iPads for doctors?

In My Humble Opinion
1

I’ve never used an iPad or anything like it, so I have zero experience with them.

I wrote web app for doctors, nurses, and PAs to use in the presence of patients. (It gets other uses as well.) The web pages accessed sometimes contain forms, mostly with checkboxes and radio buttons. There is the occasional text field, which usually will have just a little text, but occasionally will have pretty extensive stuff.

Would it be practical for the medical staff to carry iPads around to access the web app? We’re thinking that it would be way easier than finding a desktop somewhere and having to login to the network everytime a patient steps on a scale or turns their head and coughs.

But are there some unforseen drawbacks that we don’t know about? How hard are they to type on? Would it be a drag to lug the thing everywhere? (I can’t imagine they weigh much.) What haven’t I thought of?

2

I saw a nurse with one (or some sort of tablet) this morning, so I don’t think they are too big to lug around. But a less expensive Android tablet might work just as well for your application.

There are attachable keyboards as well, for when the on-screen keyboard isn’t enough.

I like your idea.

3

An Android might work too. I’m not really sure what’s available out there.

Does an Android run Windows? All we really need is a browser that can handle the app, but it would be nice to stay within hospital standards. We’ll stand a better chance of getting this approved.

4

I’ve had two doctors in the last couple of years that carry one of those convertible tablets everywhere, and those weigh more that twice what an iPad does.

5

Android is an operating system, not a hardware device. Android tablets are beginning to appear now.

6

This might be useful/relevant:

1,800 iPads ordered by Ottawa Hospital

7

Ah, good to know. I’m such a newb.

8

How easy is it to keep these machines hospital-clean?

9

Fairly easy, I’d think. The touch screens are made of the type glass that smartphones are; they could be cleaned at the end or beginning of each shift. They can also be operated with a stylus instead of a finger. There are also cases and skins for the devices, which you could probably get in a slick, non-germ-hospitable material.

10

They probably won’t go into the OR. They’ll normally be going places where there are computers anyway.

11

My gynecologist’s office started using laptops 2 years ago. It struck me as both a good and bad idea - good because I like digital info but bad because the laptops seemed SO awkward. Even though they were laptops, they just seemed too big to be carrying around and entering info.

I think an iPad or other tablet would be perfect for what they are used for.

12

My doc’s office is part of a larger health system connected with a major university’s hospital, so funding may not be as much of an issue in as in some places. But, they have a desktop computer, flatpanel monitor, keyboard, and mouse mounted on a movable stand in every exam room. The nurse who does the initial screening puts all of the info. into the system and the doc uses the computer to look at records, enter in what the visit is for and their exam results, and any prescriptions - while in the room with the patient.

Having a full desktop system setup in every exam room, plus the cost of the mounting rig, has to be way more expensive than a stack of iPads that on duty docs and nurses can use. Battery life might be the real issue.

I am not sure Android tablets are as cheap as a basic Wi-Fi only iPad. Most Android tablets seem to be subsidized by cellular carriers, and you would not need that level of connectivity. Either way, they can and are being used in medical contexts. http://www.imedicalapps.com/

13

All the hospitals I work in (and several clinics,) have laptops on portable rolling stands. I think the rolling stands are a little better than just carrying them, because all the peripherals are right theren with it. Plus, they often have little baskets to put a thermometer, manometer, pulse oximeter, etc… in.

iPads, and even Android tablets (even though I’m a huge Android fanboy,) strike me as a bad idea in hospitals. Mostly it’s a question of security. With digital information, the electronic medical record (EMR), etc… keeping patient data secure is a big issue. Although it’s more an IS issue than my department’s, we still deal with them on things like data servers, central station servers, firewalls, etc… to make sure that only those authorized to access the information can.

