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Mobile EHR Access Is Maturing

Posted on August 4, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Today I read a story that surprised me, though perhaps it shouldn’t have. A clinician, writing for a publication called Diagnostic Imaging, suggests that a “mobile EHR” is emerging, a new entity which embraces mobile technology rather than treating it as an add-on. I wasn’t surprised that this was happening, but it is remarkable that it’s taken us so long to get to this point.

As Saroj Misra, DO, notes, healthcare organizations are rolling out infrastructure for clinicians to access EHR data via mobile devices, and EHR vendors are ramping up development of mobile interfaces for their systems. And physicians are responding. According to a recent Physicians Practice survey, 78% of physicians are now using mobile-accessible EHRs, and more than 85% of doctors and practices were using mobile devices to do their jobs.

As he sees it there were three big issues which previously held back the development of mobile EHRs:

  • Mobile device screens were too small, and battery life was inadequate.
  • EHR vendors hadn’t created interfaces which worked effectively with mobile devices
  • Healthcare organizations weren’t convinced that mobile EHR access protected health data sufficiently

Today, these problems have receded into the background. Screens have gotten larger, battery life has been extended, and while security is always an issue, standards for protecting mobile data are gradually emerging. Also, healthcare organizations are developing mobile device management policies which help to address BYOD issues.

In response, EHR developers are embracing mobile EHR access. There’s vendors like drchrono, which is a mobile-native EHR, but that’s not all.  Other ambulatory vendors, like athenahealth, describe themselves as a “provider of network-enabled services for electronic health records,” and MEDITECH’s Web Ambulatory app runs on a tablet.  Also, Cerner’s PowerChart Touch solution is built for the Apple iPad.

At this point, I truly wonder why all EHRs aren’t developed primarily with mobile deployment in mind. Physicians have been engaged mobile device users since smartphones and tablets first emerged, and the need for them to manage patients on the go has only increased over time. I know desktops still have their place, but the reality is that empowering physicians to take patient data with them is overwhelmingly sensible.

My sense, after researching this post, is that ongoing security worries are probably the biggest roadblock to further mobile EHR deployment. And I understand why, of course. After all, many of the major health data breaches occur thanks to a stolen laptop “walking away” when it’s left unattended, and mobile devices may be just as vulnerable.

That being said, the benefits of giving doctors an elegant mobile EHR solution are substantial. With the right targeted security policies in place, I believe the benefits of robust mobile EHR deployment – particularly giving clinicians on-the-spot data access and getting immediate data back — far outweigh these risks. I sincerely hope the HIT software industry agrees!

By Supporting Digital Health, EMRs To Create Collective Savings of $78B Over Next Five Years

Posted on December 1, 2014 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Here’s the news EMR proponents have been insisting would emerge someday, justifying their long-suffering faith in the value of such systems.  A new study from Juniper Research has concluded that EMRs will save $78 billion cumulatively across the globe over the next five years, largely by connecting digital health technologies together.

While I’m tempted to get cynical about this — my poor heart has been broken by so many unsupportable or conflicting claims regarding EMR savings over the years — I think the study definitely bears examination. If digital health technologies like smart watches, fitness trackers, sensor-laden clothing, smart mobile health apps, remote monitoring and telemedicine share a common backbone that serves clinicians, the study’s conclusions look reasonable on first glance.

According to Juniper, the growth of ACOs is pushing providers to think on a population health level and that, in turn, is propelling them to adopt digital health tech.  And it’s not just top healthcare leaders that are getting excited about digital health. Juniper found that over the last 18 months, healthcare workers have become significantly more engaged in digital healthcare.

But how will providers come to grips with the floods of data generated by these emerging technologies? Why, EMRs will do the job. “Advanced EHRs will provide the ‘glue’ to bring together the devices, stakeholders and medical records in the future connected healthcare environment,” according to Juniper report author Anthony Cox.

But it’s important to note that at present, EMRs aren’t likely to have the capacity sort out the growing flood of connected health data on their own. Instead, it appears that healthcare providers will have to rely on data intermediary platforms like Apple’s HealthKit, Samsung’s SAMI (Samsung Architecture for Multimodal Interactions) and Microsoft Health. In reality, it’s platforms like these, not EMRs, that are truly serving as the glue for far-flung digital health data.

I guess what I’m trying to say is that on reflection, my cynical take on the study is somewhat justified. While they’ll play a very important role, I believe that it’s disingenuous to suggest that EMRs themselves will create huge healthcare savings.

Sure, EMRs are ultimately where the buck stops, and unless digital health data can be consumed by doctors at an EMR console, they’re unlikely to use it. But even though using EMRs as the backbone for digital health collection and population health management sounds peachy, the truth is that EMR vendors are nowhere near ready to offer robust support for these efforts.

