iPad EMR Eases Doctors Concerns

At least the above is the title of the Information Week article on ClearPractice’s iPad EHR interface called Nimble. You might remember that I did a short review of the Nimble iPad EMR previously. I still stand by my comments of the Nimble iPad interface not being perfect for the iPad. The keyboard was clunky and slow to appear and the boxes were surprisingly small for a native iPad app.

Here’s the doctor in the article’s take on the iPad EMR:

Having a small office, there’s no space for a desktop in the exam rooms, so prior to recently using Nimble on the iPad, Dr. Lianna Lawson, a solo-practitioner, wheeled a laptop on cart to exam rooms.

“Laptops on carts — I don’t like that, it seems impersonal,” said Lawson, whose practice, Lawson Family Medicine and Aesthetics is based in Daleville, VA. Lawson has been using ClearPractice’s web-based EMR on a laptop for about a year. Lawson added Nimble to her practice in September.

Nimble running on the iPad, “has the feel of a [paper] chart,” Lawson. “Many doctors are traditionalists, so the comfort level with technology is difficult,” she said. “But for physicians not particularly tech savvy or reluctant of about how they’ll meet the meaningful use requirements, this gives a little more comfort and confidence,” she said.

It’s true that laptops on carts are a mess. As I recently argued in a post on healthcare mobile devices, the iPad does seem to have the right size and feel. That combined with the 3G connection helps to change the game. Although, I think we’re going to see more devices that build on top of the iPad’s innovations and provide an even better user experience for doctors.

Here’s another quote from the Doctor about the use of the Nimble iPad EMR:

Now Lawson said she brings the iPad with her wherever she goes, responding to patients “24 by 7,” when they have questions over weekends, or other after-hour concerns. In the office, she can use Nimble “while scooting around” in her exam rooms caring for patients.

There’s been other surprise perks to using the iPad-based product, namely engaging patients while using the EMR, she said. “I didn’t expect this to be the result, but patients can see” and talk about what’s on the EMR as she uses the iPad near them. The interactions can help in building a more solid dialogue between physician and patient — and can even help make records more accurate.

While Lawson was using the iPad during a patient exam recently, the patient saw that an entry on the list of medications in her health record was incorrect, and the patient reminded Lawson that she was no longer taking a particular drug. Lawson updated the information.

The first paragraph highlights what some doctors hate about an EMR. They want to leave the office at the office. They don’t want to be proverbially chained to the office since it’s all literally at the touch of their fingertips. Maybe this is why there were so many work life balance sessions at the AAFP conference I attended recently.

Patients seeing what you’re doing in your EMR has often been seen as good and bad. Some doctors love it and embrace the participation with the patients. Other doctors hate having the patients look over what they’ve done and have to answer more questions because a patient saw something on the screen which they didn’t understand. I think we all know which doctor we’d rather see. Although, we can all appreciate the uneasy feeling of someone looking over our shoulders.

The article did remind me of the images that the Nimble EMR makes available to a doctor. That part is actually really cool and the iPad is the perfect way to display and navigate those images as a doctor describes something to a patient.

I should also remind people, the iPad still doesn’t print. Although, that should be remedied relatively soon. Or there are a few hacks out there to make it happen.

About the author

John Lynn

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • Nimble is pretty good, but the way you have to enter your ROS and exam is a little clunky. I could see it working pretty well with practice. Since I am not a primary doctor I have a little trouble understanding the workflow as they have arranged it. Also on the demo I can’t evaluate CPOE functionality, which is very important.

    They tell me they plan to incorporate Dragon Medical Mobile into their next release when the iOS4 is released. That would be awesome and would almost fix the problem of physician narrative entry. However, my calls to Nuance about this went unreturned. To me, it doesn’t look like Nuance is close to releasing their Dragon Medical Mobile SDK yet. Maybe a blogger such as yourself could unravel the mystery of how ClearPractice can release a Dragon ready version when the SDK is not available.

  • Brian,
    I’ll email my contact at Dragon and see what they have to say.

    I think I mentioned in my previous post (if I didn’t my apologies) that Nimble actually has some built in speech recognition software already. It’s not Dragon, but it’s some other speech recognition software that from what I understand is ClearPractice’s own software. I could be wrong on that part, but the guy who demo’d it for me said it had speech recognition already.

  • A few of our users have been using iPads for our browser-based EMR system, Ankhos, with great success. I initially doubted the effectiveness of the iPad with such feature and data-rich software as EMR systems, but with the dedication and perserverance of my users, we have made the iPad a very efficient alternative mode of access to Ankhos.

    I wrote a post about it a few weeks ago.

  • Per ClearPractice:
    “Yes, we plan on having the Dragon Dictation on the next release in November when Apple releases the new ios system. Our current Web Version that runs seamless with Nimble has Dragon Dictation.”

  • There is a clear move into the cloud and Nuance is no exception demonstrating the capability with several releases already:
    Dragon for the iPhone and
    iPad and Dragon Medical Search
    that demonstrate the capability to offer speech enablement to anyone, anywhere anyplace and anytime. We are working with many vendors on voice enablement on mobile platforms specifically to address such issues as
    >>>the way you have to enter your ROS and exam is a little clunky<<<<
    In many cases with the limited screen and input channels available speech can be the easiest and most natural means to interact effectively and efficiently on the mobile platform and Nuance is committed to delivering this functionality offered through our partners using our toolsets and technology in a mobile SDK.
    There is a lot of interest around mobile technology and the Nimble EHR. See this post

  • Nick,
    Where’s Nuance at in the progress of releasing its mobile SDK to vendors like those behind the Nimble EHR? Do they have it in their hands now to start integrating? Has the SDK been released yet?

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