Mobile Technology for Hospitalists

Mobile technology such as smartphones and tablets might not be living up to expectations when applied in the hospital setting, at least according to a new study published in JMIR Human Factors.

The purpose of the study was to identify difficult tasks and contextual factors that introduce inefficiencies to the hospital workflow, with the goal of informing better integration of mobile technology.

  • Methods – The researchers recruited 12 hospitalists at a 200-bed VA hospital in Indiana to undergo interviews guided by the Systems Engineering Initiative for Patient Safety framework, which analyzes five factors (people, environment, tasks, tools, and organization) to describe how providers’ work systems impact outcomes.
  • Results – The hospitalists identified chart reviews, orders, and documentation as the most redundant or difficult tasks, with most of the issues associated with a lack of access to EHRs at the bedside. Participants noted that many apps are designed to be broadly useful, causing them to lack task-specific features that would improve usability.

When asked about ideas for mobile technology, participants prioritized reduction in task time and task completion at bedside, leading to three representative examples of needed tech:

  • Apps that improve patient-provider communication and entering orders at bedside
  • Note-taking apps with sharing features and nurse contact information
  • Apps for electronic consent

The Takeaway

Although this was only a small study, the theme that emerged in the interview responses was clear: designing for the many overlooks the needs of the few. All participants reported that mobile apps with missing features are quickly abandoned in favor of “their memory” or “pen and paper,” while the most useful apps address a specific problem with a purpose-built solution.

The Health App Scorecard

A recent study in Nature provided a new scorecard approach for evaluating which digital health applications actually produce meaningful clinical results, using a sample of oncology apps to demonstrate the need for standardized evaluation criteria.

The Problem – Low entry barriers have created a confusing digital health landscape, with the growth of apps outpacing digital health stakeholders’ ability to validate their quality.

The Solution – The study evaluated 22 popular oncology mobile apps using a digital health scorecard with 5 evaluation criteria (technical, clinical, usability, end user requirements, cost).

The Results – Although usability was adequate, the oncology apps carried significant technical limitations, were of limited clinical value, and “generally did not do what end users wanted.”

Across all 22 apps, the average score (100% max) for each criteria was:

  • Cost – 100% (all apps were free)
  • Usability – 56.7%
  • Technical – 37.3%
  • End-User Requirements – 37.2%
  • Clinical – 15.9%

The Takeaway

Healthcare apps are here to stay, but the shortcomings of highly downloaded oncology apps highlights the need for standardized frameworks like this scorecard to evaluate their clinical appropriateness. We’ll also need far more healthcare apps that satisfy these criteria.

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-- The Digital Health Wire team