Yes, I believe that the combination of EMRs and digital health data will prove to be very powerful over time. And I also believe that platforms like HealthKit will help us get there. I even believe that the huge savings projected by Juniper is possible. I just think getting there will be a lot more awkward than the study makes it sound.

Study on the Economic Impact of Inefficient Communications in Healthcare

Posted on July 9, 2014 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Efficient communication and collaboration amongst physicians, nurses and other providers is critical to the coordination and delivery of patient care, especially given the increasingly mobile nature of today’s clinicians and the evolution of the accountable care organization (ACO) model.

For healthcare IT leadership, the ability to satisfy the clinical need for more efficient communications technologies must be balanced with safeguarding protected health information (PHI) to meet compliance and security requirements. As a result, the industry continues to rely primarily on pagers, which creates inefficiencies that can have a considerable economic and productivity impact.

To quantify this impact, the Imprivata Report on the Economic Impact of Inefficient Communications in Healthcare worked with the Ponemon Institute to survey more than 400 healthcare providers in the U.S. about the typical communications process during three clinical workflows: patient admissions, coordinating emergency response teams and patient transfers.

This report is chalk full of good information on the communication challenges in healthcare. Here’s one example chart from the report:
Wasted Time in Hospitals Due to Poor Communication

While it’s good to see that 52% think pagers are not efficient, I’d hope that the number were much higher. I think that most don’t realize how inefficient a pager really is to their organization. It’s interesting that 39% don’t allow text messaging, but it would be interesting to see how many of the 61% that allow text messaging use a secure text message solution.

I think the use of technology to facilitate communication in healthcare is one of the most exciting opportunities out there today. Certainly we have to be careful to follow HIPAA, but we need to not use HIPAA as an excuse for why we don’t use the technology to facilitate better communication.

There’s a lot more in the report that’s worth a read. I’m sure I’ll be covering more details of the report in the future.

Windows 8 Enables Healthcare Tablet Adoption

Posted on August 20, 2013 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The following is a guest post by Scott Thie, Vice President, Healthcare and Education, Panasonic
Scott Thie - VP of Healthcare and Education at Panasonic
Technology is evolving at light speed, and the way healthcare providers work is changing with it.

Mobile computing technology that was unimaginable five years ago is now commonplace, and has driven efficiency and productivity in healthcare by leaps and bounds. Doctors, nurses and healthcare administrators now have the ability to work from virtually anywhere, storing data “in the cloud” and staying constantly linked to the patient and one another.                   

One of the primary computing devices enabling this mobile evolution has been the tablet – a light weight, powerful and easy-to-use device that has gone from a niche product to widespread healthcare enterprise adoption. Tablets are an excellent way to boost mobility and workflow efficiency, and their role in healthcare continues to grow. Tablets’ portability, flexibility and ease of use have made them a great fit for health business applications of all kinds. In fact, over the next five years total shipments of tablet computers to enterprises around the world are expected to increase at a compound annual growth rate of 48%, according to Infinite Research.

It’s clear that tablets offer improved productivity and mobility, but this technology evolution has not come without its growing pains. In many cases, tablets are so attractive to users that many of them have not waited for their employers to issue them; they’ve brought their own personal devices to work. In other cases, healthcare providers have issued devices to their staff that are better suited for consumer use and lack critical security, durability and functionality features. This has resulted in a fragmented IT management landscape consisting of myriad devices with different operating systems, security challenges and support needs.

Recently, the technology industry has seen a shakeup that could play a large role in addressing this issue. Last fall, Microsoft released Windows 8, the most dramatic overhaul of its operating system since 1995. Offering a redesigned interface and several new features, the operating system is built for mobility, security and manageability. And when paired with enterprise-class hardware, Windows 8 opens the door for healthcare providers to embrace the benefits of tablets, without sacrificing on security, functionality and management capabilities.

Windows 8 Advantages

One of the most obvious benefits of Windows 8 is its redesigned metro interface. Built to take advantage of touchscreen technology, the interface offers enterprise professional users the fast and fluid efficiency and personalization found on today’s popular consumer devices. The operating systems use of swipe, tap and drag gestures allows users to easily switch between applications and multitask. While multitasking is a business reality, it’s a challenge for some tablet operating systems, potentially limiting worker productivity. The Windows 8 interface also includes live updating tiles, which can help business users retain situational awareness.

With the recent boom in mobile devices, many healthcare IT departments have been forced to integrate incoming tablets – with alternative operating systems and potential security risks – into legacy device management, security, and system integration structures. It can be difficult to securely and efficiently integrate mobile devices with newer operating systems like Android or iOS into a legacy Windows IT infrastructure, and often puts healthcare administrators into a “troubleshooting” mode instead of devoting their resources to ensure optimal patient care.

