By Kyungmi Park, Eunkwang Joo and Soren Svejstrup
All internal-medicine residents at the University of Chicago and Johns Hopkins are given iPads; entering medical students at Stanford are given vouchers they can use to buy one. iPads are also being implemented in hospitals and in private practices, and it can therefore be argued that tablets are becoming a standard tool in the practitioning of medicine (I). Of course this introduction of tablets into the healthcare industry has led to some changes in the way doctors, nurses, and patients collaborate.
Will the iPads increase productivity in healthcare? When concerning the productivity, we cannot just measure quantity of input resource and output products. Rather, there are multi dimension to measure the productivity. If we try to measure the productivity of tablet devices, we have to discuss how conveniently people finish the work, how much the quality of the work improves as well (Brynjolfsson & Hitt, 50). A hospital may benefit greatly in productivity by using this new technology with Electronic Health Record (EHR) system. With tablets, practitioners and patients can get access to health information more conveniently. It will help doctors share the information with patient by seeing the screen together. Health workers can visit patients’ home more easily thanks to the mobility of tablets. With more interactive documents, the understanding of patients will increase, which could potentially reduce conflicts between doctors and patients. In this way the increase of the productivity seems hidden, yet it really comes. This is how to work smart with smart devices.
As the use and the needs for iPad in medicine increase, its’ support in the medical system is being developed. Now apps like MedCalc allows doctors calculate the right amount of medicine and provide information on when and how to take the medicine. The Mobile Revolution has indeed allowed health care workers to be productive, when they are away from their desks (Rainie & Wellman, 173), but to many people the new tools seem like a black bag of information, which provides a way to diagnose symptoms, treat patients, and share information (II).
A new iPad and iPhone app called AirStrip lets hospitals connect an E.K.G. machine, a ventilator, or a fetal heart monitor to servers and then transmits the data to a mobile device (III). This is an example of what Rainie & Wellman term the Internet and Mobile Revolutions and how that affords opportunities for networked doctors and nurses by allowing them to communicate and access shared information at a distance. This type of communication allows for the data to be transmitted directly to the responsible persons’ iPad and he can take immediate action and prepare the treatment and the staff before the ambulance brings in a patient. This is pushing autonomy to the doctors, who do not have to wait for data, mediated by phone workers (Rainie & Wellman, 178).
However, just to adopt tablets is not sufficient to increase productivity. Supports in an organizational level is essential (Brynjolfsson & Hitt, 55). For example, the adoption of tablets multiplies several fold the importance of security. Institutions should secure more investment such as employee education, and development of incentive system (Brynjolfsson & Hitt, 50-51). Without organizational supports, the adoption of tablets can be fatal. Although it takes time, and requires much investment, it’s probably feasible to change the work practices. When we measure qualitative and quantitative analytics together, we could find the benefits of adopting the new technology.
According to Suchman(61), a thorough ethnographic fieldwork is necessary to design work and system. The work representations are artifacts contructed from particular social locations and within specific forms of practice (Suchman, 63). Since the representation of work can be quite different based on its context, controls and practice, the framework of clinical setting has to be redefined to incorporate with systematic changes from the universal tablet use. For example, re-writing in patient charts may have stereotyped as a replaceable work chore, but it might actually give the practitioners time to resonate with patient data. Thus, having a clear work representation will definitely help re-designing the healthcare with iPads.
In addition, the question we need to ask ourselves is, does an iPad or an app really make people better doctors or more caring clinicians?
Dr. Paul C. Tang, chief innovation and technology officer at Palo Alto Medical Foundation in Palo Alto, said that: “What we need to learn is how to use technology to be better, more humane professionals” (I).
It is however hard to get tacit knowledge and fine grained information online (Rainie & Wellman, 191), so doctors and nurses must be very careful, that they do not turn their backs on patients while struggling with a new computer system, or rush patients through their appointments while forgetting the most fundamental tools — their eyes and ears.
Footnotes (online articles)
Brynjolfsson E. and L. Hitt (1998) Beyond the Productivity Paradox: Computers are a Catalyst for Bigger Changes. Communications of the ACM, 41(8): 49-55.
Rainie, Lee and Barry Wellman (2012) “Networked Work” in Networked: The New Social Operating System. Cambridge, MA: The MIT Press.
Suchman, L. (1995) Making Work Visible. Communications of the ACM, 38(9): 56-64.