- Saturday, 11 October 2014 15:08
QUOTE OF THE WEEK: "We need to bring the exam room to where the patients are." - Dr. Jay Sanders, telemedicine pioneer
Mobile technology is on the cusp of creating unprecedented change in the U.S. healthcare industry. Despite its potential for improving communications and workflow, the pace of mHealth (as the new field is known) has been slothful compared with other industries. However, the scenario is slowly changing, pitting healthcare's complex and costly rigors against the technology's increasingly widespread acceptance and use.
Information privacy and security concerns loom large as impediments. Despite these hurdles, will mobile technology —from texting to imagery sharing in telemedicine consultations and mobile access to electronic health records—keep progressing? Will it reduce costs and improve clinical results by instantly lending health-enhancing information at defining moments? Will patients routinely discharge from the hospital with apps linking them to their providers? Will mobile healthcare ultimately live up to its promise?
The answer lies in how motivated organizations are to invest in technology and training. Much depends on whether there is adequate return on investment (ROI), which includes increased consumer satisfaction. Healthcare providers are notoriously slow to measure technology ROI. For every major academic medical center with massive resources and sophisticated systems, there are thousands of small hospitals and clinics continuing to rely on costly, error-prone manual paperwork, outdated administrative procedures and basic computer hardware and software capabilities. But with competition intensifying, administrators must satisfy patient and clinician expectations, and mobile technology is already a fundamental part of most Americans' lifestyles. Tech industry giants like Google, Samsung, and Apple have all announced ambitious health care integration plans with mobile devices this year.
The aim of making patient information accessible on mobile devices is to boost the efficiency and quality of care delivery with more timely, potentially life-saving treatment interventions. This is a tall task given a convoluted environment regulated by stringent privacy and security compliance guidelines. Healthcare institutions continue to grapple with how best to adopt mobile technology and transform care in an industry that has been especially resistant to change.
Taking the current temperature on this issue are researchers from Healthcare Dive and Spok, who surveyed almost 250 senior healthcare service providers about mobility in their healthcare systems. Most were administrators, but physicians, nurses and clinical staff represented nearly two in 10 respondents to the survey; nearly one in 10 respondents were information technology (IT) professionals. Most of the respondents' organizations were fairly large, ranging from 100 to 500-plus beds.
Healthcare organizations' most common use of mobility (59%) is for mobile access to electronic health records (EHRs). This is followed closely by paging (55%), secure texting (42%), and telemedicine consultations with other providers (35%). By far, healthcare organizations' most common uses of mobile technology to communicate with patients are email (60%) and the online patient portal (55%). Next comes text messaging (32%), with mobile apps and telemedicine consultations at 23%. Its use for home monitoring is below 20%.
As for staff clinicians, nearly two-thirds of healthcare organizations issue mobile phones to them, and most (53%) also issue laptops. About four in 10 organizations issue pagers to clinicians, and 35% issue tablets. Only 13% of organizations don't provide some type of mobile device to clinicians at this point in time.
Nearly three-quarters of healthcare organizations expect to expand the use of mobile technology in the next year, and just shy of 50% are increasing their budgets for it. However, perhaps because of uncertainty over Obamacare's upcoming second year of health insurance exchanges, nearly one-third of organizations don't know whether their budgets for mobile technology will increase in the next year.
Hospitals are starting to outgrow their isolated brick and mortar facilities predicated on heavy inpatient volume to becoming focused more on outpatient services and remote health management intervention. The Affordable Care Act (ACA), by covering previously uninsured Americans and expanding Medicaid, was intended to provide better access to primary care services and reduce unnecessary emergency room use. But many hospitals have documented more ER crowding since the ACA's exchanges initiated coverage in 2014. As a result, hospitals are competing to become (or remain) part of exchange plans' increasingly narrow networks, participating in new care delivery models such as accountable care organizations and trying to comply with ever-changing reform regulations. All this uncertainty could put implementation of mobile health on hold.
For complete survey results: Survey report 2014