Apple iPad Prepares Nurse Practitioner for House Calls

Apple iPad Prepares Nurse Practitioner for House Calls

In 2005, nurse practitioner Dr. Scharmaine Lawson-Baker lost her office building to Hurricane Katrina, but before evacuating to San Antonio, she was able to save most of her patients' records on her Pocket PC PDA.

Lawson-Baker, who holds a DNP (doctor of nursing practice) degree, uses the Apple iPad to make 10 house calls a today to senior and disabled patients as owner of Advanced Clinical Consultants in New Orleans.

"Basically, I'm providing primary care in the home without the patient ever leaving," Lawson-Baker told eWEEK. "That's a major blessing for someone who's 96 or 97 who can't get out. So I bring it all to them high-tech."

Lawson-Baker's iPad runs Practice Fusion's free EHR (electronic health record) application to keep track of patients' health data and allow them to view their lab results.

"Scharmaine is a health care hero," Ryan Howard, CEO of Practice Fusion, said in a statement. "She is leading the charge with medical technology to support her community and deliver the highest quality of care to patients."

eWEEK spoke with Lawson-Baker to find out how the iPad running Practice Fusion's EHR application enables her to make house calls to her patients' homes.

eWEEK: Do you see the iPad as a trend for house call providers?

Lawson-Baker: Oh yeah, I do. I think it's going to be something that's catching on, because the iPad is very light, it's easy to carry, it's pretty easy to maneuver and use when you're in the home. In most of those situations when you're in the home, less is best. You need something that's more compact, something that's light, something that's easy to take out and easy to get going with and use. In a nutshell, you're on the front lines of health care when you make house calls.

It just helps so much with functionality, when you're able to make something appear, make something get bigger, make something get smaller. So those are things I use a lot, especially with the magnification of vital signs. I use that function a lot with my elderly patients because their vision is poor. So you need to increase the font rather quickly. The way you can expand something, make it smaller, with your fingers, it's great. 

I think my oldest patient now is 102. They need to be able to see big words and big letters. So I increase the magnification, and they can see it.

eWEEK: How does using the iPad compare with rugged models?

Lawson-Baker: I have one of those [Panasonic] ToughBooks. I went with the iPad because it was lighter and not as bulky. If you get the right carrying case for your iPad, you have the same protection.

I have a case that stands up and pretty much covers the entire iPad, so if I drop it, if I spill something on it, it's just as durable without having all the bulkiness. Don't get me wrong, I love my Panasonic ToughBook. It's great, but it's a little thick and bulky.

eWEEK: How much are you using the EHR application versus the patients?

Lawson-Baker: I'm showing them their vitals, and I'm letting them see their lab work. If I have some X-ray reports, I'm showing them their radiology reports and any other type of diagnostic type results I may have. They're looking at that, but as far as them actually doing anything else on the screen, no, we don't have that capability just yet.

eWEEK: What features in the Practice Fusion EHR have been helpful to you?

Lawson-Baker: I like that the whole product is Web-based. If my staff has some orders or lab work or something they need me to see that's come in on a particular patient, then I can get them to scan it in, and while I'm in the field I can pull it up immediately as long as I have an Internet connection.

The other function is e-prescribing. I'm able to electronically prescribe all of my prescriptions. A lot of my patients are not able to get out of the home, so they don't have transportation. Being able to e-prescribe or send a prescription electronically is a lifesaver for many of them because they don't have transportation. So I send the prescription electronically, and then I have a local pharmacy who delivers the medicine.

One of the other features I like about Practice Fusion is you can do live chat. It's kind of like instant messaging. If you have a question or issue, you can just pop up the little box and go on live chat. That's a feature I've never experienced before where you can get instant help.

If you've got something major like your system's out, that really takes a little more time and you may need to open a ticket or go on a queue for something like that. If it's something really small, like I keep getting an error message, EMRs should make themselves available.

Apple iPad Prepares Nurse Practitioner for House Calls

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eWEEK: On the iPad, can you track information such as blood glucose levels and blood pressure?

Lawson-Baker: Yes, I can track all of that from each visit that I make. I can pull up the last visit, the one I made three months ago, the one I made last year, and it all shows up in a nice little graph. They can see chronologically what the progress has been, whether it's been positive or negative regarding their blood pressure, blood sugar or any other lab work.

eWEEK: What was your experience like during Hurricane Katrina?

Lawson-Baker: Before Hurricane Katrina I was a tech geek, but after Hurricane Katrina I was really a tech geek, because I actually saved my practice from literally being destroyed, my paperwork and all my patient documents because I had 100 patients stored on my PDA, my PalmPilot. I synched with my main computer before I left, when we were told to evacuate. But of course the city was underwater, so we couldn't get back.

And when I returned, everything was gone, so all I had was my information on my PDA. I was able to get up and running and seeing patients as soon as we returned in October 2005, whereas most of the hospitals couldn't even get started and a lot of physician offices and other nurse practitioners were pretty much... they couldn't do anything because they didn't have their patient information. But I at least had my patient information stored and was ready to go.

I returned in October 2005. I had a PalmPilot and a Pocket PC. One was my backup, so most of my data was stored on my Pocket PC. I had some on my PalmPilot, but the majority of it was on my Pocket PC.

I realized the power of technology once I returned. People take it for granted as far as how technology can be beneficial to the health arena. I don't think people realize how important technology can be to your practice until, unfortunately, something like Hurricane Katrina occurs.

I learned firsthand how helpful and timely [technology] can be. I was just thinking, OK, time to evacuate again. I just kind of haphazardly grabbed my Pocket PC. I'm glad I did have it because while I was in San Antonio, I had to correspond with patients and their physicians who were all out of town, trying to find out what medicines these patients were on. I was able to give them some data from my PocketPC. I was at least able to tell them the medicines, give them emergency contacts, let them know when their last mammogram was. It was very helpful once I evacuated, and certainly once I returned to the city I could pretty much just get up and running because I had most of my records with me, even though my office was destroyed.

eWEEK: How long were you away from home?

Lawson-Baker: Three months. We wanted to come back sooner and hit the ground running. I wasn't sure what I was going to be doing. I was just as shell-shocked as everybody else, but I knew I had to get back.