Physicians see numerous obstacles to mobile computing, other new technologies
“IT needs to recognize that physicians are mobile professionals,” said Gregg Malkary, BA, MS, managing director of Spyglass Consulting in Menlo Park, Calif. He presented the results of an independent study on physician views on mobile computing during “Staying Connected: Trends in Mobile Physician Solutions,” on Tuesday at the annual Healthcare Information Management Systems Society (HIMSS) in San Diego.

The study found that physicians see several obstacles to mobile computing, he said. These include costs, longer workflow compared with the trusty pen and paper method they already know works well, a lack of incentives, and security and privacy concerns.
According to the study results, physicians don’t invision one ideal mobile computing device. For now, physicians prefer PDAs, although tablet PCs are gaining traction. PDAs are easier to carry around compared with tablet PCs and laptop computers. However, they don’t provide much screen space or processing power. Most physicians said they find tablet PCs and laptops too big and heavy for rounds.
When asked about handwriting recognition and speech recognition, physicians said the technologies are not yet viable (61 percent and 71 percent, respectively). They said handwriting recognition has too low of a recognition rate resulting in them being in a continuous error correction mode. Physicians find speech recognition to have unpredictable results, a low rate of recognition, and requires too much training—sometimes up to six or eight months.
Infection control is another obstacle to mobile computing. Nurses and doctors see the problem differently—75 percent of nurses said mobile devices pose an infection risk, while only 25 percent of physicians agree. “A device is only as clean as the last person who touched it,” said Malkary. He cited an Alaskan doctor who cultured hepatitis B off of a PDA. Plus, studies show that only about 50 percent of clinicians are compliant with handwashing standards, he said.  
Other deployment challenges include limited funding for the devices, the true cost of ownership is unknown, and clinician adoption—they have no compelling reason to give up paper.
Another problem is that most physicians feel that product vendors over-promise and under-deliver.
Malkary also filled in for Stephen Davidson, MD, chair of the emergency department at Maimonides Medical Center in Brooklyn, who missed the presentation due to travel problems. The 700-bed facility is ranked as one of the top 100 wireless hospitals. They purchased PDAs in 2001. This was heavily funded by drug companies and was used as a recruiting tool. The facility is now in the process of testing tablet PCs in the emergency department, primarily to reduce the congestion at nursing stations. So far, they’ve found that physicians prefer a device with a keyboard.