Managing devices at the edges of the network is not a new problem. In fact, looked at one way, we’re still dealing with the same problems of sharing computing intelligence that the first gen of client-server developers did.
But in a world where mobile devices are expected to do such critical work, I believe we’re at a unique juncture. HIT leaders are going to have to figure out how to completely transform balance between smart/dumb clients and their relationship to applications. In other words, they’re going to have to manage from the edge in as well as from the core outward from now on. Too strong a statement? Hear me out and see what you think.
Since the 1960s, we’ve gone back and forth between expecting edge devices to be dumb conduits for computing results (the green screen) and super-smart computing devices which needed the network only to connect users to each other.
Now, here in health IT land, we’re trying to find a balance that generations of brilliant developers and engineers have struggled to achieve. With the advent of relatively cheap, flexible WiFi networks and widespread use of 3G/4G devices on the road, we’ve got the network infrastructure nailed for the time being.
But what do we do with the pesky limitations of those oh-so-popular iPads, Android tablets and smartphones? Short-term, the answer for many IT organizations is making EMRs accessible only via devices that can run a remote desktop. This compromise works for some users and is detested by others. This may be a decent technical solution, but it may not be a usable one.
According to one reader, the way to create this balance is to create a better virtual desktop:
Were I a present-day EHR vendor, I’d start designing interfaces that work well when accessed via touch-screen devices that are using remote-desktop software, in preparation for a future when it is standard practice for all clinical staff to carry around iPad-like devices.
I think he’s dead-on. These devices aren’t an add-on anymore, they’re a permanent part of the clinical workflow where a lot of important, nay, life and death work will get done. Readers, are you aware of anyone who has created an iPad virtual desktop interface which feels workable to the clinicians you know?