Mobile vs Computer and the Patient Interaction

“It’s Friday, Friday! Gotta get down on Friday. Fun, fun, fun, fun. Looking forward to the weekend.” – Friday Music Video by Rebecca Black Dang those viral videos, but I have to admit that I’m grateful that today is Friday and I have a weekend to catch up on things. I’m sure that many of you can relate to this feeling.

As we head to the weekend, I’ll leave you with a little something to think about and discuss in the comments. Someone at HIMSS pointed this out to me and I thought it was worth sharing. Think about the patient interaction in the exam room. For some reason, doctors don’t and haven’t had any problem pulling out their mobile phone (or previously their PDA) in order to pull up Epocrates (or some other similar app) while in the room with the patient. It was perfectly natural for them to pull it up to look up a certain drug or other information.

Why are doctors comfortable with a smart phone between them and a patient, but a computer is not? Is there a relationship between this and why the iPad is so popular with doctors?

About the author

John Lynn

John Lynn

John Lynn is the Founder of the 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.

7 Comments

  • I would think the answer to this question would be fairly obvious, but apparently not.

    When you pull out a smart phone to check a drug dose or drug interaction, it is targeted to a specific relevant question. The software is typically easy to use so you can go straight to the information that you need. The patient can see that you are clearly doing something that is of value to them. It typically occurs in the context of an understandable flow to the visit (e.g., writing a script) so it doesn’t disrupt the clinical flow, the clinician’s thought process or the patient’s description of his/her concerns. It’s small so that it doesn’t require turning your back to the patient (as in many office configurations of desktops) and it is a brief interlude in the scheme of the entire session with the patient.

    This is in contrast to struggling with a clunky piece of poorly designed EMR software that disrupts one’s interviewing and thought processes and distracts from what the patient has to say.

    iPad applications like the smart phone tend to be better designed in terms of usability and also make it easy to maintain eye contact just by looking up (without a laptop screen in the way or desktop monitor).

  • I was going to further what the doc had said above in distilling it to a possible case of trust. The doc had lots of hours utilizing an application on their iphone or ipad in their own time. Just as muscle memory for a sport helps build mental confidence, the same applies in this senario – the doc just trusts this device because of the hours logged using it.
    I do believe that if an EMR had the same functionality, with enough flight time, a doctor would become just as trusting with the EMR as they would with their iphone, provided it works reasonably well.

    Long time reader – thanks for your thoughts and ideas!

  • Thanks Michael; yes, the muscle memory anology is apt for such a setting.
    Further to Dr. SB’s comment, IPAD is great and looks good. A Windows 7 Notepad provides the same functionalities of IPAD and more in terms of Handwriting Recognition which, we found amazing. We do recommend the Windows Notepad as a standard HW for our clients. Works better and has all the functionalities required including a twist ou/pull out keyboard as opposed to IPAD which looks sexy alright, but does not (at least not yet) deliver all the functionalities.
    Although bashing up EHR Vendors is a norm in most of the blogs, I believe we can all agree that we are in the early stages of Electronic Health Records and we have ways to go. We are just getting the Providers to start using technology; clunkiness will improve as more users start using EHR so that proper usability research can be conducted. Its a process all EHR vendors (good vendors!!!!!) are going through; each of these studies take time to complete. Patience is a virtue!!!!!!!!!!!!!!

  • Thanks SB MD for sharing your thoughts. I certainly would have similar ideas, but it’s always good to hear from other people to expand my and other readers of the site’s perspective on it. Here’s a summary of what you said:
    1. Do Something of Value to the Patient
    2. In context of visit and normal flow of visit
    3. Small (Facing Patient)
    4. Data Entry is Brief

    That’s a great list of things that need to be done with an EMR interface and EMR implementation to ensure that you keep the patient interaction that’s best for quality care.

    Michael, I love the concepts of “Muscle Memory” and “Flight Time.” I’ve seen this first hand when you see doctors complaining when you first get an EMR and then seeing them a few months later. It’s amazing what familiarity will do.

    Thanks for reading and for joining the conversation.

    Anthony, I saw a Fujitsu tablet recently that looked and felt like an iPad, but ran the Windows O/S. I’m hoping to get a demo model once it’s officially released, but it definitely looked like a great alternative to the iPad and with all the security and flexibility of the Windows O/S.

  • The hardware is not the main problem. When vendors say a certain tablet (usually a PC) provides more functionality, they mean more functionality for their clunky software. That being said, I have used PC tablets and found them to be heavy, warm, slow, glitchy, and with short battery life. Not to mention you would be using point-and-click software on it.

    Doctors like the iPad because it is not all those things, and because the software works and feels right. But you can’t just Citrix your way into an EMR on your iPad and think it is somehow going to be better than a PC tablet. There has to be a marriage of hardware and software. Apple gets that. No one else does.

    I also don’t understand the security issues IT people have. Hospitals are using iPad all over the country. They can be completely locked down, wiped remotely, fully encrypted, used only on a secure network, etc. What’s the problem?

  • “They can be completely locked down, wiped remotely, fully encrypted, used only on a secure network, etc” but most iPad’s aren’t and it’s beyond most small doctors offices to do this now. This will likely change as iPad implements many of these features into their O/S and other apps make it simple to implement as well.

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