This article appears in the January/February 2013 issue of HealthLeaders magazine.
Like a surging tide, the next wave of technology has landed in hospitals, changing the nature of healthcare delivery. Tablet computers are overturning concepts of how clinicians will use technology, raising work-life balance issues, and having a beneficial impact on hospital IT budgets.
Tablet computers have gone from relative obscurity to something approximating the appearance of stethoscopes: Nearly every doctor has one. What's different with this generation of technology is that demand is coming from clinicians rather than being rolled out by IT departments.
"Certainly the iOS devices from Apple are very popular among physicians," says Ferdinand Velasco, MD, chief health information officer at Texas Health Resources, an Arlington-based system that includes 25 hospitals, more than 21,100 employees, 5,500 physicians with staff privileges, and 3,800 licensed hospital beds.
A recent internal survey of more than 2,000 Texas Health–affiliated physicians found that 80% of them have smartphones and 50% have tablets, Velasco says.
The spread of these devices parallels a recent surge in bring-your-own-device—or BYOD—behavior at hospitals. But the so-called consumerization of IT is hardly unique to healthcare, Velasco notes.
Apple's iPad has been the catalyst for tablets in healthcare, says Frederick Holston, chief technology officer at Intermountain Healthcare, a Salt Lake City–based network that includes 22 hospitals, a medical group with more than 185 physician clinics, an affiliated health insurance company, and more than 33,000 employees.
"We have PCs at every bedside, so tablets haven't been a big thing for us," Holston says. "But for us, the word tablet changed with the iPad, and it changed because we had a long-battery-life device that was very light and had a very intuitive user interface that was very responsive and provided what was really missing in tablets."
Unlike many previous iterations of the personal computer, clinicians want to use them, says Jonathan Perlin, MD, CMO and president of the clinical and physician services group at HCA, the Nashville-based for-profit company that includes about 163 hospitals and 110 freestanding surgery centers in 20 states and England and employs approximately 199,000 people.
"We love tablets because our providers, physicians, nurses, and pharmacists have an emotional attachment," Perlin says. "They want to use these devices. That makes uptake really easy, and it improves the security because they tend to store their own personal information, have their own apps, so they guard devices judiciously."
More than 5,000 HCA physicians use tablet technology daily, and Perlin describes the technology as providing a new level of work-life balance for these physicians. He describes a typical day in the life of one of those physicians, starting with the ability to log in to a virtual desktop from home, checking Meditech electronic health records and vital signs from her tablet computer.
"In an electronic age, we couldn't possibly have enough workstations in the hospital, and even if we did, the workstations are in one place," Perlin says. "Tablets allow the information to be securely available anywhere a decision-maker needs it."
The rise of tablets is being matched by the decline of interest in laptops in hospitals. "A lot more clinical services now are mobile and also outside of the hospital walls," says Mark Moroses, senior vice president for information technology and CIO at Continuum Health Partners, a New York City–based system with seven major facilities, 2,180 certified beds, and an annual operating budget of $2.8 billion. "Laptops are kind of clunky when you do that; iPads have a nicer fit in terms of form factor," he says.
"The mobile technologies we now finally have are actually very compatible with the workflow of clinicians," Velasco says. "Clinicians are fundamentally a mobile workforce. They don't work in a desktop or a work office type of environment like in other businesses. They're constantly moving about. They move between their physician office setting and the hospital, and when they're in the hospital, they go from room to room and floor to floor. Even in their own office they're not sitting behind a desk. They're going from one patient room to another, one exam room to another, and to some extent that also applies to the other healthcare workers as well.
"Rather than the old paradigm where we were encouraging clinicians to use these fixed devices, or at least somewhat semi-fixed devices with the laptops on carts or WOWs [workstations on wheels] or COWs [computers on wheels], now they actually carry these devices around, and so the adoption actually is much easier."