By Houston Neal
Although unexpected by some, it appears the iPad is not only leading the tablet charge, but in computing, in general. One of the first mass-produced modern tablet computers, Apple’s iPad boasts great design and durability, a long battery life, and a iOS developer platform that’s helping the tablet lead the way into the next generation of computer technology.
Physicians and medical professionals have been some of the earliest adopters and strongest supporters of the iPad, and many electronic medical record (EMR) vendors are responding to the increased demand by producing solutions that are iPad-compatible.
Medical software vendors are approaching iPad solutions in various ways, but the development efforts can be summarized into these three options:
(1) Native iPad EMRs. These solutions have been developed specifically for the iPad and its iOS operating system. They take full advantage of the operating system and iPad user interface. The downside is that they are limited in terms of availability – so you only have a few robust choices if you want a native iPad EMR.
Many of these iPad apps are really great software applications. One solution, Dr. Chrono, allows physicians to easily pull up previous history charts and electronically send prescriptions to pharmacies. Nimble, another native iPad EMR, includes a module that allows physicians to display medical images and actually mark on them via the touchscreen interface – an intuitive and useful application that is the type of design that we’ll most likely see in other, future touchscreen-compatible EMRs.
These applications are new, meaning they lack many of the complex feature sets that on-premise or web-based EMR solutions offer. It will take some time for these systems to develop the full functionality of the more traditional systems. They most certainly will, but they simply don’t have all that the other systems can offer today.
(2) Remote access EMRs. Many software vendors are porting their native EMR solutions to the iPad by the means of remote access utilities, such as Citrix. The benefit is that most systems can be ported to the iPad using this technology. The drawback, however, is that this approach is simply creating a “window” via the iPad to access these on-premise EMRs. Physicians invested in the iPad because of its operating system and design, which is lost in these remote access ports.
Because remote access EMRs require some IT resources to host the system, this isn’t the best solution for physicians that are looking to eliminate server or hosting responsibilities.
(3) Web-based EMRs. These EMRs are some of the most popular solutions for doctors seeking HITECH Act incentive funds. In addition, there are a large amount of solutions from software vendors offered in a web-based, software-as-as-service model. With many solutions to pick from, physicians can select the system that best fits their budgeting and practice needs. Web-based EMRs run through the physician’s web browser, and many solutions are optimized for Apple’s Safari. That’s perfect for the iPad, as Safari is the native iPad Internet browser.
These systems do have their drawbacks when used on the iPad, though. The performance of web-based EMRs on the iPad will largely depend on your Internet connection – so an excellent WiFi network is essential. In addition, since these systems were created with a keyboard and mouse in mind, tablet use many be hindered at times, especially when manual key entry is required.
So what are physicians’ options? Today, most vendors offer some sort of remote access option for their EHR solutions. Look for many of these to offer more iPad-centric solutions as the platform gains more and more physician and industry support.
For more information on the iPad EMR options check out: iPad EMR Apps | A Guide to Electronic Medical Records. In the guide, we took a look at the top ten EMR solutions (in terms of market share), and put together a list of their iPad EMR offerings.
Allscripts (Allscripts Remote). Through Allscript’s propietary web services technology (UAI), the Appscripts EMR can be accessed via the iPad.
eClinicalWorks (iClickDoc). The eClinicalWorks reseller easeMD offers a remote access application.
Eclipsys (Sunrise Mobile MD). Sunrise Mobile MD allows remote access to the Sunrise hospital EHR. Note: Eclipsys is now a part of Allscripts.
Epic (Canto). Little is known about the Epic iPad app. The system has three stars and 13 reviews in iTunes.
GE Centricity. GE just launched their native iPad application. The app is a free download for all of GE’s web-based EMR clients.
Greenway Medical (PrimeMobile). The system provides remote access to Greenway’s PrimeSUITE EHR. The native application is available to Greenway customers, and offers a 30-day trial of the software.
NextGen (NextGen Mobile). NextGen’s mobile EHR software works on all Apple devices, Blackberries, and some Android systems.
Practice Fusion. Physicians can log into Practice Fusion on the iPad via the third-party app, LogMeIn.
Sage Intergy. The Intergy EHR solution can be accessed via remote access applications.
SOAPware. Physicians can use third-party applications such as Jaadu or LogMeIn applications to access SOAPware.
Houston Neal is Director of Marketing for Software Advice.
Tablets with EMRs or EHRs can lead to more unnecessary or nonevidence-based treatments, particularly in hospitals managed by so-called hospitalists. A hospitalist by definition is a physician contracted to maximizes hospital billing and collaborates on insurance funding. Instead of using the EMRs accessed in a tablet to refer to specialists like cardiologists and neurologists, a hospitalists will generate billing by connecting with other wellness type of providers. An example is PacificHospitalists.com contracted at Hoag Hospital in Newport Beach. When calling Pacific Hospitalists, their statement was the doctors do not work with patients but only with hospitals and insurance companies. My experience at Hoag was being billed for 45 chest X-rays by seven providers over 18 days despite no cardiac arrest, blockage, cholesterol or cardiomypathy. One provider stopped at 10 chest x-rays, and there were no reports of any physician actually reading the redundant chest X-rays. But the lead physician at Pacific Hospitalists did bill several thousand dollars for Day Encounters that supposed were to manage who did what with actual in-hospital services. Will physician tablets merely be a tool to connect for more unnecessary medical services? Insurance providers like UHC already disseminate patient records through outsourcers like inContact to telemarket hospital patients after returning home. Physician tablets with EMRs and EHRs could become social media for work-at-home nurses selling remote nursing, prescription management, and other wellness deals.
Bento, like most other iPad apps are not encrypting patient data on the device. If you sync it to iCloud or transmit any record, you are in violation of HIPAA regulations.
In my case I use Bento for iPad with a personalized database optimized for my work.
I hope an iCloud integration soon to save my medical records on the cloud.
Airprint service like Filemaker Go for iPad would be great, too.