Tablets in Healthcare: Two Real-World Case Studies

When it comes to mobile technology in the workplace, I believe that the devices are only as good as their usability. Throughout the mobile implementation process, IT managers must consider business applications, workflows and usability.

Questions like these can be instrumental at guiding the proper assessment:

  1. Do end-users understand how to make the most of their new devices?
  2. Can IT fully support their organization's systems and tools .. and are these tools aligned to real-life workflows?
  3. Do the devices meet employees' needs to the point of improved productivity and work quality?

Last week's post, 5 Important Factors to Consider When Choosing a Tablet for Healthcare, shared IDC Health Insights author Lynne A. Dunbrack's perspective on finding the right mobile devices for clinicians. This week's post will share two of Dunbrack's real-world examples of healthcare systems either implementing or considering PC tablets for their clinical workers.

I particularly like the focus on this week's case studies - the realistic manageability of tablets from the perspective of both the IT administrators and the end-users.

In the comments section, tell me what factors you consider when doing your due-diligence to implement user-friendly technology to employees?



In the next 12 to 24 months, forward-thinking healthcare organizations will be poised for mobile transformation by making the requisite investment in smartphones and tablets, mobile management tools, virtualization, wireless networking, security, infrastructure, and services. In this blog, we’ll examine 2 healthcare organizations that have started their respective journeys to tablet adoption.

Large Multispecialty Academic Medical Center

One of the healthcare organizations interviewed is a nonprofit, multispecialty academic medical center with nearly 1,500 beds at its main campus and more than 4,450 beds across the system, which, in addition to the main hospital and community hospitals.

The health system's physicians have been using a variety of corporate-liable tablet devices — slates, hybrids, and convertibles — at the point of care. There is no single preference when it comes to form factor. Ultimately, it depends upon the particular use case, role of the clinician using the device, and even personal preference. For example, a mini tablet might be convenient for looking up medication history or lab results because the device fits into a lab coat pocket. However, the mini tablet is not an ideal device for looking at radiology images. For clinicians who are heavy data entry users, a convertible device with a keyboard would be preferable.

To that end, the health system is considering Intel-based hybrids and keyboard docking stations with built-in chargers strategically placed throughout the nursing unit. If clinicians needed to look up information, they can use their slate at the patient's bedside. But when they have more documentation to do, they can go to a docking station with a keyboard, then "grab and go" when done.

Other current uses for tablets include patient survey tools for clinical practices, such as pain management or sleep studies. The health system's home care nurses also use tablets, preferring the convertible tablets because they combine a pen feature to take handwritten notes with a keyboard for more extensive data entry. The nurses have been using Intel-based convertible tablets for approximately six years with very good results.

The primary impetus to evaluate Intel-based tablets running Windows 8 Pro is that

the health system's electronic health records (EHRs) are not touch-enabled, making clinician documentation cumbersome when using a highly touch-oriented tablet with limited keyboard functionality. The IT team met with the clinical systems office to explore other potential tablet options, and together they decided to pilot Intel-based tablets running Windows 8 Pro and a physician rounding application developed internally from the ground up as a touch-enabled application. Other selection factors included:

  • Application interoperability. The health system's IT portfolio consists of between 3,000 and 4,000 applications, which would have to be virtualized to run on an iPad since almost none of the applications have an iOS equivalent. Using Intel-based Windows 8 tablets obviates this time- and resource-intensive process because the applications can run natively in the Windows 7 partition of the Windows 8 platform.
  • Reliable connectivity. The Intel-based Windows 8 Pro tablets feature an enterprise WiFi card, which is more robust than the consumer NICs typically found in consumer-grade tablets.
  • Managed devices. The ability to manage mobile devices was also an important consideration for the IT team, according to the health system's enterprise lifecycle manager. "From a technology perspective, manageability is a huge consideration," he explained.

Intel-based tablets running Windows 8 Pro can be managed like PCs with the existing IT infrastructure. The IT team is more familiar with the Windows device management solutions, and the tools are more robust than solutions for other vendors' tablets.

Penn Medicine — University of Pennsylvania Health System

Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania and the University of Pennsylvania Health System (UPHS), an academic medical center.

Penn Medicine is in the early stages with regard to clinicians using tablet devices. Pilots have tested convertible laptops and consumer- grade tablets. Currently, the desktop engineering team is piloting 20 Intel-based Windows 8 Pro tablets, including a hybrid tablet that can be attached to a docking station with a keyboard or detached and used as a standalone tablet.

The following factors helped Penn Medicine select Intel-based devices over other consumer-grade devices:

  • Common infrastructure. The ability to use the same security and device management infrastructure was a significant consideration for evaluating tablets powered by Intel processors and running Windows 8 Pro. Penn Medicine can use the same technology it uses to manage Windows desktops and laptops. Using the same underlying technology to manage devices obviated the need for a parallel infrastructure and associated investment to support the variety of devices.

  • Security. Timothy Young, end-user device engineering manager, commented that "patient data safety and security are of the utmost importance for us, so the ability to use the same security mechanisms throughout the entire organization is a huge plus." Penn Medicine makes extensive use of Active Directory, and more of its applications are moving toward Active Directory–aware authentication. Active Directory is also at the root of Penn Medicine's single sign-on application, virtual desktop infrastructure (VDI), and application virtualization solutions. Penn Medicine found that other mobile platforms could not be as readily secured using the same security infrastructure it already had in place to manage all devices (e.g., desktops, laptops, mobile devices).

  • Physical space constraints. Founded in 1765, the Perelman School of Medicine is the oldest medical school in the United States. A number of the UPHS buildings are more than 100 years old and were obviously not laid out with a modern digital hospital in mind. Small hospital rooms and narrow hallways make it difficult to navigate workstations on wheels (WoWs) from patient room to patient room. Space is equally limited at the nursing stations for technology. Penn Medicine views the deployment of compact tablets as another avenue for extending bedside computing within its space constraints.

Penn Medicine is focusing first on ensuring that all the infrastructure and device management solutions are fully operational before distributing tablets widely to clinicians. That said, a few clinicians are evaluating the tablet's form factor (e.g., weight, battery life). Rollout of the devices will be more project focused, based on workflows and use cases where mobility will improve ease of use of the EHR application or increase clinician efficiency, rather than department focused.

Particular use cases include a new EMR module that supports the operating room environment and physician documentation. By year-end, Penn Medicine anticipates that between 200 and 300 Intel-based tablets — purchased by the institution — running Windows 8 Pro will be in use across the enterprise.

As tablets revolutionize healthcare delivery, flexibility and customization will be key. There is no one single preference when it comes to form factor. Ultimately, determining the appropriate compute model or device form factor depends upon the particular use case, role of the clinician using the device, and even personal preference.

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