Tablets in Hospitals: Mitigating Risk for Successful Use

It’s no coincidence that the iPad Mini was made with proportions that fit perfectly into the pocket of a medical professional’s standard lab coat. In fact, one in three physicians surveyed recently by Epocrates said they are planning to purchase an iPad Mini for this reason. But there is more behind the tablet’s popularity with clinicians than its convenient size.

Tablets allow medical professionals to quickly view and share patient data, software, and images; a doctor may connect remotely with patients and colleagues at a moment’s notice. As a result many are jumping at the chance to create slings and hands-free apparatus to cater to the growing presence of iPads in a variety of clinical environments.

Healthcare designers take heed: there are a number of risks associated with greater mobility that need to be considered as we continuously move away from pad and pen.

A plastic cover allows sterile use of tablets in the operating room.

I. Potential Risks

• Threat of potential security violations With the utilization of wireless communication in health care immediately comes discussion of potential security violations. For instance, Dropbox cloud storage is commonly used to share information (i.e. medical records) between two or more parties, and is popular among medical professionals. But according to the Dropbox website, the service is not HIPAA certified.
• Misplaced Tablet A more likely scenario might involve somone physically misplacing their tablet - a side effect of carrying it to and from work, or even throughout different areas of the hospital.
• Risk of Germ Transmission If the iPad is going from patient to patient (abiding by proper sterilization methods to avoid germ transmission), it may eventually be carried home on the train, and go from briefcase to living room. Some hospitals are attempting to mitigate the risk of transmission by using disposable or cleanable cases that can be sterilized in between uses. Physical security and hygiene are of paramount importance, which is one of the reasons ‘Computers-On-Wheels’ are kept solely in the hallways of the hospital.

Bringing a tablet from bay to bay requires meticulous sterilization.

II. Impact on the Patient-Provider Relationship

• Practitioners must be careful not to let the convenience of technology override their inherent social responsibilities as givers of care.

An article in the Society of General Internal Medicine Forum also explored the negative effects of mobile device usage on doctor-patient relationships. They note the importance of doctors developing intuitive bedside manner, and that information gathered from the patient themselves (rather than from staring at information on a screen) is an invaluable resource. Actively listening to patients and establishing emotional trust are core activities that cannot be neglected.

Used wisely – and with the patient in mind – tablets become a foremost tool for ministering communication between health care professionals, their colleagues, and their patients. A surgeon may utilize her tablet to demonstrate the basics of a procedure to a prospective patient during the initial pre-op appointment. A nurse might use his iPad to provide educational material to a patient being discharged, ensuring proper recovery behaviors and procedures are followed at home.

Tablets can inform interactions, increasing understanding and efficiency. As health care evolves into an information science, no real progress can be made unless the user’s experience is given priority over all else.

Like any new technology, tablets are still under continuous improvement: ever-increasing capabilities, size, and cost of use. For this reason, Ximedica foresees the use of applications in clinical environments overtaking that of paper. To address HIPAA and sterilization issues, perhaps tomorrow’s progressive healthcare experiences will be equipping every admitting patient with their own tablet for use, allowing the patient to participate in their own care continuum with access to Electronic Health Records, lab results, a digital nurse call button and an in-hospital entertainment system.

Sources/Further Reading:

http://www.sgim.org/File%20Library/SGIM/Resource%20Library/Forum/2012/November2012-02.pdf
http://appleinsider.com/articles/12/11/02/physicians-excited-about-lab-coat-pocket-ability-of-apples-ipad-mini
http://www.fastcompany.com/3004129/your-doctors-ipad-good-your-health