The recent hoopla surrounding the release of the Apple iPad has been fascinating. Many of the most reticent PC users are beginning to see how revolutionary this is. Even in the very early days of EMR use everyone clamored for portability. The problem is not with the technology of rendering the EMR information to a Blackberry or even an iPhone, it’s the issue of screen real-estate. To put it simply, the amount of scrolling, clicking or font-adjustment, just makes this impractical. The iPad is on the right track, but since it doesn’t fit in my pocket, it will never be the device I use while on-call. The truth is, my phone is always with me and this is how I will continue to receive calls and pages when I am out of the office. And why shouldn’t I? My wife reads books on her iPhone. My kids spend time on Facebook on their phones. I don’t think it’s too much to ask for a busy physician to have the ability to see vital patient information when he or she is making important care decisions.
Now let’s rethink the conventional wisdom a bit. Suppose my Blackberry (or iPhone) could display relevant information that is specifically rendered for small screen. Take things a bit further. If I was paged with a request for Coumadin orders, wouldn’t it be cool if I could easily see just the most recent lab results (PT/INR), diagnoses (a.fib, DVT, prosthetic valve), and start/stop dates? Now that would be game-changer. How about chronic disease specific summaries and dashboards? You get the idea.
In my opinion, we don’t wish to replicate the medical chart on a hand-held device. We want to serve up the most useful information in a way that takes advantage of the limited screen real estate.
This is where knowledgeable vocabulary management, coupled with a sophisticated medical ontology, facilitates the understanding of semantic neighborhoods.
My good colleagues at UPMC have embarked on this journey by uniquely displaying harmonized data from multiple systems on the Blackberry. (See the upcoming webinar: Delivering a SOA-Based Community Record to Caregivers Everywhere at UPMC with BlackBerry® Smartphones on April 28, 2010).
Many challenges exist—security and patient identity amongst them. More difficult, I suspect, will be changing old operational models of on-call communication.
