Physicians and Media Tablets 2.0

Family physician Saroj Misra may have been one of the first doctors in line to purchase Apple's iPad when the device came out three years ago - but if you asked him how he planned to use it, the answer would have been pretty short.

"When I initially got the iPad, my plan was to use it primarily as a reference tool in my office to look up information that I needed to find," says Misra, the family medicine program director at St. John Providence Health System in Detroit.

Today, Misra's iPad and new iPad mini, one of which is always with him while he's working, do so much more than he had originally imagined.

"Now I have the ability to access my electronic medical record system, as well as patients' hospital records, from my tablet," says Misra. "I don't have to go back to a laptop PC when I need to find relevant information for my patient."

*Read more about Misra's experience with mobile technology, here.

Misra represents a growing contingent of physicians who can't imagine practicing without their beloved tablets - and it's easy to see why. Tablets have evolved into sleeker, easier-to-use, speedier devices with more and better applications and features suited to the needs of healthcare professionals. And in doing so, they have morphed into the ideal physician companion: According to Manhattan Research's "Taking the Pulse U.S. 2013" online survey of 2,950 U.S. practicing physicians in 25 specialties, 72 percent of doctors own a tablet for professional purposes. That's more than double the number from the same survey in 2011 (35 percent).

Here's a closer look at what today's tablet market offers physicians.

More styles and choices

Pre-iPad, many tablets looked more like scaled-down laptops. Today, tablets come in all shapes and sizes, and many of the leading ones possess thinner screens and smaller dimensions.

But while physicians still predominantly gravitate toward touch-screen tablets like the iPad, Carl Fleming, principal consultant with Impact Advisors, says convertible devices - those tablets that come with lightweight, removable keyboards - have come a long way, too.

"For business users needing to do more than just consume content, I see the convertible device being a fantastic solution," says Fleming, offering the Microsoft Surface and HP ENVY x2 tablets as examples. "It's easy to envision a clinician using this device much like a traditional laptop but in the form factor of a tablet PC."

Also, while many physicians are aware of "consumer-grade" tablets like the iPad, Fleming says there are also "health-grade tablets" that are "built specifically to withstand the rigors of the healthcare environment." The Toughbook H2 or Motion Computing C5, for example, are more durable (so they won't break when dropped in the exam room or hospital).

Size is another selling point . Apple's latest, the iPad Mini, for instance, is seeing popularity rates that could trump its flagship product, the iPad.

"The size is the perfect size to actually fit in the lab coat for a physician," says Marianne Braunstein, vice president of product management at Epocrates. "Even when you're seeing adoption rates of 70 percent for the iPad, we saw one-third of all physicians indicate they were going to purchase the iPad Mini even before it came out. It achieves the perfect balance in real estate, in terms of physical size and ease of use."

*For a slideshow on various tablets for physicians, click here.

Better features, healthcare apps

Tablet features have also come a long way. Here are a few of the biggest improvements that are aiding physicians:

Longer battery life. Misra isn't the only physician who enjoys using his tablet all day without thinking about charging it. "The lithium-ion polymer battery found in many tablets keeps getting better and lighter, resulting in a better user experience," says Fleming.

Better processors. Processor chips (aka, "central processing units" or CPUs) are at the core of high-speed computing, and high-bandwidth functions such as video. "The processors found in tablets in 2013 are much faster than in the first-generation tablets, allowing them to multi-task better and run more robust apps," says Fleming.

More tablet-native apps for physicians. The list of medical applications for physicians is growing every year, with the largest number available for iOS and Android devices. Even better, a growing number of new or upgraded apps are "native" to certain tablets (such as the iPad)

- meaning they are specifically designed to be used for that tablet. "When you're introducing something that's native, you're taking control of the [features] of the tablet, such as tabs, that allow you to view something side by side," says Braunstein, noting that Epocrates launched an iPad-native version of its reference app at the end of last year. "It better conforms to the screen size and allows physicians to see more content … and [requires] fewer taps."

Boosted security. A growing number of tablets allow users to track the device’s location remotely (and allow data to be wiped remotely, if needed). Many tablets also have encryption technology, and even biometrics technology, to prevent protected health information (PHI) from getting in the hands of the wrong party, per HIPAA security rules.

All of these features make it easier for physicians to engage patients in their care, using tablets to share rich, visual medical information.

"I can use the iPad in order to create and present information that may be educational in nature," says Misra. "I can talk to a mother of a 10-year-old who broke his tibia, and I can actually show them where the break is on the tibia, I can show them how the break occurred, I can draw for them what we're going to do in terms of putting a cast on it or splinting it, and what we expect will happen as the break seals."

Improved EHR access

Other advances have created huge differences in how physicians use tablets today, versus three years ago, to access their EHRs. Even as recently as 2010, accessing most EHRs on tablets required physicians to use a remote-desktop, Citrix receiver connection that resided on the screen.

Today, many, if not most, major EHR vendors have released EHR apps that conform to a tablet's native operating system.

"Before, you were lucky to get four hours of use out of them, and you always had to have a replaceable battery, a charging station," says Stanley Crane, chief innovation officer of Allscripts, which released a tablet-native version of its EHR for iOS last year. "Android and iOS and Windows 8 have improved user-interaction; for example, you can pinch the screen down to see more or less data."

As a result, Allscripts physicians report that using tablets saves them up to six minutes per patient over using an EHR that resides on their desktop computer, says Crane.

Picking a tablet

Ready to go shopping? Before you buy, here are a few things to consider:

Work flow. Consider your work style. For example, if you prefer typing your notes rather than using a drop-down menu, a touch-screen tablet like the iPad might not be the best choice. A convertible tablet would be better.

Corporate policies and limitations. Is there a corporate policy governing whether you can bring your own device to work? That might dictate what devices you can use to interact with PHI. Often times, large practices will purchase a fleet of tablets, so that they may be managed more efficiently by IT staff (and wiped remotely, if necessary). So before buying a tablet, check on corporate IT device policies. Also consider how much IT support is available to assist with troubleshooting when something doesn't work, says Fleming.

The EHR experience. The EHR your practice uses may be a guiding point for tablet choice. If, for example, your EHR vendor only offers a version of its software for the iPad, that narrows the choices.

Features. Look up online ratings for battery life, speed, and security. If, for example, you use a Windows PC, you might want to look into whether having a tablet that runs on Windows 8 would allow for a more familiar experience.

Ergonomics. Before purchasing a tablet, make sure you like the way a tablet looks and feels. "Form factor cannot be ignored," says Fleming. "If the tablet is too heavy, too fragile, or has a screen that is not legible or crisp in image, it simply will not be used."

Marisa Torrieri is an associate editor at Physicians Practice. She can be reached at marisa.torrieri@ubm.com.

This article originally appeared in the July-August 2013 issue of Physicians Practice.