Behold the iPad in All Its Glory
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The iPad has the potential to become a real workhorse in hospital information systems. One of my first good-paying jobs included working with people developing bedside information system. The goal was to make data entry a normal part of a patient encounter, remove the ambiguity and lapses of a memory-based handwriting system, and even allow collaboration between physicians, nurses, and patients.

As John Halamka, MD, CIO of the Beth Israel Deconness Medical Center conveys, the iPad may be the vessel that makes this vision a reality. His emissary from iPad land? Dr. Henry Feldman, and hospitalist and informaticist who works with Halamka. Feldman is quoted as saying:

In general it was incredibly useful and given that all of our clinical apps are web based it basically all worked perfectly. Probably the most useful was rounding (or the nurse snagging you as you walked by) and during a trigger where I could stay at the bedside and do/see everything and not leave my critically ill patient. I have the apple case, which means that I can “wedge” the iPad so that it forms a useful keyboard. I typed fairly long notes, but certainly nothing like a DC summary, and it was perfect. On Friday evening had a late discharge, and up on 12R there wasn’t a computer free. I sat at the little round table and did it all sitting there, including all the DC instructions, scripts (except printing as below), etc… Battery life is epic, and I finally had to charge today at 3pm (Monday), after last charging Thursday night.

Feldman’s report is very insightful and useful to read. It’s clear that the iPad could change a lot about how information is purveyed and conveyed in medical settings, at least in a large, well-funded, and technology-savvy organization like the BIDMC. It could be the centerpiece of an entire patient-oriented IT strategy.

One thing Feldman tested was whether hand sanitizer and sanitizing sheets worked with the iPad. And for good reason. A recent report from the New York Daily News showed that iPads in New York stores were growing plenty of bugs, including Staphylococcus aureus. Having iPads widely adopted without finding a solution to this could be a disaster in the making, transforming these useful tablet computers into large, mobile, open petri dishes — nosocomial infection carriers of the first order.

As Stephen Colbert quipped a couple of months ago, “Only Apple could get us to buy something just to find out what it is.” As we learn exactly how the iPad works into our lives, it’s worth noting that for information-intensive jobs done by people on the move who also need to report back to central systems, the iPad may be a great solution.

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Kent Anderson

Kent Anderson

Kent Anderson is the CEO of RedLink and RedLink Network, a past-President of SSP, and the founder of the Scholarly Kitchen. He has worked as Publisher at AAAS/Science, CEO/Publisher of JBJS, Inc., a publishing executive at the Massachusetts Medical Society, Publishing Director of the New England Journal of Medicine, and Director of Medical Journals at the American Academy of Pediatrics. Opinions on social media or blogs are his own.


4 Thoughts on "The iPad in Medicine: The Good, the Bad, and the Germy"

For everyday handling and data entry, check out these silver treated adhesive polyurethane covers for mobile devices, including iPad. They have also produced a stethoscope adapter.

A friend of mine in the company says not only are they are targeting the medical field, but also iPad equipped informational kiosks at gyms, restaurants, and other order taking sites. Makes it safer to get fries with that.

It seems like tablets are going to be inherently more sanitary for hospital use than the alternative, currently in place, which is the desktop. Leaving aside the use case of operating rooms for a moment, many hospitals have desktops in physicians’ offices, in out-patient treatment rooms, and outside of in-patient treatment rooms. I can only imagine what microorganisms lurk on the keyboards. At least with a tablet you can cover it and/or wipe it off with some sanitizer.

I agree that the germ thing may be bit of a problem, but certainly no worse than for the pocket handbooks and procedure manuals that are ubiquitous in all hospitals I have worked. You couldn’t even wash them if you wanted to, they’re made of paper.

The other overlooked part of getting to use the iPad or similar fancy things in the clinical setting is that we must get Apple to design the underlying system as well. I have so far not seen an electronic patient chart that would be conductive for use on the iPad without scrapping the whole thing and starting over. Something that would indeed be a good idea for the lot of them.


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