Even though most hospitals now have wireless networks throughout, in my experience, non-Windows tablets don’t always have the neccesary network cards/firmware/software to access the more secure networks, and are often on the guest/open network. And even if the iPad can get on the secure wireless that the official hospital computers are on, I doubt it can actually interface to the real data server for the EMR (not that I have experience with every EMR software suite, but what I have seen is generally just limited to Windows, at least freom the user’s side.)

So it probably has to have an intermediary step and stores it locally until it’s plugged into a base computer that DOES have data server access, and then it can download to that PC which can then transfer the info to the data server. To me, it makes more sense to just use a laptop or Windows tablet than already has the ability to connect to the data server directly.

So while I’m not against the idea in theory, I think there still needs to be more work done to make sure things are integrated. If they are officially purchased by the hospital and (presumably) set up by the IS department, that shouldn’t be too bad, in theory they know what they’re getting into. But when I hear stories of random doctors and such using their personal ones, or just buying a few willy nilly without looknig into it or involving IS, that strikes me as a bad idea.

14

We’ve got the security thing covered. We already have WiFi just about everywhere in the hospital, and a lot of people are using laptops. Laptops are required to get an extra security layer installed. As long as that can be installed on an iPad, I don’t think it should be an issue.

15

I recently used one for a project in a contaminated environment for about two hours for which we double bagged the ipad and sprayed it with bleach water (while bagged) at the end. We used some kind of squichy tipped stylus that just barely worked through the bags, so it would have been a bit clunky for doing extensive, fine input.

16

I work for a company where this is what we do - a web-based Practice Management/Electronic Medical Records application. We are in the process of writing an iPad app (we already have one for iPhone) that will allow doctors to use the iPad instead of a standard tablet/laptop. Doctors are really crying out for iPad or other small tablet applications. Ours will allow charting, charge entry, ePrescribing, dictation, etc. and it all interacts with the “full” verson of the app.

However, we currently have lots of physicians that use a convertable tablet (tablet/laptop) for the application. Our charting templates are customized, so with a stylus, it’s just a bunch of checkboxes and the note is generated. Hospitals can be stingy with the wi-fi, so sometimes it’s an issue, but not so much anymore. As long as you’ve got the security thing covered with a good encription, you should be fine.

17

I’m not so sure about iPads, but there are certainly plenty of doctors who carry around iPhones and use apps on them for work. Is there any chance you could make it practical for use on a smartphone?

18

Just as a data point, the oncology department of my hospital (and I imagine the other departments too) have a network-connected laptop in every exam room, and every doctor’s office. They went paperless a little while back, and the laptops seem to work well for them.

They don’t carry the laptops around, but there’s one available in every context where they’d actually be examining a patient. I think the labs have them too, but I’m not allowed in there, obviously. :slight_smile: The laptops are small enough not to get in the way in the exam room, but they have the standard keyboard for typing out exam notes etc.

If there’s a specific reason why the docs would need to carry the computer with them instead of just using them in the exam rooms, a tablet might be the way to go, otherwise, other hospitals are just using ordinary laptops.

I’ve not seen any of my docs/nurses with tablet computers in hand, personally, but that’s not to say that it doesn’t happen somewhere.

19

I think you’ll see iPads in use more than android tablets for a few reasons. There’s been a lot of development in management software to keep the data safe, and the issue is primarily one of proving a device is HIPAA compliant ($$$). Tablets can be set to auto-lock, iPads encrypt data by default(*), can be remote wiped, and they’re well built from an aerosol disinfecting standpoint. Really, rubber plug the dock and headphone jack and spray away.

*= I’m also researching iOS forensics and while there ARE ways to jailbreak and rape an iPad, the exposure isn’t any greater than other devices and can be avoided by strong physical controls.

I wouldn’t bet AGAINST the iPad in general medicine. They have the numbers, they have the developer interest, they have the upper hand in having two hardware versions while ot her folks a just now releasing tablets that aren’t quite fully baked.

20

A friend of mine walks around with an Ipad 2 in her lab coat, so they are used in medical contexts.