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Clinicians using tablets DO deliver better care

Oh, how I wish tablets were around when I was providing patient care as a Registered Nurse on a busy surgical floor! I had a legion of patients, and masses of information to find and remember ‘in the moment.’ It seemed like I could never find the person or the equipment I needed fast enough.

Sometimes, the most practical option was to take pen to paper (or to my scrubs) to jot down a note, and then go find the information I needed in a chart, the EHR, or reference once I got back to the nurses station. Could I have delivered more timely, efficient and safer care if I had access to the information and data I needed at the patient’s bedside? You bet I could, and here’s how!

Tablets!

Tablets provide information access at one’s fingertips – especially at the patient bedside – helping doctors and nurses to render quick, safe and sometimes lifesaving care. This is echoed in Institute of Medicine (IOM) reports calling for direct care providers to have quick access to electronic references. Moreover, up to 70% of sentinel events in healthcare are caused by poor communications, according to a Joint Commission study (1995-2006). Given these findings, tablets offer a new and improved way to ensure patient safety because up-to-the-minute information and immediate communication is readily available where and when needed.

Tablets help save time by increasing mobility and productivity, reducing errors and keeping information readily accessible within the clinician’s reach.

Come on clinicians … no mater if you are a doctor, nurse, respiratory therapist, case manager, educator or another team member … surely you can think of all kinds of ways tablets could enable you to have the information you need when you need it. You and your patients will be all the happier and satisfied for it.

I quickly came up with a short list of ways that tablets, one of several mobile devices, can make a difference for patient care delivery:

  1. Workflow efficiencies by having access to information and data at the point of care
  2. Real-time communication amongst team members while in different locations
  3. Video consultations
  4. Patient education
  5. BCMA and real-time drug interaction checking … possibility for a real-time pharmacy consult at the patient’s bedside via voice or video conferencing
  6. Clinician satisfaction

My questions to you: Have you used a tablet to deliver patient care? If so, what has been your experience – is the tablet adding real value, or is it just “another toy”?

Let us know what you think!

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12 Comments.


  1. This is an interesting post. I am a resident and have used a laptop room to room. However, I have not used a tablet. I can’t imagine that this is much more helpful, but it is at least much less bulky. Most of us have PDA’s which allow rapid access to drug information and decision making applications. Even though I haven’t used one yet, I feel it is probably just another “toy,” but one in which is less bulky and may add enough function to be the wave of the future.

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    • Curtis Dikes

      Hi Brian, Having used both, I believe the form factor of the tablet is favored as it is less bulky, doesn’t need to be sat down for input. The tablet balances the benefits of laptops and PDAs with the opportunity of a larger screen than a PDA, use without the bulk and keyboard of a laptop and many tablets have cameras for photo documentation and/or bar code scanners to enable BCMA or other specimens as a part of the bedside care delivery process for many clinician users. That said, there is no best device for everything … Tablets are not optimal in all cases such as vast amounts of data entry in the example of a full admission, or EHRs which have a lot of scrolling involved for documentation (e.g., application not optimized for tablet use), but it would be easier and less costly from a end-user equipment perspective to use a tablet over wheeling a clinical documentation cart (aka, WOW and can be very heavy) to the patient’s bedside for simple entry or data look-up, or a laptop needing to be sat down in the patient’s room and then moved from room to room with the thought of infection control in mind.

      In my opinion, no toys allowed! Technology adds must contribute not confuse the care delivery process, maintain existing but hopefully decrease steps in a process or workflow, and increase patient safety, quality outcomes and user satisfaction.

      Thank you for your comment!

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  2. Unless your EHR or PACS applications are written expressly for a tablet OS it can be dificult to use one in the inpatient/clinical setting. Tablets are intended to CONSUME data (read and view) not to create data (enter chart info as structured data). So for now it is a toy unless your EHR/PACS vendor has created a mobile version.

    Cheers!

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    • Curtis Dikes

      You make a great point as different size screens and displays (touch-screen or not) make a difference with the presentation of applications. Most EHR-like applications have traditionally been developed for a standard computer monitor. As technology, including form factors and usage have evolved, not all applications have been optimized for use on multiple end devices. Many EHR applications have scrolling screens which are fine with use of a mouse, but not great for a tablet display. I understand Epic or example has and continues to work on the addition of application modules which enable optimal display and use on both iPads and Android devices.

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  3. Like almost any technology, it can be a toy or a valuable tool. Considering that doctors and nurses are very mobile workers, then having a mobile device makes sense. Then what is available on the mobile device makes the difference. For example, if the pad automatically brings up the patient’s data when the user enters the patients room, then provides a list of priority to do, then we are moving towards a useful tool. If the pad permits accessing any patient data, decision support, or knowledge, it is even better.

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    • Curtis Dikes

      Hi Ed, Very well said! I can remember working with Linda Goodwin and team at Duke on a PDA project for nursing documentation back in the early 2000′s. Technology and applications for documentation and data review have come a long way, but it seems few have combined several of these technologies optimally to enable real time and location based specifics such as the right task list for nurses from the EHR popping up when they enter a patient’s room (RFID/RTLS) or the ability to document by voice with a mobile device and have the application/EHR update easily for example.

      I hope there are some great examples out there and would enjoy hearing from those who are doing this today.

      Keep the comments coming….

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  4. As an IT manager I agree that tablet devices are an attractive platform for access to clinical systems. The problem is the clinical system worth using do not yet have applications written for talets (iPads and Android devices). You can access applications on these devices using Citrix but the clinical applications are made to be used with a keyboard and mouse; navigating them on a touchscreen and virtual keyboard is difficult. Until the application developers (Epic, Cerner, NextGen, etc.) write applications specific to tablet computing, laptops are still the most productive platform for protable access.

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  5. This is an interesting post.
    i agree that tablet device are an attractive platform

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  6. I do accept as true with all of the concepts you have presented on your post. They are really convincing and will definitely work. Nonetheless, the posts are very quick for beginners. Could you please extend them a little from subsequent time? Thank you for the post.

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  7. Lovely Post i think its a great achievement of science to improve quality of clinics through tablet device…real boom boom for the Clinicians..i didn’t try yet i will inform you after using it…thanks for such a nice and informative blog…

    Foot Comfort

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  8. January 4, 2012 at 10:55 am

    Having had a failed tablet deployment to our Emergency Department, the biggest hurdle we found was the EMR being ready for mobility. Yes the interface without a mouse was a problem, but the show stopper was the fact that the EMR had to be run over Citrix because the EMR client couldn’t handle a single packet drop. This caused more issues because the EMR didn’t want to work with our ILE document store through Citrix. The tablets themselves were the right fit, but the EMR software is just not ready.

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  9. I like the principles that help for ease of access to information but I am somewhat concerned about what precautions are taken to ensure that the risk of cross infection especially for patients with suppressed imune systems is. Do the tablets stay in one area, like a dialysis suite for example or are they carried from ward to ward? The UK has had more than its fair share of hospital acquired infections stories in recernt years. lets hope this isn’t another one waiting to happen.

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