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Connecting Physicians and iPads to Support Patient Care
- 1. Emily Vardell, MLS October 13, 2012 http://www.flickr.com/photos/99771506@N00/5791228117
- 2. What do we know? http://www.flickr.com/photos/60242105@N00/3903176411
- 5. (iPad or iPads) AND (physician OR physicians OR doctor OR doctors) Mobile reference Patient education Imaging Building applications Complete questionnaires
- 6. Seminal article? CIS-based registration of quality of life in a single source approach Abstract: Background: Documenting quality of life (QoL) in routine medical care and using it both for treatment and for clinical research is not common, although such information is absolutely valuable for physicians and patients alike. We therefore aimed at developing an efficient method to integrate quality of life information into the clinical information system (CIS) and thus make it available for clinical care and secondary use. Methods: We piloted our method in three different medical departments, using five different QoL questionnaires. In this setting we used structured interviews and onsite observations to perform workflow and form analyses. The forms and pertinent data reports were implemented using the integrated tools of the local CIS. A web-based application for mobile devices was developed based on XML schemata to facilitate data import into the CIS. Data exports of the CIS were analysed with statistical software to perform an analysis of data quality. Results: The quality of life questionnaires are now regularly documented by patients and physicians. The resulting data is available in the Electronic Health Record (EHR) and can be used for treatment purposes and communication as well completion of questionnaires by the patients as research functionalities. The themselves using a mobile device (iPad) and the import of the respective data into the CIS forms were successfully tested in a pilot installation. The quality of data is rendered high by the use of automatic score calculations as well as the automatic creation of forms for follow-up documentation. The QoL data was exported to research databases for use in scientific analysis. Conclusion: The CIS-based QoL is technically feasible, clinically accepted and provides an excellent quality of data for medical treatment and clinical research. Our approach with a commercial CIS and the web-based application is transferable to other sites.
- 8. Patient education Mobile reference Imaging Complete questionnaires Building applications
- 10. Handout with recommendations Survey of use and needs Pilot iPad study
- 12. Resources Prior iPad use Patient care Contact info
- 13. 30 25 20 15 10 5 0 Epocrates Medscape PubMed UpToDate Google electronic medical journal sites/apps association Other record sites/apps
- 15. iPad Use Our study ITG survey of 600 physicians Have you Do you have used an iPad an iPad or before? tablet device? http://alert.marketingresearch.org/documents/Alert_1111.pdf
- 17. look things up while in a patient’s room pull up images for patients to view imaging software to help inform patients during pre-operative and post-operative evaluation show neuro patients images of the brain demonstrate videos to patients
- 18. quicker access to help with diagnosis, medical orders, and literature searches dosage film review diagnostic assessment criteria conduct search in the room with patient
- 19. Will any iPad do? Are physicians interested in borrowing iPads? http://appadvice.com/appnn/2012/06/apple-launches-new-ipad-tv-ad-shows-how-versatile-the-companys-tablet-can-be
- 20. • Physicians vs. nurses • Craft a message specific to each group http://askanmd.blogspot.com/2009/10/nurses-vs-residents.html
- 21. Handouts Office hours Outcomes Needs assessment Highlight benefit of librarians
- 24. What is the iCloud? • Access what you have downloaded on any of your devices • “iCloud stores your music, photos, docume nts, and more and wirelessly pushes them to all your devices” • http://www.apple.com/ icloud/
- 27. • Anatomy Atlas imaging for patient education • Skype for telemedicine • for reference and clinical decision support
- 28. Image courtesy of Urmen Desai, MD
- 29. Acknowledgements • Yanira Garcia- • Rebecca Jerome Barcena • Brenda Linares • Mary Moore, PhD • NN/LM Southeastern • JoAnn Van Schaik Atlantic Region • Faculty and staff of • National Library of the Calder Medicine Memorial Library This project has been funded in whole or in part with Federal funds from the National Library of Medicine, National Institutes of Health, Department of Health and Human Services, under Contract No. HHS-N-276-2011-00004-C with the University of Maryland Baltimore. http://www.flickr.com/photos/45409431@N00/3272079115
Notas do Editor
- I think we can all agree that physicians are using iPads increasingly more to support their work. We may have seen them in our institutions or we may have seen them at our own bedside. However, this may be more of a collective “feeling” rather than an evidence-based decision.
- What does the literature tell us?
- Complete questionnaires leads me to the next topic
- Only article with any citations – 4 citations total
- There is a need for librarians to get involved.
- There is a need for librarians to get involved. We can get involved in everything mentioned in the literature.
- Phase One
- Identifying apps
- We set up office hours in the physicians cafeteria and general hospital cafeteria and administered 46 paper-based surveys over six sessions. We obtained permission from hospital staff to set up a table in the entry way. We approached physicians by asking them about their use of mobile resources and inquiring whether they’d be interested in participating in an iPad study.
- What resources (websites, databases, etc) do you use for patient care?
- In that other category
- ITG survey mentioned in the last MLA webcastWhen was survey conducted? Any more recent data?
- If you had an iPad, how would you use it to improve patient care?This is an area where it helps to have librarians at the table during the discussions regarding electronic medical records. I have heard from medical librarians who are heavily involved in this area that physicians often can access EMRs through Citrix (proxy).
- If you had an iPad, how would you use it to improve patient care?
- If you had an iPad, how would you use it to improve patient care?In summary Electronic medical recordsPatient demonstrationsClinical decision support tools
- Observations
- While physicians already had iPads and weren’t interested in borrowing, nurses spoke about limitations with mobile devices and often said they weren’t able to use mobile devices for health information due to limited funds and no institutional device.Specific message – we were targeting physicians, so we didn’t have much to say when confronted with nurses. Perhaps different handouts for each group.
- Many of the people we spoke with didn’t even know we had a hospital library. This was a great way to increase visibility of the library’s services as well as a way to find out what our patrons were using.
- Phase Two – the next step was to loan iPads purchased through an NN/LM Award to selected participants
- The first hurdle was how to make sure that everyone had the same apps on their iPads. We also wanted to have a way to push content to people if need be.
- Accessories – concern about the cleanliness of iPads in the healthcare setting. Perhaps it would be a good idea to encourage iPad users to use bleach wipes to make sure that their iPads stay clean.
- Liability StatementHow are you using the iPad to improve clinical care?What resources are most useful to you?What have you downloaded to the iPad?What would you like to download to the iPad?What surprised you about using the iPad?
- Warning of graphic imagesYou may have heard of the recent highlighted story in the local and national media of Ronald Poppo who suffered significant facial mauling and was cared for by my service at Jackson.He was seen on several occasions in follow-up in my clinic after being discharged from the hospital. There was one particular appointment when I used the iPad you provided to me to Skype with some of his other doctors involved in his care who were in another part of the country at the time.
- You may have heard of the recent highlighted story in the local and national media of Ronald Poppo who suffered significant facial mauling and was cared for by my service at Jackson.He was seen on several occasions in follow-up in my clinic after being discharged from the hospital. There was one particular appointment when I used the iPad you provided to me to Skype with some of his other doctors involved in his care who were in another part of the country at the time.This is clearly a tool that is helping physicians support world class patient care. We as librarians can support this activity by recommending apps and instructing on the use of technology. This is another avenue for us to pursue to be seen as part of the clinical team. It highlights the importance of information literacy and promotes the reputation that librarians are tech-savvy and focused on improving patient care.