Design for Care
Collaborative learning for transformative healthcare design
Will Healthcare adopt the iPad? Where, When, and How?
Full article posted on Design Dialogues. Will clinicians adopt the iPad en mass, or will they wait? Does it make sense for them in the near term, or will there be a long delay as they come on board as late adopters in 3 years?
Clinicians are thought to be conservative IT adopters (on the whole) because they don't pick up every new device, and there is this mistaken notion that they are savvy IT users, because they are smart professionals who work in high-tech locations. My research with specialists and residents shows that more senior docs actually use smartphones less than ever, not more than ever, at least for clinical IT. Yes, there's interest and better apps will make a difference. But on the whole, doctors use the phones to talk, and the hospital computers to look things up. Residents love smartphones when they are learning things, but once they have learned their procedures and are doing the work, there is less time to search, and less need to use the smartphone for lookups. I mean, you try scanning an EMR record on an iPhone!
What do you think?
Clinicians are thought to be conservative IT adopters (on the whole) because they don't pick up every new device, and there is this mistaken notion that they are savvy IT users, because they are smart professionals who work in high-tech locations. My research with specialists and residents shows that more senior docs actually use smartphones less than ever, not more than ever, at least for clinical IT. Yes, there's interest and better apps will make a difference. But on the whole, doctors use the phones to talk, and the hospital computers to look things up. Residents love smartphones when they are learning things, but once they have learned their procedures and are doing the work, there is less time to search, and less need to use the smartphone for lookups. I mean, you try scanning an EMR record on an iPhone!
What do you think?
Views: 5
Replies to This Discussion
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Permalink Reply by David Fore on
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Nice article, Peter.
My own experience researching the needs of clinicians and designing various interactive products for them bears out your main themes.
Clinicians are increasingly served (held hostage) by institutional IT organizations. IT in hospitals behave pretty much like all others, for good or ill: they want to drive down costs by driving up standardization and reducing maintenance/replacement costs. The idea that Hospital IT will embrace an ungainly, delicate, theft-worthy device such as the iPad is sort of crazy, not just because they're so much more expensive than paper and pen, but because they aren't battle-tested in healthcare environment yet.
I'll add one other point, implied by your article: doctors are mostly interested in what saves time. Until we design a perfectly suitable, adaptable, secure "clinical OS" for a touchscreen iPad, there's nothing about this product that will get a doctor to their daughter's soccer practice on time.
~David Fore
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Permalink Reply by Peter Jones on -
Excellent response David, all good points that support the case that tablet adoption will take longer than we may expect. I bet specialists, like cardiologists and surgeons, may be early users, but they are not the mainstream hospital user. I think the portability and durability will be big hurdles - the form factors looks great at first, but where do you set the thing? How do you keep it safe and yet locally available? Plus, there are fixed computers everywhere - what's the best display trade-off for a portable device in a clinical unit?
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Permalink Reply by Dean Karavite on -
Thanks for posting this Peter,
I'm going to offer something that comes from a completely different direction. I don't have anything to cite, but I have spoken to a number of people about a completely different approach that seems to be having success in outpatient/clinic settings. Instead of designing a device/UI that will allow the physician to manage every aspect of the visit alone, some are employing a dedicated "EMR scribe" who performs the visit with the physician. The scribe is usually a nurse and is highly trained in the EMR, but also in documenting patient care in a thorough and consistent manner. Apparently this approach is having a lot of success in first, allowing the physician to concentrate completely on their patient, but to also produce patient data that is complete and consistent across all patients (it also has advantages in correct billing - a huge issue in any setting). In addition, it is being said that such an approach is also highly cost effective. Appointments are on time and the clinics see more patients at a lower cost, even with the additional scribe salary.
I actually encountered this scenario in my wife's care over a year ago here in Philly. As a patient (and patient's husband), it was fantastic. The doctor was great, but the scribe (a nurse) was super sharp and contributed a lot to the visit by asking questions, offering advice and information. She was much more than a "medical stenographer" and the physician seemed to treat her as a respected peer and full partner. Unlike other trips to the doctor, I really felt like my wife was the center of attention and all her issues, questions and concerns were addressed. It may have been the best physician encounter we ever had.
Of course this is not to suggest in any way that improvements in UI design aren't needed or that tablet devices don't have a ton of potential in many healthcare settings. Still, it may be that in an outpatient setting (and others), no matter how elegant the UI or device, asking the physician to do it all isn't the best thing for them or their patients.
Thanks,
Dean
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