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Mobile computing

Ottawa Hospital increases use of iPads

OTTAWA – The Ottawa Hospital now has some 3,000 iPads being used by clinicians at its four campuses. The hospital has committed itself to a strategy of using the devices to make access to hospital records easier for doctors and nurses.

The hospital surprised onlookers last year when it announced plans to acquire up to 1,800 iPads. The experiment turned out to be such a success that it has increased its acquisitions of the tablets from Apple.

The move to iPads was promulgated by CIO Dale Potter (pictured), who came to the hospital from the manufacturing sector in 2008 and didn’t have much experience in the healthcare field. He followed clinicians on their rounds to better understand how they used existing computer resources.

He was unnerved by what he found. “The work flow was broken,” he recalls. Physicians were printing stacks of patient charts before making their daily rounds with their clipboards. Or they would leave the point-of-care to gather or enter data and then return.

Before settling on the iPad, the Ottawa Hospital tested several other tablet PC solutions, but none of them pleased physicians. “Two main issues with the previous generation of tablets were boot times and battery life,” Potter says. Physicians were not going to wait around for the tablets to boot up. “Until a year and a half ago, there wasn’t a solution practical and elegant enough to support their mobile work flow,” Potter says.

In the spring of 2010, Potter returned from a speaking engagement in Las Vegas with four brand new iPads, excited about their potential as a mobility solution. He gave two to his technology team and one each to a surgeon and general internal medicine physician to get their assessment of the iPads’ potential value to the staff.

“Their response was, ‘How quickly can we get these?’” Potter recalls. He decided to take a huge plunge in purchasing over 1,000 iPads initially and developing a native iPad version of the electronic health record (EHR) software in use at the hospital.

The Ottawa Hospital, which has close to 12,000 employees, now owns 3,000 iPads and may buy a few thousand more in next year.

Potter has set up his own software development team of approximately 70 people made up of internal employees and contractors. They built a clinical mobile application that pulls information from the data source but takes advantage of the native functionality of the iPad.

Launched in January 2011, it initially allowed physicians and nurses view-only access to clinical data that resides in the EHR. Now they are working on adding features that allow physicians to order digital imaging, medications and lab work.

Potter recognizes that at some point he will have to reduce his internal software team. “I know we shouldn’t be in the software design business, but there is such an appetite for it, I can’t cut back on it yet.”

Instead he has challenged the team to create one app a month. “Clinicians provide suggestions and then we try to create what they are asking for,” he explains.

For instance, using a new pain management app, a nurse hands the iPad to patients and asks them to look at a human body atlas and touch on the screen where they are experiencing the highest level of pain. Then they choose from a color grid the intensity, with crimson red being the highest. That information is fed into a database, and if the clinical parameters are high, the most responsible physician or anesthesiologist is notified immediately.

Posted December 15, 2011