After being dragged kicking and screaming into the electronic age, many a physician surely has dreamed of cutting the cord and ripping the computer out of the wall. Ironically, that may be the fastest and cheapest way to get information technology to catch on in clinical settings.
The cost to implement computerized physician order entry in a 200-bed hospital is about $4.4 million, says William Dawson, M.D., chief technology officer at MercuryMD, a Durham, N.C., company that builds mobile connectivity tools for physicians. A mobile data-delivery system for a same-size facility costs only about $250,000, he says.
Charles Webster, M.D., vice president for medical informatics at Marietta, Ga.-based electronic medical records vendor JMJ Technologies, says a wireless thin-client network can save small and mid-size physician practices 20% to 25% of the cost of wired networks with full-powered PCs. Thin clients are applications delivered via a network or Web browser that are not stored on a local hard drive.
Clinics can save 30% by buying only one mobile thin-client computer per clinician rather than one PC per room, thanks to lower software licensing costs, Webster says. The need for a backup wired infrastructure cuts savings slightly, however.
Webster and Dawson cited these compelling numbers last month in Minneapolis at a national conference on m-health and electronic order entry sponsored by the Newton, Mass.-based Medical Records Institute and the Mobile Healthcare Alliance.
What makes mobile technology even more appealing is how it made its way into healthcare. Physicians buy cell phones and personal digital assistants on their own volition, whereas EMR installations tend to start with technology people pushing systems onto reluctant clinicians.
"People embrace change. People do not embrace being changed," says Peter de Jager, an IT and management consultant from Brampton, Ontario.
For these reasons, C. Peter Waegemann, CEO of the Medical Records Institute, calls mobile and wireless technology "a major component of all health IT systems in the future." Waegemann says, "Expect the mobile healthcare device to become a practitioner's best friend."
Tempering this enthusiasm a bit is Robecca Quammen, chair of the Mobile Healthcare Alliance, an organization that the Medical Records Institute helped found. Quammen mentions that she gave a presentation in 2001 about the coming boom of PDAs and wireless healthcare IT. "We're still talking two and a half years later about the same topic," she says.
Mobile healthcare is much broader than just the PDA or wireless networking, however.
Allen Wenner, M.D., vice president for clinical applications design at Primetime Medical Software, Columbia, S.C., and a partner in the four-physician West Columbia Family Medicine, has an all-inclusive view. "I consider instant messaging a mobile application. I consider a quick response to e-mail a mobile application," Wenner says.
Wenner views m-health as something that liberates physicians and empowers patients. For example, patients can request prescription refills on the Web, and physicians can sign off on such requests from remote locations.
"We have a system that revolves around physicians. You can make an appointment between 9 and 5," Wenner says. "We need a system that revolves around patients so you can make an appointment 24/7."
Mobile technology makes this happen. "Mobile health transcends collection, storage, reporting and transmittal of data. It encompasses people, business practices and systems," says Quammen.