Designed with mobile productivity in mind, Windows 8 allows providers to avoid compromising on mobility, functionality and security by integrating seamlessly with legacy enterprise IT infrastructure. With Windows 8, users have the ability to use the same operating system in desktop and tablet environments. Not only is the IT department supporting a single operating system, users benefit from a seamless and familiar operating environment across all their devices.

Security is a critical need in healthcare technology, and Windows 8 offers several features not found in many other tablet operating systems. Secure Boot, for example, is a boot-up process that helps prevent malware from running at startup. Unlike some mobile app download services, Microsoft vets each app included in the Windows Store for quality and safety before making it available for download.

From an IT management perspective, a key benefit of Windows 8 is its ability to work with existing software and hardware. Many business-critical applications, especially in the healthcare segment, are designed to run on Windows. It’s also integrated into the enterprise in other ways, such as the many third-party cloud and software-as-a-service providers using Active Directory for identity management. Windows 8 works with mobile device management (MDM) systems as well, including offering features to secure devices from unauthorized use.

Choosing the Right Device

Equally important as the operating system is the right hardware. Purpose-built tablets, designed specifically for challenging environments, offer the durability, ease of use and warranty support that healthcare providers require, without compromising on security or manageability.

Before investing in a tablet deployment, verify that the device will offer the features your care providers and healthcare facility demand. Something as simple as a user-replaceable battery, which many consumer devices lack, could be a potential life-saver for doctors and nurses remotely accessing critical patient data. In other cases, it may be as simple as a tablet with a daylight-viewable screen, which ensures a clinician can work efficiently regardless of lighting challenges. Some hospital workers may need a device that can be used with a digitizer pen for signature capture or an all-touch interface for easy manipulation of medical images or text.

The most common causes of mobile computer failures are drops and spills. These dangers are magnified for healthcare mobile workers. Tablets should be engineered to be rugged enough to withstand a fall to a hard surface, sealed to withstand spills and dust, and easily sanitized help to ensure reliable operation.

With computer hardware such as tablets, it’s also important to understand the difference between price and cost. Even at an enterprise level, it’s natural to gravitate toward the lowest sticker price. However, if that device has a high failure rate, hinders productivity, lacks enterprise-level support or has a short standard warranty, it will end up costing more in the long run – not just in replacement costs but also labor costs, inefficiency, the loss of critical data, reduced patient satisfaction and more. Think about products in terms of their total cost of ownership in order to get the most for your money.

Tablets represent a turning point for the healthcare industry, with the promise of new efficiencies, methods of decision-making and competitive advantage. By making the right technology decisions, healthcare providers can ensure their physicians, nurses and medical staff are equipped to take advantage of these gains without compromise.

Scott Thie is Vice President of the Healthcare & Education Sectors for Panasonic System Communications Company of North America (PSCNA). He is a 24 year veteran of the technology industry and has been with Panasonic since 1998.

Scott began his career at Panasonic as an Area Sales Manager. He was promoted to Regional and then National Sales Manager before his current position. Scott has been recognized several times with awards including Rookie of the Year and Area Sales Manager of the Year. He successfully developed Panasonic’s Field Service Vertical and managed its growth for five years. During his career, he has held positions in sales and sales management, as well as management of marketing, business development and sales engineering. Scott’s current challenge is driving growth and extensively expanding PSCNA’s Healthcare Sector. Before joining Panasonic, Scott was District Sales Manager at Alps Electric, a company specializing in printers and OEM PC components. He was also Regional Sales Manager for Philips Electronics. Scott holds a BS degree in marketing with a minor in sales management from Ferris State University.

BYOD Deploying a Mobile Device Management Strategy

Posted on April 30, 2013 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The following is a guest blog post by Marcus LaFountain.
Marcus LaFountain Headshot
LaFountain has worked in IT for the last 10 years as a PC Technician, Help Desk Analyst, and System Administrator. He is currently a Healthcare IT Consultant specializing in Cerner and HIM implementations.

A recent Ovum study showed that almost 60% of employees bring some type of mobile device into the workplace. There are a few names for this, Bring Your Own Device (BYOD), Bring Your Own PC (BYOPC), Bring Your Own Phone (BYOP), User Introduces Unsecure Device onto My Network and Then Loses My Secure Data (UIUDOMNTLMSD). Alright, so I made that last one up, but that is how most IT Managers feel when the discussion is started about BYOD. An end user bringing a device to work is both a gift and a curse for any sized company. We see an increase in productivity but also the increased threat of data being lost or stolen. Having a strong Mobile Device Management (MDM) strategy can help companies reap the benefits of BYOD while limiting the consequences.

