Untethered Healthcare

If 70% of clinicians are already carrying smartphones, then the obvious target for taking your clinical data with you is the smartphone. Everybody including the big telcos seems to be entering this space. There are already hundreds of healthcare apps for the iphone, including  one with FDA approval.  But suppose you are a network of hospitals and your clinicians don’t all carry iphones. Suppose you want to see your own data, your own way, on all your current phones. Developing custom apps for multiple types of smartphones is a headache. Smartphones are all different, with different screen sizes and ratios and different CPUs, and operating systems. Native applications must  still be custom designed for each platform. There are some promising technologies emerging to help overcome this hurdle, but then you have the risk of building your apps on top of a proprietary technology layer from a small company. Lots of big and little projects have gone south this way when the small company gets sold, changes direction or stops support. For now, the only real “platform independent” solution is still using HTML to build web applications. I put the “platform independent” in quotes because the mobile browsers are all different and so you will still have to test, tweak and perhaps optimize your app for each. Also, HTML is still insufficient for some types of streaming data.

The bigger issues with using mobile platforms for clinical and workflow data are usability, network security and FDA scrutiny. Good mobile apps tend to do a few things really well. Many mobile apps in the Windows world are really scaled down PC apps with the attendant problems of putting one hundred pounds of beans into a fifty pound sack. Also mobility creates new potential workflows like viewing real-time patient vitals remotely, even allowing off-site clinicians to check on patients from home and direct care, while remaining transparently behind the hospital firewall. (My group at a previous employer developed a mobile clinician notifer application for doing this.) The skills of capturing the most essential, actionable workflow data and marrying them to a well-designed user experience so that people can use your application with minimal or no training may be challenging for many IT departments. Thought leader institutions like Mayo and Kaiser are spinning up groups to understand the issues and create the new mobile apps to support their workflows, but most hospitals can’t afford that level of effort. I won’t address the issues of network impacts and FDA scrutiny here, but they are significant. Tim Gee over at www.medicalconnectivity.com has good discussion of  the enterprise network as a potential medical device here and there is a good summary of when FDA oversight is required for mobile clinical apps here.

I spoke with the CEO of a network of community hospitals and a new medical school in Oregon recently who said “our younger clinicians and incoming students already live and think this way.” The lifestyle driver is definitely there and lots of startups are entering the space. Uptake will depend on how well the mobile clinical solutions started with a need rather than a good idea, and thoroughly deal with the network security and regulatory impacts.

Your thoughts?