News 10/28/12

KLAS issues a new report titled Mobile Healthcare Applications: Can Enterprise Vendors Keep Up? I don’t usually read KLAS reports, but this one was particularly interesting to me for a few reasons. The biggest issues with mobile relate to data entry, security, and assurances all important data is viewable over mobile. One thing that shocked me was the finding that 94 percent of organizations support Apple iOS. The reason for this is the popularity of bring-your-own-device (BYOD) policies. Below are some specific highlights from the actual report.

overview 
Above are the overall ratings for the major EMR vendors across four categories. Epic gets the most consistent positive ratings, but no vendors earn high ratings for data entry. I don’t think mobile will ever be a good place for documentation, just like I don’t think I’ll ever create presentations or large documents on mobile devices. Not so surprisingly, the majority of mobile access is enabled with virtualization software such as Citrix. How high can the usability ratings be for software that  was never intended to be used on the smaller form factor?

MDMA
Above is a list of the different mobile device management (MDM) services used. I’ve written about MDM before and was surprised to see that 35 percent of respondents are using some form of MDM, though maybe I shouldn’t be surprised considering the popularity of BYOD. It looks like MobileIron, Good Technology, and AirWatch are the most popular MDM vendors.

I think whenever anybody mentions mobile EMR and documentation, the first thought is always that it will happen with voice, not typing. Nuance definitely hopes so, and its products are now available on Epic’s EMR apps for the iPhone and iPad.

ipads
The iPad Mini, along with some other new Apple products, were announced earlier this week. All of the talk is about how this new mini iPad will fit in a white coat pocket so docs will prefer it to the larger iPad. I think it’s not just the pocket-fitting aspect that makes it superior for truly on-the-go people. I have friends that have been raving about the Nexus 7 and what a great size it is to have with you all the time. I’ve always felt more comfortable using my iPhone over an iPad if I’m just sitting on a couch or on the go. But when I travel now, I sometimes only bring my iPad (with a keyboard) and not my laptop, using the iPad more like a portable computer and less like a touch device. I think the iPad Mini will feel more comfortable to hold and use for consuming information. For clinicians, the experience is going to be crappy regardless of tablet size if viewing virtualized desktop screens, and I really don’t think mobile EMRs should be heavily used for data entry (order entry is the exception). With that in mind, I think you could create great native mobile EMR apps that users will be more than happy to view on this smaller screen size.

Rock
Rock Health announces its newest class of startups. You probably haven’t heard of most of them. There are companies doing obligatory functions such as addressing readmissions, finding home care, and gamifying wellness. Others on the list are more interesting, though I was surprised to not see more of a range and more newness in terms of concepts. I’ll do a write-up on the companies in the class this weekend. Rock also added Kaiser as a partner.

Speaking of new incubator classes, Healthbox recently announced its London class. Desktop Genetics seems the most interesting to me as it is trying to make DNA synthesis capabilities more widely available.

Not long after AirStrip received its patent for mobile remote patient monitoring, it filed a patent lawsuit against mVisum. I spoke with Alan Portela and Cameron Powell when the patent was issued and they made clear that AirStrip would defend its intellectual property.

In more AirStrip news, the company signs a strategic partnership with Vanguard Health Systems. Vanguard will roll out the AirStrip mobile platform system-wide (28 facilities) with Cardiology, OB, and Patient Monitoring. It will also be an early adopter for new AirStrip applications.

How confident are you that the quantified self movement will make inroads in medicine? I’m still a bit skeptical myself, though I think the comparison can be convincingly drawn to other technologies where the early adopters launch an industry that eventually becomes mainstream. Eric Topol, MD says he prescribes more apps than medications these days, which is an impressive statement from any physician, especially a cardiologist. To me, Dr. Topol is the physician early adopter that has to be used as a model for other physicians. That’s how the quantified self movement goes mainstream.

In a story that I think is related to the quantified self and mainstream medicine, Kaiser launches an initiative to collect and integrate exercise information and include it in the EMR as a vital sign. Making this information easily viewable and analyzable by clinicians is a key early step. Some will say that just providing the data to the patient will drive behavior change, but I’m less confident in that.

A new evaluation of physicians who use Twitter finds them to be an active, well-followed group. The group looked at 1,400 physician tweeters. I’m not that surprised as these docs are likely social media-curious active early adopters, and probably the early members of services like Healthtap and Doximity.

A new study on the reliability of health information for pediatric conditions (specifically pediatric orthopedic conditions) finds that it is not very reliable. It impressed me that even academic sites did not score very highly.

A new survey of 106 pediatricians finds almost 60 percent of them use text messaging for work-related messages. Not all of these messages represent HIPAA violations, but I’m sure a certain percentage of them do. The message of the article is that hospitals have not been able to keep up with the rapid adoption of smartphones and BYOD.

TGphoto
Travis Good is an MD/MBA involved with health IT startups. More about me.

  • Christopher Wasden

    It is interesting to think of doctors prescribing apps versus drugs for several reasons:

    1) 1/3 to 1/2 of all drugs don’t work for the patient anyway, so apps are more likely to be more efficacious than a drug on average

    2) 1/2 of all patients don’t take their drugs, so if half don’t follow their app they share the same level of utility

    3) 1/3 of drugs taken often have an adverse reaction or effect, where as few apps have such a reaction

    4) most people’s healthcare problems, especially in the chronic space, are a byproduct of bad behaviors or habits, therefore an app that can help correct these behaviors eliminates the need for a drug

    If you believe these four things, then what Dr. Topol is doing is the best practice than a physician can follow.

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