Should Hospitals Buy iPads or Let Doctors Use Their Personal Device?

Does your hospital allow iPads or tablet devices?  How about smartphones?  Nope don’t feel too bad, a lot of hospitals (including mine) still haven’t thought of  personal devices as necessary medical devices.  The personal information device (iPad, tablets, smartphones) represent a watershed event where doctors are able to access medical information on the go.  They aren’t tied down to a computer or laptop.  It will be interesting to see how small and large hospitals deal with this watershed event.  It has been interesting to see what hospitals (well known and not so well known) have made the progressive leap and what hospitals (well known and not so well known) have not. 

There are two schools of thought (three if you count a no adoption policy).  One is the hospital buys one specific device and supports it.  The other school of thought is to allow physicians to user their personal devices.  

FierceMobileHealthcare looked at two institutions that implemented mobile device policies, one hospital bought the device and the other allowed doctors to use their own device(s).  Both institutions are trying to provide doctors with a way to use mobile technology at the bedside, but each have their own reasons for the path they chose. 

Hospital buys the device:

Dale Potter, CIO of 1,300-bed Ottawa Hospital in Ontario, Canada implemented an iPad roll out which was described by FierceMobileHealthcare as “arguably the largest roll out of hospital-owned tablets in the northern hemisphere.”

Dale’s hospital bought 2,000 iPads, has 1800 iPad 2’s on order, and may buy even more  in the year.  Dale believes hospital ownership was important and the way to go for moving his hospital forward to be “recognized as a top 10 health center in North America.”

Because the devices are hospital owned, it allows them to have control over the apps and other software on the devices.  They completely relying on the App store or outside vendors either, the hospital hired 120 developers to create apps for the institution, including a mobile electronic health record and a dozen in-house apps.  Because the devices are hospital owned and they not only can control the apps and software but they have created a remote wipe, log-ins, and other security protocols.  Even though the iPad is $600, Dale says that the costs of buying each doctor an iPad is cheaper than buying the a PC or laptop and “significantly less than other medical instruments that physicians carry with them each day.”

Doctor’s choice:

Todd Richardson, CIO with Deaconess Health System, Evansville, Ind., lets physicians use their personal devices for work.  Richardson’s primary reason for this is the devices are constantly changing making it difficult to remain current financially and logistically (constantly updating new devices with OS updates, patches, etc.).
In addition to the financial issues, management and ownership of the devices can be difficult to deal with.  Todd states that maintaining the devices, providing sync and charging stations and keeping track of them is “a hassle he just doesn’t need.”  Additionally doctors are going to load their own apps and software on the devices regardless, so if it is their person device it makes it easier. 
Deaconess allows doctors to use personal devices because they use Citrix to access the EHR via a secured wireless SSID and physicians must register their device’s MAC address.   
It is an interesting debate, which method is right lies more with the culture of the institution and what the CIO feels will work best there.  At least these CIO’s are addressing the issue. 
Now how does this relate to medical libraries?  Well we probably don’t have much say, if any,  in what direction the CIO goes with.  But once the decision is made, librarians can get on board by supporting the devices.  That means helping with the selection of apps, looking at library and information apps, helping doctors use the apps or the device itself.  There are a few doctors who have come into my library asking about certain resources for their iPad or Android.  Currently my hospital has yet to adopt a mobile device policy so much of the stuff they ask are general questions of getting on the network, how to access a medical video on YouTube (hint: turn off wifi and use 3G), how to connect to full text articles, etc.   But even if you hospital has adopted a mobile technology policy, you will still get questions (especially on ebooks, ejournals, and what databases have apps), so it is important to know what is out there. 

6 thoughts on “Should Hospitals Buy iPads or Let Doctors Use Their Personal Device?”

  1. When I was at my old hospital they were going to hand out PDAs (2003ish) to physicians so they could access the patient record. That got stopped because of the issue of Anti-Kickback and Self-Referral Concerns legal concerns. It may be at this time that has been clarified in the rules that something that is less than a $1000 is okay. If all of the clinicians or students or employees than I can’t see why it would matter. Since we only had about 40 out of our 900 physicians on receiving a paycheck from the hospital that was a big issue. Anything that can be viewed as unfairly causing referrals makes compliance people itchy.

  2. Here they give physicians a Blackberry – and are considering switching to iPhone. iPads would be better because of visibility & the ease of showing info to patients.

    Incidentally, in your title “Doctors” is a simple plural – no apostrophe – please. 🙁

  3. While I understand you suggestion accessing YouTube videos via 3G to bypass network blocking, users need to be aware that 3G is usually slower than wi-fi, and using 3G for videos will use a lot of your monthly data cap.

  4. Mark I totally agree with you. But if your hospital blocks wifi access to YouTube you don’t have other alternatives.

    What is even worse is the iPad is blocked from getting on the Intranet here. So if you want Internet access you have to use the public wifi BUT people using the public wifi are blocked from accessing servers on the institution’s server farm which host many hospital resources (including the library). So iPad users have to have and use 3G on campus and login to our network as if they are off campus. Very back asswards.

  5. We have a guest wireless network and a Citrix Access Gateway, the only issue is that physicians are competing for bandwidth with the patient who is checking their mail, upload YouTube videos, etc. They are upset that the speed of their devices are not what they thought it would be, but our guest access was never designed to support Citrix sessions.

    I have seen many hospitals adopt an internal wireless approach where they MAC authenticate each physician on a supported SSID, but I don’t have the staff to manage that.

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