Since the day the original iPad was announced more than two years ago, there’s been a constant discussion about its use in healthcare. At face value, the iPad offers a lot of tools to doctors and other healthcare professionals like access to electronic medical records (EMRs), access to electronic prescribing systems, and access to a wealth of reference materials like medication guides. To some extent the same benefits are available from the iPhone and other smartphones.
Those seem like great additions to a doctor’s daily workflows – both in the office and while on rounds at hospitals. Those great healthcare features don’t live in a vacuum, however. They live on mobile devices that also allow their owners to check-in on social networks, send and receive texts and emails, play games, and do all manner of personal tasks. That has some doctors and hospitals concerned that iPad, iPhones, and other mobile devices could actually be putting patients in harm’s way.
An alarm about the dangers of doctors being distracted by their mobile devices was sounded by Dr. John Halamka, a physician and former CIO of Beth Israel Medical Center in Boston, who wrote a case study in December about an incident in which a resident was entering a medication order into a smartphone when she received and responded to a text about party. In the process, she became distracted and didn’t finish entering the drug change, which had dire consequences for her patient who nearly died and required open heart surgery as a result of her error.
Since then, Dr. Halamka has been raising awareness about the dangers of distracted doctors. His efforts included an interview with NPR that ran earlier this week. In that story, NPR’s David Greene also interviewed Dr. Henry Feldman (also from Beth Israel in Boston) who is a such a big proponent of mobile technology and iOS devices in medicine that his collegueas have dubbed him the iDoctor. He points out the advantage sof the iPad, including during patient consultations and notes that he can easily switch off distracting devices.
This story raises the question of whether iPhones and iPads can be too distracting to doctors. A report that coincided with the NPR story from Kaiser Health News cites multiple studies about the dangers of distracted doctoring over the past two years including incidents that occurred during surgery. At the same time, a recent study from the University of Chicago illustrated that iPads made residents more efficient and effective.
It’s worth noting that the majority of these cases occurred in hospital settings rather than in a doctor’s office. The frenetic pace of hospitals may be as much of a contributing factor as the personal devices themselves, a point that Dr. Feldman makes in his interview with NPR.
One pro-iPad argument in the medical field is that, as the U.S. moves closer to widespread EMR adoption, other electronic records solutions like laptops in the exam room or even clunky laptop carts in hospital settings can raise a different type of dangerous distraction – distancing the doctor from the patient. According to several health care professionals I’ve spoken with since the iPad’s introduction, focusing on a laptop and typing records creates a barrier that can prevent doctors from picking up valuable clues in a patients demeanor or behavior.
In the end, as with other distracted driving, the crux of the issue really isn’t about the mobile devices themselves, it’s about how doctors and other healthcare workers choose to use them. As Dr. Feldman points out, anyone can turn a distracting device off – or at least turn off notifications from potentially distracting apps. Setting policies around that idea is actually the approach that Beth Israel Medical Center has adopted to prevent such incidents.