BYOD (Bring Your Own Device). Since the advent of smartphones and tablets, more and more clinicians have been bringing them to work. BYOD has created concern among hospital administrators because of its security risks. Some healthcare systems allow doctors and nurses to use only hospital-supplied mobile devices when they are on the hospital campus. Others allow people to bring their own devices but prohibit them from storing protected health information on them. Nevertheless, clinicians have discovered that the easiest way to get one other’s attention quickly is by texting their colleagues. To address that trend, a growing number of hospitals have adopted secure texting systems.
eICU and telestroke. Both of these terms refer to the use of remote monitoring technology to provide appropriate staffing to understaffed areas of community hospitals. In an eICU setup, a critical care specialist in an academic medical center or a remote monitoring center can track patients in another hospital’s intensive care unit, using both monitoring data and remote cameras. Some organizations have used this strategy to reduce costs and improve patient outcomes. Telestroke systems allow neurologists to diagnose strokes remotely in time to order life-saving “clot buster” medications. The neurologists review and interpret CT brain scans that have been stored and forwarded, and they examine the patient via videoconferencing. In some systems, robots with cameras wheel up to the patient’s bed, allowing the examining physician to make more accurate observations.
Mobile health. Mobile health, also called mHealth, encompasses mobile devices and applications used in healthcare. In this context, mobile devices include smartphones and tablets, as well as add-on devices. In some cases, smartphones can be converted into medical devices, such as an ECG or a stethoscope. Alternatively, they can be used in combination with add-on devices such as glucometers that transmit data via Bluetooth to a smartphone app. The overwhelming majority of mHealth apps are designed for wellness or fitness, such as diet and exercise apps. Consumers use most of these by themselves, but some apps allow users to share information with friends and family. Apps for monitoring chronic diseases have yet to gain much traction, mainly because most physicians are not yet willing to review the data. But some physicians are beginning to prescribe mHealth apps to their patients.
Mobile-native EHRs. Some vendors provide either full mobile-native EHRs or apps that supply limited EHR functionality. One vendor’s mobile app, for example, allows doctors to retrieve visit notes, view diagnosis and medication lists, write prescriptions, and send secure email. The small screen size of smartphones and the clumsiness of onscreen keyboards are barriers to mobile EHRs. But speech recognition ameliorates the keyboarding issue in some of these EHR versions. Although there are mobile-native EHRs for Android tablets and smartphones, physicians favor iOS devices.
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