Mobile healthcare applications
Mobile devices, such as cell phones and PDAs, are becoming the main medium by which people send and receive data while out of the office or home. With the advent of smart phones, the internet and the most common software applications are available without relying on a PC. In healthcare, mobile applications can reduce delays by providing digital information quickly, thus having the potential to reduce system cost, as well as errors [1]. Also, there is evidence to show that patients or healthcare consumers would likely engage more in their own care if they had healthcare applications on their cell phones [2]. This article will give examples of EMR (electronic medical record) applications for mobile devices with a description of key functional features. Secondly, the technological framework for these applications will be explored. Finally, a few general recommendations of using mobile health applications for clinical care will be given.
Mobile devices are already being used to retrieve data. A Pew Internet & American Life Project survey revealed that 17% of cell phone users have utilized their device to look up health information and about 9% have phone software applications to help track or manage their own health. The number of users becomes exponentially greater when you consider there are least 5,000 health-related applications, 70% of them intended for the consumer [3]. An additional use of mobile devices by patients would be to use them to access their personal health records.
For clinicians, several health applications designed for mobile devices are currently in the market. For example, Allscripts Remote is an application that enables providers to remotely control their Allscripts Enterprise EMR or Allscripts Professional EMR from any location. In a few seconds, providers can take advantage of their practice’s EMR functional features through devices such as an Apple iPhone, iPod Touch, BlackBerry, or other smart phone [4]. Using Allscripts Remote, providers have been able to make complex medical decisions even while out of the office – such as in the hospital, while on the road and at home. The actions performed while using Remote are immediately recorded in the Allscripts EMR, creating a complete and accurate patient record in real time [4].
Another example, of a successful iPhone application that connects users to an EHR is Haiku. This product was the result of Apple’s iPhone teaming up with EMR giant Epic. Some of Haiku’s strengths include a robust user interface design, ability to render clear photos (ie. patient picture), a complete problem/ medication/allergy list, labs and full demographic information. [5]
However, there are technological limitations with mobile based EMR applications. First, the cell phone has limited ability to process large quantities of data. Image and xml files are especially difficult to support. Secondly, even if data can be properly accessed timing must be synchronized. Some devices may not have adequate memory for caching. Third, the small user interface areas of these phones slow down data entry [6].There are certain languages that would be used to support mobile based EMR applications. J2ME allows good portability and Windows CE provides users the same display found on Windows machines. C++ would not be appropriate since there is no hardware to be used with these applications [6].
A study out of Sweden examined mobile technology in health care and included very practical and clinically applicable suggestions about design. The authors stressed the importance of developing systems that allow for both extensive and quickly accessible medical data. Secondly, it must adapt to the specific medical information requirements of individual patients. Thirdly, it would for the mobile communication technology to allow for enabling providers to access medical guides through linking up to databases in the server of an office or organization [7].
To put this into context, consider an example. A physician on-call, travelling in his car, is contacted by the hospital nurse about an elderly patient’s medical history. Before she starts him on a medication that could be potentially harmful if he has certain medical conditions she needs to check with the doctor. The doctor must be able access the chart quickly and able to refer to it in entirety (in case, the problem list not updated and he needs to search the chart). To verify the medication is safe to administer, the clinician must find the last 2 labs indicating kidney function for this patient. Lastly, he may want to look up details about the hospital dosing guides for antibiotics to make sure that he can suggest an appropriate dose to the nurse. In conclusion, accessing healthcare information and patient data through mobile devices is useful in the provision of care and could allow consumers to be more involved in the process of their own care. Several well-known vendors have brought mobile EMR applications, with rich functional features, to the market. There are specific technological considerations in designing such applications. Last but least, there are well defined recommendations on what applications should be able to do in order for them to be useful in clinical care.
References
1. http://74.125.155.132/scholar?q=cache:9t-za88aiCMJ:scholar.google.com/+cell+phones+AND+EHRs&hl=en&as_sdt=0,34 Mobile eHealth: Making the CaseNorm ArcherDeGroote School of BusinessMcMaster UniversityHamilton, Ontario L8S 4M4 CanadaE-mail archer@mcmaster
2. Designing Mobile Applications to support Mental Health Interventions Mark Matthews(1), Gavin Doherty(1), David Coyle(1) and John Sharry(2)
Department of Computer Science, Trinity College Dublin.
3. EHRs gone mobile. [1 screen online] 3/2/11. Retrieved on May 21, 2011. Available from: http://www.practicefusion.com/ehrbloggers/2011/03/ehrs-and-healthcare-have-gone-mobile.html
4. Treat and triage patients from anywhere with Allscripts Remote.{online 1 screen] 3/5/10. Retrieved on May 21, 2011. Avaiable from: http://www.imedicalapps.com/2010/03/allscripts-remote-electronic-health-record-eprescribing-iphone-android-iphone-medical-apps/
5. EMR applications for cell phones. [online 1 screen] 7/9/09. Retrieved on May 21, 2011. Available from URL: http://www.ayokasystems.com/blog/emr-applications-for-mobile-phones/
6. Epic Systems launches iPhone EHR app, Haiku. [online 1 screen] 1/13/10. Retrieved on May 21, 2011. Available from URL: http://mobihealthnews.com/6030/epic-systems-launches-iphone-ehr-app-haiku/4/
7. Int. J. Mobile Communications, Vol. 5, No. 4, 2007 371 Copyright © 2007 Inderscience Enterprises Ltd.Mobile innovations in healthcare: customer involvement and the co-creation of value Per Andersson* and Christopher Rosenqvist Center for Information and Communications (CIC), Stockholm School of Economics,