Let’s start by going over some numbers. By 2014, the number of mobile devices (mostly mobile phones) in the workplace is expected to reach 350 million globally. A remarkable 57% of full time employees are already using mobile devices for work related tasks. Out of that 57%, about half is unmonitored, unmanaged BYOD activity. Another study shows that in 2011, 78% of companies did NOT have a BYOD policy and only about 20% of employees actually sign a BYOD policy.

There are many reasons to justify a BYOD policy:

Productivity:  An employee who uses their personal device for both work and play is on average likely to work an extra 240 hours per year than those who do not. They can answer emails on the go, answer phone calls while on the road (using a hands-free device of course!) and receive that last minute meeting update. . Most employees won’t want to bring a work laptop home just to check emails after dinner or during downtime at home. Letting them receive push emails may empower them to write a quick mail back to a client in a different time zone rather than having to wait until the morning.

Cost: There is also a cost justification. Not having to provide every employee with a business only device can save not only the cost of the device but the monthly service plan that goes along with it. The number of devices can be reduced as well. A mobile phone is a cheaper and sometimes more convenient alternative than a laptop with a 4G cell card. Employees can still stay connected when not physically at their desk.

User Experience: Tech Savvy employees tend to have strong preferences when it comes to the technology they choose to use. Forcing an Android user to use a BlackBerry device may not be an ideal situation. Giving employees the ability to choose their mobile operating system, screen size and other technical specs may make them more likely to use the device rather than it sitting in a desk drawer unused.

However, it isn’t all sunshine and rainbows in the world of BYOD. As the use of mobile devices increase in the work place, so do the number of malicious attacks. According to the Ponemon Institute, 6 out of 10 security breaches were traced back to mobile devices. Apple and Google are constantly removing mobile malware from their app stores. And as always, attackers are trying to pick the low hanging fruit of the mobile community first. Businesses must have policies and security measures in place to protect their data. In 2009, the US Government enacted the Health Information Technology for Clinical Health Act (HITECH) that requires healthcare companies to notify patients if they have had their health records compromised. Similar acts were also put in place in the financial industry.

Constructing a comprehensive Mobile Device Management (MDM) policy is imperative when users are allowed to bring and use their own devices. As with many policies, the contents may vary greatly by company. However, almost every company from small businesses to enterprises will need to focus on security and support.

Security:  A lost or stolen device is the most common type of security breach. A company must have measures in place to combat this. While an entire article can be written about mobile security, I will touch on some common features.  Both Android and Apple offer AES 256 – Bit encryption as a standard on their devices.  Lock screens, passwords and certificates all play a role in device management as well. Microsoft Active Sync and other software also allow administrators to perform a remote wipe of a compromised device. This is a necessary requirement when employees have company data on their mobile phones.  Samsung has developed an Enterprise suite called SAFE that allows the user to partition company data with personal data. It also gives administrators the ability to perform a complete or selective wipe, tracking of the device and local password enforcement.  Apple and other mobile providers are starting to or already have incorporated these features as well. If your company is using application virtualization, you may need to define new rules for allowing mobile devices. Users will also need a way to get a hold of someone 24/7 in the event of a lost or stolen device.

Support:  This may be a slippery slope for some. Most IT policies only allow for support of company devices. So who supports a personal device that is used for business? Depending on the size of your company, you may want to assign a dedicated resource from your IT Security team to manage your MDM policy. If you are an enterprise, you may need a small team to manage different aspects of the policy. Your Help Desk will need training on the various mobile operating systems and communication will need to be sent out to end users on how to stay on top of security. Documentation will need to be created on how to setup email, VPNs and passwords. Do you need to setup an approved device list or will you allow any manufacturer or mobile OS on the network? A pilot group (usually IT) will need to be put in place to test your new systems and policies as well. Audits should also be enabled to check for OS updates, application updates and security updates.

In a growing mobile market and the on demand nature of business today, IT Management will need to be one step ahead of its users by developing a MDM policy. When developing an MDM strategy, you must take into account your business needs as well as infrastructure requirements. Like any new implementation it is ideal to begin testing your technology and policies with a small subset of users and conducting a review process before rolling out corporate wide. Doing so may limit mistakes while in a beta phase instead of having them on a mass scale. Focusing on security and support will allow for a comprehensive strategy that will allow employees to operate efficiently and productively but most importantly safely.

Related Whitepaper:
How Technology Executives are Managing the Shift to BYOD
This white paper looks at the growing adoption of BYOD in healthcare and the possible benefits and hurdles of enabling employees to use their own consumer devices in the workplace.

Download Whitepaper or see More EMR and Health IT Whitepapers