Fletcher Allen uses native ActiveSync MDM tools in its Microsoft Exchange Server 2010 servers, as well as the Haiku iPhone and Canto iPad mobile accessibility apps from Epic Systems Corp., its electronic health records vendor. Expanded mobile use, however, has been hampered by limitations in Epic's ability to support mobile computing, McConnell notes. "The challenge for us is to give access in a matter usable on a small touch-screen device and the software has to catch up." Using the EHR on an iPad has been possible but inefficient, as the device is great for looking up data, but not for documentation. Some users do document, using PocketCloud software from Dell Inc. The software creates a virtual keyboard and mouse on a tablet, along with a virtual desktop, but it's a "little clunky," he adds. McConnell expects Epic's next version of the EHR to have much more mobile functionality including touch screen features.
Still, the benefits of mobile computing already have become clear with significant workflow improvement for physicians and nurses, McConnell says. Clinicians are back to using a form factor similar to the clipboard they used before thin clients and PCs were put in exam rooms in 2009.
An iPad essentially is an electronic clipboard with information much easier to find. And mobile users can respond quicker to e-mails. As always though, there is a downside, as e-mail availability does increase interruptions.
The payer view
Some health insurers also are finding the need to develop mobile device management policies. Capital BlueCross in Harrisburg, Pa., "kind of backed into it" about five years ago, recalls Andy Hardy, technology specialist.
Telecommunications firm Verizon resells the Good Technology MDM products and sent 10 free licenses to the Blues plan, which was seeing some personal digital assistants with phone capabilities coming into the enterprise. But the licenses went on a shelf until the first iPhones came out a couple of years later, when some licenses were upgraded and put on a few phones to see how MDM technology worked.
Used to enable employees to access corporate e-mail on their smartphones, the MDM software now has been licensed for about 110 personal mobile devices and 10 corporate devices for unit managers and higher executives, Hardy says.
The software encrypts e-mail in transit and at rest, and can wipe corporate data off a missing device while leaving personal data on it. The corporate users have expanded and role-based read-only access beyond e-mail use. They can access the internal wireless network and additional corporate servers.
MDM users share their lessons
Organizations using mobile device management technologies have learned lessons along the way. Here are a few:
* A core lesson is that there is never a static version of MDM software. Vendors are constantly upgrading functionalities and performance on at least a weekly basis to keep up with provider needs-such as supporting radiologists and home health nurses-and ever-increasing security threats, says Jim Shellhamer: technical systems analyst, Lehigh Valley Health Network, Allentown, Pa. Home care nurses, for instance, no longer carry a three-pound laptop, but a 12-ounce iPad. They can easily show patients their data, and data is encrypted when cellular transmitted or at rest. "The technology is only going to get more prevalent in our lives," Shellhamer adds. "MDM vendors will have to work day and night to keep up."
* It's important to understand just how fast the MDM market changes on a continuous basis, says Alan Dabbiere, chair of vendor AirWatch. "Most people don't realize there is a new version of an operating system coming out every 15 days." And every new version has functionality designed for consumers and not an enterprise. There is no way that health care organizations have the personnel or expertise to track all these versions and figure out how to make them compatible in an enterprise MDM environment. MDM vendors which make tracking and adapting to the changes their problem are the ones to consider, he advises.
* Mobile device management, by its nature, restricts use certain functions on mobile devices, and providers must be prepared for the restrictions. Shellhamer suggests focusing on positive aspects of MDM, such as having mobile access to necessary patient information, while making sure users clearly understand they won't be able to email notes, take photos or put games on the devices. A lesson quickly learned was that facility engineers need an exemption from some restrictions. They need capability to take and transmit photos so that a problem is better understood and a list of materials and an appropriate repair team can be quickly assembled.
* The big lesson for Fletcher Allen Health Care was that supporting mobile devices turned out to be a larger challenge than anticipated, says enterprise architect John McConnell. He has a good I.T. team, but they've spent most of their time working in a Windows PC environment and had a learning curve to master with mobile devices. He suggests getting I.T. staff their own mobile devices earlier in the planning stages, giving them more time to learn the quirks of the technology and how to support the devices.
* Cost was the lasting lesson of mobile device management for Capital BlueCross in Harrisburg, Pa. The insurer is pleased with its MDM services from Good Technology, but licenses cost $140 per device. Buying 120 licenses has brought some sticker shock, says Andy Hardy, technology specialist.
