Mobile Device Use in Hospitals
Healthcare professionals struggle to leverage these tools amid the barriers of workplace regulations
May 4, 2016
Mobile device use continues to transform information access and patient care at medical centers, dominating the IT agenda of hospital information professionals. There is new research every month pointing to expanding in-hospital mobile phone and tablet use either with or without official sanction.
With ongoing debates around appropriate devices and their secure use, healthcare professionals struggle to leverage these tools amid the barriers of workplace regulations including bring your own device (BYOD) policies, EHR integration, staff use policies and others that address important concerns yet impact productivity. In this context, the latest tallies of device use by both physicians and nurses can serve as a foundation for defining 2016's key health information issues and opportunities.
96% of physicians own smartphones1 and between 56% and 76% own tablets.2 Multiple studies have shown in-hospital physician smartphone use at approximately 80%,3 but differing use cases exist for mobile phones and tablets, with smartphones used more for search functionality (48% compared to 35% for tablets) and accessing a professional resource (34% to 16%). Tablets are used far more for EHR access, notes or prescribing (35% compared to 10% for phones).4
Nurses are using smartphones for patient care far more than previously estimated. Some 95% own a smartphone and 88% of them use smartphone apps at work to get information faster - earlier estimates had assumed only 65%.5
This is a higher figure than 67% of medical residents using smartphones in clinical care.6 In addition, nurse smartphone use is taking place regardless of facility reimbursement or sanctioning. It's also in contrast to a 2015 survey showing that in medical centers where BYOD use is allowed, 91% permit it for physicians, while only 51% do so for nurses.7
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The study's insights came from some 241 nurses in a "Crowd" of 1.8 million verified clinicians in the U.S. reached through InCrowd over a two-hour window on May 30th.8
Other time-saving uses of smartphones not related to smartphone apps - such as staying in touch with colleagues in their hospital (69%) - reflect the multifaceted role that the smartphone is playing in day-to-day patient care. Besides access to drug interactions, clinical data dominated nurse smartphone use, with 73% looking up drug information on that device. Some 72% used smartphone apps to research various diseases and disorders.
In additional comments to the survey, nurses reported using their smartphones for fast access to patient care information across a wide range of daily nursing tactics, from receiving patient rash photos to setting a timer for meds administration.
While respondents stressed that smartphones "enhance but don't substitute" the need for a physician consult prior to administering care, 52% of nurses reported using their smart phone instead of asking a question of a nursing colleague, according to a subset of users probed in greater detail about their phone use. This was particularly the case if a medication, illness or symptom was unfamiliar.
For example, 32% of RNs said they used their smartphone instead of asking a physician, explaining how doing so saved time such as "in-patient homecare situations when I need quick answers without making a bunch of phone calls," or "so I can make an educated suggestion to the doctor."
Reimbursement seemed to have little connection to use. Some 87% of nurses in the follow up survey stated that their employer did not cover any of the costs related to their smartphone. Only 9% of these RNs were reimbursed for the cost of the monthly bill, while just 1% received coverage for the cost of the smartphone itself and only 3% had the cost of both a smartphone and their monthly bill covered by their employer.
Despite the disparity in use policies and the earlier cited study showing a decline in the number of hospitals allowing BYOD use in 2015, less than 1% of InCrowd's respondents reported their hospital prohibited nurses from using smartphones during their shift.
Defining Issues and Opportunities
Mobility has so dominated everyday living, let alone almost every professional domain, that asking professionals to avoid its obvious time-saving use flies in the face of common sense - regardless of patient privacy concerns and security considerations.
Data security concerns, however, should drive these policies. A 2013 Cisco study showed that of the 89% of healthcare workers using personal smartphones for work purposes, 41% of these smartphones were not password protected and 53% of employees accessed unsecured WiFi networks.9
Healthcare professionals are more than wiling to embrace innovations in communications and technology to improve care. Institutions and their use policies need to reflect the advantages of these advances, rather than suppress them. Payer and provider organizations will continue monitoring use of mobile devices in the workplace and will likely need policies that adapt to the changing landscape.
Diane Hayes, Ph.D. is president and co-founder of InCrowd.
1: Spyglass Consulting, Point of Care Communications for Physicians 2014. Available at http://www.spyglass-consulting.com/press_releases/SpyglassPR_POC_Comm_Physicians_2014.v1.3.pdf
2: Kantar Media, Sources & Interactions, March 2015; Medical/Surgical Edition. Cited at: http://www.emarketer.com/Article/Mobile-Officially-Staple-Doctors-Office/1012271
Available at http://www.kantarmedia-healthcare.com/sources-interactions-march-2015-medicalsurgical Manhattan Research, 2014 study. Cited at http://mobihealthnews.com/32232/in-depth-mobile-adoption-among-us-physicians/2/
3: Kantar Media, Sources & Interactions, March 2015; Medical/Surgical Edition. Cited at: http://www.emarketer.com/Article/Mobile-Officially-Staple-Doctors-Office/1012271
Available at http://www.kantarmedia-healthcare.com/sources-interactions-march-2015-medicalsurgical
4: Epocrates, Mobile Trends Report 2014. Available at: http://www.epocrates.com/oldsite/2014MobileTrendsReport/MT14_WP_03.pdf
5: Wolters Kluwer Health press release, September 10,2014. Available at: http://www.wolterskluwerhealth.com/News/Pages/Wolters-Kluwer-Health-Survey-Finds-Nurses-and-Healthcare-Institutions-Accepting-Professional-Use-of-Online-Reference--Mobi.aspx
6: Raaum, S. Patino, A. Vallejo, CE. Arbekaez, C. Milne, C. Annals of Global Health, 80:3, page 221, United States resident smartphone use during international clinical rotations. Available at: http://www.annalsofglobalhealth.org/article/S2214-9996(14)00236-7/fulltext#sec3
7: Spok 2015 BYOD Study. Available at: Spok 2015 BYOD study
8: InCrowd nurses and smart phones survey. Available at: https://www.incrowdnow.com/2015/06/nurses-and-smartphones-a-vital-connection/
9: Cisco, BYOD Partner Insights 2013. Available at: http://www.ciscomcon.com/sw/swchannel/registration/internet/registration.cfm?SWAPPID=91&RegPageID=350200&SWTHEMEID=12949