Despite being on the cutting edge of science, the medical field can be slow to adopt new technology.
However, modern hospitals are embracing mobile technology more and more as user -friendly devices and data-rich applications become available. The iPhone and iPad led the consumerization of IT movement and iPad use has already extended to hospitals, with doctors demanding iPads and other tablets to take their work with them as they roam the halls and see more patients.
Is the iPad a panacea for physician productivity? No, not yet. Security concerns and incompatibility with desktop apps have some medical CIOs thinking twice about full-scale iPad adoption. But the iPad's portability, ease-of-use and connection to a wealth of apps is opening doors for mobile technology in medicine and other industries.
But it's not only Apple's iOS that is catching the medical field's attention. Google's Android OS, generally considered to be a more open platform than the proprietary iOS, is also being in hospitals and other industries along with customize mobile apps.
In 2010, PPH, which includes two hospitals in the San Diego area and is the largest hospital district in California, kicked off a project to build its own mobile healthcare platform called MIAA (Medical Information Anytime Anywhere).
The centerpiece of MIAA is a specialized mobile app that pulls in data from the hospital's legacy system to give physicians all the information they need on a patient in real time. The MIAA mobile app was developed for the Android OS and the creation process was run much like a start-up company by Orlando Portale, Palomar's chief innovation officer.
"We sandboxed it outside the IT organization at Palomar and got funding for it and used contract resources," says Portale, who adds that the main priority is to use the MIAA app at Palomar and its affiliates, but also plans to sell it as an independent product to other hospitals and health care facilities.
Developing your own app will make your user community much happier
Here's how MIAA works: Physicians log in to the app, which uses location services to generate a list of their patients who are currently in the hospital. The app communicates with patients' RFID wristbands to determine their whereabouts. And the list is auto generated and sorted by patients who are closest in proximity to the doctor accessing the app.
The app gives doctors up-to-date summaries of patient information including allergies, active medications, lab info, recent vital signs, and more. A doctor can drill down into more detail in each area by tapping an icon, to see, for example, data on recent blood tests, prescriptions, various patient charts and notes, and even look at X-rays.
The MIAA app is compatible with any Android smartphone or tablet. But the PPH staff primarily use Cisco Cius tablets because they incorporate Cisco's unified communications features not available on other Android devices into the MIAA app. Portale considers the Cius the first enterprise tablet because it provides a controlled environment, enterprise-level support and is complimentary to the Cisco network.
PPH uses the Cius tablet to hook into Cisco's voice, video and instant messaging services through a feature called "Care Team," which is a list of PPH physicians associated with a particular patient who have access to Cisco's UC tools via the MIAA app.
"So you could have a specialist and the primary care physician looking over the same patient information and talking via a video call from within the app on the Cius," says Portale, adding that Cius tablets can also be docked next to patients' beds so a doctors can video conference with patients.
Portale chose to develop the MIAA app on the Android platform first because it is an open model, as opposed to the tightly-controlled iOS platform.
"Android allowed us to use and extend the platform in our own way," says Portale. The MIAA app supports Android 2.2 through the latest version, 4.0, aka "Ice Cream Sandwich," or "ICS."
Although the app runs well on other Android smartphones and tablets from the likes of Samsung and Motorola, Portale admits that non-Cius devices are more of a challenge to support.
"You go to Best Buy and every week it seems there's a new version of the Android tab. And Samsung and Motorola do not come with an enterprise support and service model," he says. "You're kind of on your own."
Over the next few months, PPH plans to port the MIAA software to the iOS platform so doctors and nurses can access the app on iPads and iPhones. "The way the app is architected, the brains are really on the back end, regardless of whether it's Android or iOS," says Portale. "The work we have to do with iOS is port the different screens, the look and feel and the interaction in the app over to iOS. We have our own API that we developed where we expose our back-end infrastructure out to mobile devices and iOS is going to talk to the same API that Android talks to."
Portale adds: "It's really about doctors and nurses learning the app first, independent of what device and OS it's on. The app is going to look the same."
With the medical industry's strict security regulations always looming, Portale acknowledges that Android does not have the greatest reputation for security as of late. But he feels confident about the security of the MIAA app because his staff has incorporated the same user authentication, security and audit requirements into the app that exist in the hospital's traditional systems. Also, users are required to have VPN access into the PPH network, and multi-factor authentication.
And just as important, the MIAA data on mobile devices doesn't live there. "The patient data is streamed from our legacy systems to the app and viewable to physicians in real time, but no data is stored there," he says.
Portales encourages CIOs to outsource or set up their own lab environments to test consumer and enterprise devices and work toward opening up their legacy systems to mobile apps. Legacy systems are often old, he says, so recasting them as mobile apps is something you may have to do yourself because waiting for a vendor could take too long.
"Developing your own app gives you a competitive advantage," he says. "And it will make your user community much happier with touch-based apps and devices that fit in their pockets."
The centerpiece of MIAA is a specialized mobile app that pulls in data from the hospital's legacy system to give physicians all the information they need on a patient in real time.