As physicians select their first EHR systems or look to switch vendors, a survey by Black Book Rankings has identified a “meteoric trend” toward mobile EHR applications – especially a marked leaning for iPad apps.
The Washington, D.C.-based research firm conducted the poll as a follow-up to its 2013 electronic health record study, foretelling the “Year of the Big EHR Switch.” Nearly one in five physician users indicated a high likelihood of shifting systems after disappointing first vendor results, officials said, while several EHR-integrated mobile apps have been added to the list of physician must-haves in the replacement market demand.
According to the survey, 8 percent of office-based physicians use a mobile device for electronic prescribing, accessing records, ordering tests or viewing results. In addition, 83 percent indicated they would immediately use mobile EHR functions to update patient charts, check labs and order medications if available.
The mobile application market is expected to grow 500 percent by the end of 2014, Black Book officials said, primarily because of the government's meaningful use incentive program. But the marketplace remains crowded, and overall physician usability and approval are the main factors that will keep vendors competitive.
“A mandate has been issued and progressive vendors are reacting,” said Doug Brown, managing partner of Black Book Research, in a news release. “A full 100 percent of practices participating in the poll expect EHR systems that allow access to patient data wherever physicians are providing or reviewing care."
For its survey, Black Book received 122 vendor responses, indicating they plan to introduce fully functional mobile access and/or iPad-native versions of their EHR products by the end of 2013. Another 135 EHR product vendors claim to have mobile applications in their strategic plans.
The desire for mobile apps and their actual use are two separate matters, according to Black Book researchers. Although 89 percent of primary care and internal medicine doctors use smart phones to primarily communicate with staff and 51 percent of clinicians use tablets to perform independent medical reference and Internet research, less than 1 percent estimate they are maximizing the use of their mobile clinical and business applications.
In a separate Black Book poll of hospital CIOs with network physician practices conducted last month, mobile applications ranked above cloud computing and clinical analytics as well as business intelligence in upcoming technology urgencies.
“The business priorities of operational results and reducing costs, combined with the digital management requirements for records, access, identity and risk, have healthcare information executives seeking broader EHR solutions with useful mobile applications,” Brown said.
Criticism for some mobile apps
Although authorities debate the differences between virtualized and native iPad implementations, users of both mobile types have noted flaws. Of the mobile app issues most criticized, 95 percent of physicians indicated the small screen size of the iPhone/Smart Phone/Android as their biggest problem; 88 percent saw difficulties in the ease of movement within the chart; 83 percent said they don't want an EHR system replicated on their mobile device preferring simplified versions, and 71 percent don't appreciate non-optimized touch screens.
“The vast majority of all survey respondents favored mobile applications that focus on the patient data and core parts of medical practice most needed when the physician is away from the office setting,” noted Brown.
Ultimately, practice leaders and clinicians are seeking to enhance healthcare delivery and reduce medical liability through the documentation of out-of-office practices, including lost reimbursement. The highest ranked EHR mobile applications determined from polling had 10 common characteristics: the ability to remotely review charts, update charts, assign tasks, view schedules and appointments, send messages to practice staff, request lab orders and view results, permit electronic prescribing, document patient encounters, input vital signs and access EHR data after office hours.
The highest rated vendors in physician user satisfaction were awarded to the few mobile EHR applications that link to patient portals, assure enhanced security access, enable billing, allow for speech-to-text technology, have real-time features such as eligibility checks and include customizable templates for specialists. Vendor system certification for meaningful use was the unanimous prerequisite.
Primary care and internal medicine physicians indicated a strong preference for electronic health record usability on their mobile devices. Of physician specialties, Black Book recorded the highest anticipated use of mobile applications reported from:
- 100 percent: hospitalists
- 98 percent: primary care/ general and family practice
- 97 percent: Internal Medicine
- 92 percent: office-based physicians
- 88 percent: rheumatology
- 87 percent: nephrology
Surgeons, particularly the specialties of orthopedics, ophthalmology and ENT, indicated the lowest interest in mobile and iPad devices, currently at less than 14 percent on average.
The most popular mobile devices used by physicians and practices that Black Book surveyed:
- 68 percent: iPhones
- 59 percent: iPads and tablets
- 31 percent: smart/android phones/other
Black Book’s report on native and virtualized iPad applications also shines a light on the performance disparity between vendors seeking to capture both new EHR and replacement physician practices and hospitals. The May 2013 report focuses on measuring user perceptions on the performance and functionality in several key areas and meaningful use readiness.
Mountain View, Calif.-based drchrono achieved the highest customer satisfaction scores for iPad EHR applications, as determined by the responses of more 1,400 practices nationwide. Other top-scoring vendors include MediTouch Health Fusion, Care 360 by Quest, MacPractice, Greenway Prime Mobile, NextGen Mobile, Practice Fusion, Cerner Physician Express, Nimble Clear Practices, Mitochon Systems, Point Click Care Mobile, GE Centricity, IClickDocs, Allscripts, IMedDoc EMR, Mediforms, Acumen EHR Mobile, One Touch EMR and eClinicalTouch.
