Options for Mobile Health Devices Fall Short

Outpatient and hospital physicians have markedly different preferences when it comes to mobile health devices, but both groups agree that currently available products are inadequate, according to a new report by the Spyglass Consulting Group.

Over half of the physicians interviewed said PDA (personal digital assistant) screen size and data entry methods limit its use in clinical work. For the Tablet PC, size, weight and battery life were the problems cited by the majority of physicians.

New devices hoping to combine the advantages of the small PDA and Tablet are already emerging, said report author and Spyglass Director Gregg Malkary, describing the NEC Mobile Pro as such a hybrid. “What were already seeing is convergent devices,” he said. “The screen sizes are starting to get larger.”

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Tablet PCs were favored for more complex applications. Ninety-eight percent of survey participants said the PDA is the mobile device used for simple tasks like looking up usage or formulary information on drug reference databases or for figuring out dosage programs on a medical calculator However, this shrank to only 48 percent for tasks like managing data for specific patients.

PDAs might not fare well if single-function applications are replaced by more-demanding integrated ones, said Malkary. “As you bring in more robust infrastructure, as you bring in more robust solutions for managing networks, the requirements can overwhelm the PDA.”

Malkary said some application vendors support both PDAs and Tablets, but sometimes not optimally. “The applications need to be not just ported to the Tablet but rewritten to take advantage of its functions, like handwriting recognition,” he said.

But Tablet PCs also need significant improvement. Malkary said the device should drop to less than 2 pounds, and battery life needs to be longer. Just over half of those surveyed said health care IT vendors provide poor-quality products for easing physician workflow.

Flash Gordon, a private physician in Greenbrae, Calif., who did not participate in the survey but has used both PDAs and Tablet PCs, said good software is key.

Gordon said hed tried and given up using a Tablet PC, but much of that was the fault of the application, not the device.

“I think Tablets will largely supplant PDAs, once the EHRs [electronic health records] get better,” he said.

The device itself has some advantages, he said, like not needing to log on and off continually if there are screens in each room. On the other hand, he said, “the batteries would die after three and a half hours, and the day would be broken into segments,” posing a major inconvenience.

Next Page: Why outpatient physicians are open to the Tablet PC.

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Although the PDA is the most common device used, outpatient physicians are much more open to using the heavier Tablet PC, which has a keyboard and larger screen. Overall, 20 percent of such physicians surveyed for the report use Tablet PCs, up over fourfold from a similar survey in 2003.

When asked whether a Tablet PC is suitable for daily clinical use, over three-quarters thought it is, compared with just under half of physicians who work in hospitals. Outpatient physicians are also twice as likely to use a Tablet PC than their hospital-based counterparts.

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Part of the difference, Malkary said, is that hospital physicians walk farther from their offices when doing rounds and are more likely to access computer terminals spread throughout the hospitals, sometimes even at patients bedsides.

“In a hospital-based environment, the need for mobile computing seems to be less,” Malkary said. “Hospital docs look at this as carrying around a brick with them.”

Ultimately, he said, the right device depends on environment, complexity, personal preference and tasks.

The Spyglass report, “Healthcare Without Bounds: Mobile Computing for Physicians,” is based on interviews with 102 tech-savvy physicians conducted toward the end of 2004. Malkary said that Spyglass Consulting did not receive outside funding to conduct the research.

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