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What’s wrong with “mobility” today

People often ask me about Allscripts mobility strategy. It’s tempting to talk about our iPad, iPhone, Droid and Blackberry products. I think we’ve set the bar in that class of applications, considering some of our competitors are satisfied with remote desktops.

Unfortunately when most people talk about “mobility,” they’re just focusing on mobile devices. And that is far too limited a view.

The hazards of taking a narrow view of mobility

Recently I spent a day as a patient. I was in a room with a mobile desktop, also called computer on wheels (COW). The nurse arrived to take my vitals. And what high-tech instrument did she use to record the vitals?

A notepad. The vitals capture device was not integrated in to the Electronic Health Record (EHR) (not Allscripts), nor did the nurse use the COW. She wrote it down on paper. Which means someone has to type it in later.

We need to make much better use of our time. Writing down vitals on a slip of paper, entering them later, and re-verifying data – is that really the best use of clinicians’ time? And mine?

True mobility goes well beyond computers on wheels, tablets and smartphones.

It’s a common problem that is often “solved” by using smartphones or tablets. While mobile devices are important, they are not the whole answer. Yes, they can help us acquire, analyze and present data. But we need much more than that.

Re-imagining mobility with Allscripts WandTM

When we developed Wand (our native iPad application), we had to re-think everything. For example, relative to a full electronic health record (EHR), the screen is tiny. And 3G mobile networks weren’t everywhere so the amount of data had to be “skinny.”

To build a useful and successful product, we couldn’t just think about how we usually do things. We had to start over and re-imagine a completely different interaction model.

The question is not simply: “How are you going to use a tablet?”  Rather we asked: “How are you going to re-design the entire process of interacting with an EHR?”

Because we took a broader view of mobility, the solution is more comprehensive. Today a number of non-standard mechanisms – such as vitals capture devices and ECG machines –  feed Allscripts EHRs. They all provide discrete, rich data. With better data at their fingertips, doctors and nurses can make better use of their time, doing what they do best – caring for patients.

Thinking outside the box on mobility

Let me share with you some examples of an expanded view of mobility:

Shareable Ink’s “automagic” pen:  Shareable Ink has a pen with a video camera in it, which conceptually recognizes what you’re writing while you are writing it. So we get discrete data in the EHR (as if someone typed it), and the caregiver gets the ease of use of a pen. (Instructions: the pointy end goes down.)

Galen’s clinical decision support: Many developers in Allscripts Open App Challenge – such as Galen eCalcs – are extracting patient data from the EHR, examining it with their own special technology, and giving clinical alerts to caregivers.

University of South Florida’s patient intake form: Instead of doctors and nurses entering initial data, what if the patient provided it? Doctors and nurses must verify it, of course, but this is yet another way to obtain rich, clinical data for the patient’s record.

None of these examples require manual data entry. None of them are bound to a tablet or smartphone (or notepad). But they are all examples of re-imagining the ways in which we interact with EHRs.

A call to arms: Let’s do better

It bugs me when “mobility” discussions are just about tablets and phones. We need to be constantly challenging ourselves to find alternate ways to drive the data in to the EHR – and let’s think about more than just mobile devices.

We can never be satisfied with where we are. One reason we built Wand was to help the nurses NOT have to use a slip of paper in the room for vitals.

We must continuously look for better ways to deliver health care. Because at the end of the day – we all receive health care and will ultimately benefit from our technology.

Let’s do better. And then let’s do better again.

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About the author

Stanley Crane is Chief Innovation Officer for Allscripts. In his more than 30 years of healthcare and consumer-related software experience, he has led the development of award-winning software programs including electronic health record, electronic prescribing, web-based medication sales, online physician education, resource scheduling, financial systems, materials management, medical translation software and voice recognition dictation systems. Previous to his healthcare experience, Stanley was involved in Silicon Valley, where he held positions with many well-known software companies. As the General Manager of Lotus cc:Mail, he created the first remote mail products. He was also the Vice President of Engineering at WordStar International, and Director of Applications at Ashton-Tate, managing their Macintosh products as well as dBase IV. Before that, Stanley was a founder of two Internet startups – MaxMiles, an automated frequent flier mileage aggregator, for whom he built the first versions of the product; and Shopping@Home, a company that was acquired by Allscripts in 1999 to support medication sales.

1 COMMENT on

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Managed care says:

07/15/2013 at 1:21 pm

Incorporating mobility within the office is absolutely the right direction for the health care field to be moving in. And I agree with you Stanley that “mobility” means more than just smartphones and tablets. Love the Wand and Shareable Ink ideas.

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