Since the debut of the iPad and iPhone, new applications have been developed that are being used in almost every field. The iPad debut in April 2010 drew crowds to stores across the country, dwarfing the frenzy created when the iPhone went on sale in 2007. Nationally, the pace at which physicians are using the iPhone and iPod Touch is timidly accelerating with widely used clinical applications.
At The University of Toledo Medical Center (UTMC), the iPad and iPhone were embraced as having the potential to transform healthcare delivery the very week they debuted. The design of iPad overcame the inconveniencies and limitations of the widespread adoption of personal computers (including laptops and tablets). The size and functionality of the iPad were a compelling factor that piqued the interest of the UTMC chancellor and executive vice president for biosciences and health affairs and dean of the College of Medicine. An initial introduction of iPads and iPhones to physicians willing to be part of early adoption was met with success. This initial reaction and demand by many UTMC physicians, young and old, propelled the need to create interfaces to UTMC’s electronic medical records and electronic health records systems for iPad and iPhone users.
Using UTMC’s 4G speed of 300mps wireless on both Health Science and Main Campuses, physicians are able to connect to “virtualized EMR/EHR systems.” Through Wyse Pocket Cloud on iPads, UTMC physicians are able to access clinical systems in a virtual environment wirelessly on hospital floors and in any of the 34 clinics. iPads are also used to access the Clinical Portal, view EEG images, sign charts, and work in any other software while on any campus, hospital, or clinic. UTMC physicians also use the iPad and iPhone to take clinical notes instead of the old clipboard in minor exams and other diagnostic evaluations. In addition to using the iPad and iPhone to access all clinical information system applications, physicians also use the iPad and iPhone to access their email, calendar, and contacts.
Contrary to some statements that iPad and iPhone would only be embraced by young physicians, a majority of UTMC early adopters are more senior physicians, including many of the clinical and basic science department chairs, associate deans, etc. However, The UTMC is exploring a requirement for all medical students to own and use an iPad in lieu of laptops and desktop computers. This will create an overwhelming widespread adoption and make the iPad an indispensable tool as they train.
While the use of iPads at UTMC has been successful, it is, however, not without some initial challenges. Undoubtedly, the bright, crisp, light, thin, and high-performance iPad debuted with high expectations, requiring UTMC to modify, reconfigure, and develop applications to scale up to iPad full screen. The characteristics of the iPad make it less intimidating to physicians and patients during exams. The omission of flash, camera, external mouse connector, and USB ports created some initial challenges. The challenge posed by the virtual keyboard was overcome by physical keyboard options through docking and the use of Bluetooth; however, the iPad does not currently support Apple’s Bluetooth mouse, so extended activity within iWork and other click-heavy applications became a challenge.
The challenge of using an iPad on a busy hospital floor was overcome through the use of an invisible protection for the iPad from Simplism’s Crystal GABAN set. The set is made of an impact resistant, high-transparency polycarbonate material. It is shaped to fit the iPad, with openings for direct access to all controls. Theset comes with hook carabiners and straps that can withstand disinfectants. The challenge of having enough battery power for shift changeover was overcome by individualizing the iPad for physicians, making them responsible for charging the battery of their own system. Although the technology is still quite young, this type of interface appears to have great promise in preclinical and clinical health sciences education, as well as in inpatient and outpatient healthcare delivery.
Godfrey Ovwigho, Ph.D., is the vice president of Information Technology and chief information officer at The University of Toledo. The University of Toledo Medical Center is the only academic medical center in northwest Ohio with specialty care in cardiology, neurology, orthopaedics, cancer, surgery, kidney transplantation, and a level-one trauma center. It also maintains the area's only accredited primary stroke and cancer centers dedicated to clinical and translational cancer research, education, and treatment.