A Special Two-Part Report On IT & Health Care | Part 1: Mobile Medicine As medical records go electronic, hospital CIOs are finding that wireless networks can get the records to where the doctors and nurses want to use them. CIOs in other industries would do well to watch and learn
Electronic medical records systems top hospital CIOs' agendas because they can prevent errors, enforce standards, make staff more efficient, simplify record keeping and improve patient care. But the systems deliver only when doctors, nurses and other medical staff actually use them.
In hospitals, where patients and medical staff are constantly moving, it's difficult for staff members to take a break to enter patient data, or to order tests and medications. So, even though many hospitals began installing data-access terminals a decade ago at nurses' stations and near hospital wards, staff members still tend to scribble notes a few hours before they enter data and place orders. That can lead to transcription errors, delays in test results and incomplete records when other staff look up a patient's status.
Health-care information has to be available anytime, anywhere. "We didn't see any other way to do it other than wireless," says Tim Stettheimer, vice president and CIO of St Vincent's Hospital in Birmingham, Alabama.
"If you're not entering data as you go, a lot of efficiency is lost. With paper, it sits in a pocket for an hour, then sits in a bin," says Dr Andrew Thomas, assistant dean and internal medicine professor at Ohio State University (OSU) Medical Centre, a teaching hospital in Columbus, Ohio.
That's why wireless systems, especially those based on the 802.11b standard (also known as Wi-Fi), are more widely deployed. This new conduit lets staff access and update records and make orders at the point of care. That reduces errors and delays, and fits into the doctors' and nurses' workflow. And they're inexpensive to deploy, costing a few per cent of the total budget of an electronic medical records (EMR) system. Plus, they can be a springboard to services such as communications badges and mobile sensors.
More Patient Face Time
Bruce Brown, a physician at St Vincent's, says he believes using mobile technology to access and update medical records will help him spend more time with patients.
Before Brown began using a wireless wearable computer from Xybernaut, complete with an LCD screen mounted on his glasses, he commuted between his patients and hills of paper. "I used to work on a stack of papers, then see the patient, then go back to the patient's stack of papers," he says. "I spent only 20 per cent of my time on a patient in front of me." With wireless systems, where he can access records and order needed tests while still with the patient, "I expect that to increase to 50 to 60 per cent." Brown has also seen the cycle time per patient - from diagnosis to test result and later to delivery of treatment to the patient - shrink from 24 hours using the old-fashioned paper methods to four or five hours with the combination of EMR and wireless systems.
Wireless makes productivity sense whenever workers are mobile and work with time-critical data, says Chris Kozup, a Meta Group (US) analyst. And, notes Kathryn Korostoff, president of consultancy Sage Research, the use of wireless can also relieve staff constraints. "Hospitals are always understaffed," she says. "In the face of economic hardship, wireless has a payback scenario. It's not a huge amount of capital investment. They're clearly saving time for doctors and nurses, which is their greatest asset." For the users, "it really becomes a part of their job satisfaction - it relieves stress. It has a major effect on how people are satisfied with their job," she adds.
However, wireless and mobile technologies have supported mission-critical needs only in the past few years, and hospitals deploying the new systems continue to wrestle with the best ways to deploy them and integrate them into their overall IT structure. While wireless network security has become a straightforward issue for CIOs to address, several other technology hurdles continue to require experimentation and greater heterogeneity than many IT departments would prefer to support.
Hospitals are early wireless adopters, and the issues they face and the benefits they achieve apply to any industry - professional services, retail, inventory warehouses - that has mobile workers within a building, Korostoff says.
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