaluating the cost, functionality and other customer implementations for five systems before choosing the MobiLab application from Iatrac Systems, Boxford, Mass. They also ensured the software could integrate with the 200-bed facility's hospital information system, from Medical Information Technology, Westwood, Mass.
Howard County executives, however, didn't do the same due diligence to select mobile hardware for the system. While the software is hardware "agnostic," executives decided to purchase the same PDAs, from Motorola Inc., Schaumburg, Ill., and mobile printers from Zebra Technologies Corp., Vernon Hills, Ill., that a few of the vendor's other customers use.
The specimen collection system, however, is the only application Howard County is using with the new mobile hardware. The facility's hospital information system doesn't support PDAs, so it doesn't have any other applications that can be used on the devices, Edwards says.
Howard County already uses other mobile devices that both systems can run on, such as mobile carts from Stinger Medical, Murfreesboro, Tenn. It also has other Symbol handheld devices tethered to the carts that nurses use to scan bar codes on patient wristbands and drugs during medication administration.
But the hospital didn't balk at purchasing new hardware just for the specimen collection system because it wanted to ensure a successful implementation, says Rick Edwards, senior director and CIO.
"We got favorable references on the devices from the vendor's other sites," Edwards says. "There also aren't a lot of PDAs and mobile printers on the market that are ruggedized and have the bar code scanners we needed for this application."
After implementing the specimen collection system, Howard County began an initiative to enhance its wireless network to better support its various mobile hardware and software. While he's looked into converging mobile technologies and strategies across the hospital, Edwards says it likely wouldn't work.
"It would be nice to standardize the PDAs and scanning devices we use," he says. "But because of the reality of the applications and how they work we haven't been able to do it."
Managing Multiple Devices
While many hospitals are deploying mobile hardware and software for various applications, most, like Howard County, haven't developed an enterprisewide strategy to bring them all together, many industry experts say. Even if they did, however, an enterprise game plan would be difficult to achieve -vendors offer mobile hardware, wireless infrastructure and clinical software that doesn't always play well together, says Cary Brown, senior consultant at Tower Strategies, a Houston-based consulting firm.
"Mobile applications should be driven by the vision of what you want to do and that usually starts with the software," he says. "So most mobile hardware decisions are driven by individual applications."
Disconnected mobile strategies can begin when organizations implement best-of-breed applications with various hardware requirements or clinicians balk at using standardized hardware and software that disrupts their workflow, Brown says.
"The usability of the application and the hardware itself is how most organizations choose their mobile technologies," Brown says. "But there's not one single device that does it all well."
For Howard County General Hospital, automating specimen collection was more important than keeping its number of mobile devices down. Its previous collection process, which involved printing labels at nursing stations before specimens were taken, sometimes resulted in mismatched or unlabeled specimens, says Edwards, the CIO.
Now clinicians use PDAs to access the MobiLab system and scan bar codes on patient wristbands to verify specimen collection. They also use the mobile printers to create matching bar code labels for the specimen containers - all at the point of care. And they use the PDAs to document that a specimen has been collected. The automated process has enabled Howard County to reduce specimen identification errors from 11 per month to one per month, Edwards says.
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