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From the August 2001 Issue Nursing System Makes a Difference |
Walk a Wireless Mile Research reveals big divide in expectations versus experiences among healthcare providers. By John Morris, Ph. D., and Brian Zeman Leadership involves linking one’s vision of the future with the ability and willingness of the community to follow. Usually, the key to success is avoiding getting too far ahead of the community, instead articulating a comprehensible vision that speaks to the daily experiences of that community. For new information technologies, this is a core requirement for “crossing the chasm” from limited market acceptance among early technology adopters to general acceptance by the mass market. According to a recent survey research report published by Zesearch, Inc., Alpharetta, GA, it seems, for the moment, that wireless and mobile computing vendors in healthcare need to reduce the distance between visions of the wireless future and the healthcare provider community’s ability to follow. In short, they need to walk a wireless mile in the shoes of physicians and other caregivers. The report, titled “Mobile and Handheld Computing in Healthcare,” shows that mobile and wireless computing in healthcare has advanced considerably in the recent past, but actual adoption of wireless technology is still somewhat uneven across provider types, and rather limited and fragmented among clinics and physician practices. Furthermore, the report shows important differences in the perceptions of non-wireless health- care organizations, and the actual experiences of those organizations already using some sort of wireless system. Generally, non-wireless survey respondents indicated that wireless technology was too advanced and complicated for their needs and technical abilities. Wireless Future–When and How? Resources dedicated to building the new and, no doubt, inevitable wireless future are plentiful and growing. Numerous niche software and solutions vendors have sprung up in the past few years: Large hardware and operating systems vendors are rolling out new and improved products; established full-service healthcare information technology (IT) vendors are beginning to build alliances and launch integrated wireless solutions; and pharmaceutical companies and pharmacy benefit managers are establishing networks of partners among wireless and IT vendors. Even the philosophical foundation for wireless computing has been firmly established, if indirectly and unintentionally, by the Institute of Medicine’s two recent reports on medical errors (“To Err is Human,” 1999) and the quality of medicine (“Crossing the Quality Chasm,” 2000). The former is often cited by wireless vendors promoting the error-reduction benefits of wireless computing. The latter proposes 10 specific policy guidelines for improving the quality of care, some of which clearly could be facilitated by wireless computing. Despite this, there are notable disconnects between the expectations of non-wireless healthcare providers and the actual experiences with this technology on the part of those providers who have implemented a wireless system. This can be seen specifically in the:
This suggests that many non-wireless healthcare providers may not be quite ready to be led into the wireless future. It indicates a need on the part of wireless vendors to develop and promote wireless systems and technologies that are the most immediately relevant and easily absorbed into caregivers’ daily working environment. Wireless and Mobile Computing Research The survey research aimed at broadly covering the healthcare provider market for wireless and handheld technology, focusing on trends and possible contrasts between distinct segments of the market. Four distinct segments of healthcare provider organizations were targeted in the research:
A total of 208 IT decision makers and physicians were interviewed from more than 2,000 individuals contacted. Figure 1 (see below) shows the distribution of respondents across the four respondent segments and the levels of current adoption of wireless information systems. Figure 1
The variation in adoption rates of some sort of wireless or mobile computing across organization types is notable. While more than three-fifths of IDNs reported having such a system, this was true of slightly more than one-third of hospitals, and only a handful of clinics and physician practices. Adoption rates likely reflect both the availability of wireless and mobile solutions, and perceptions of the suitability of such technology to respondents’ organizations. This can be seen in the differences in:
Respondent identification of geographic location as urban or rural was compared to their acquisition plans. Notably, 11 percent of the rural IDNs and 38 percent of the rural hospitals indicated that they do not expect to implement wireless and mobile computing systems ever. This compared with zero percent of the urban IDNs and 16 percent of the urban hospitals. When respondents were presented a list of 12 potential barriers to acquisition, “cost/budget constraints” was the most frequently cited by three groups: IDNs, hospitals and clinics (Figure 2, see below). Figure 2
“Lack of need” also was cited among the top three barriers by hospitals, clinics and physician practices. Additionally, “small size” of respondent’s organization ranked among the top three barriers to acquisition for hospitals and clinics. Although it is true that recent budget constraints among IDNs, hospitals and clinics have been severe, taken together, the three barriers cited most often suggest there is a general perception that wireless and mobile computing solutions are expensive, large and complex. These results are somewhat ironic, given that wireless and mobile computing in healthcare has shown rapid and positive return on investment. Indeed, they suggest that misperceptions may exist in the market. Also notable: Most of the responding IDNs and hospitals that have implemented wireless and mobile computing systems have focused on limited parts of their operations, like the emergency room and physical therapy department. This shows that wireless and mobile computing need not involve implementations on a grand scale. Acquisition Criteria and Healthcare Functions This pattern of perceptions is further illustrated by comparing the top rated acquisition criteria of the wireless and non-wireless respondents (Figures 3 and 4, see the August 2001 issue of Health Management Technology). Respondents were asked to rate 13 acquisition criteria on a scale of 1 to 5, with 1 indicating lack of importance and 5 indicating critical importance. While most of the healthcare provider groups in both the wireless and non-wireless segments tended to rate security and convenience highly, only the non-wireless group rated price highly important. Indeed, price was rated among the top three most important criteria by all provider groups except hospitals, which nevertheless registered a high average rating of 4.5 for price. “This shows the need for market education in many areas,” observed Jeff Schou, director of worldwide healthcare market for Symbol Technologies. “Every major vendor of hospital IT systems has developed wireless applications that pay for themselves in months, not years. Given the recent focus on errors and the nursing shortage, wireless applications such as medication administration that reduce errors and increase productivity are on the verge of exploding.” Other interesting comparisons include the fact that both hospitals and physician practices in the non-wireless group rated adaptability to other technologies and back-up strategy highly (4.4 to 4.6). But their counterparts in the wireless group assigned only moderate levels of importance to these criteria (3.0 to 4.2). Meanwhile, the wireless groups were very focused on data transmission speeds, giving it average ratings in the range of 4.6 to 5.0. In contrast, the non-wireless groups gave it average ratings from 3.9 to 4.4, and not even including this among their top 3 criteria. The data on acquisition criteria indicate significant differences in concerns between the wireless and non-wireless segments. The non-wireless groups inidicate much more concern with the cost of the technology, back-up strategy and adaptability to other technologies. Together these concerns indicate considerable doubt and uncertainty about the technology. However, there are signs of hope. The data on healthcare functions indicate that the non-wireless respondents may be willing to suspend any disbelief some time in the future (Figures 5 and 6, see below). Figure 5
Figure 6
Figure 5 shows the top three functions (identified from a list of 14 functions) for which wireless and mobile computing are currently used among the wireless respondent groups. Figure 6 show the top three (of 14 functions) most frequently identified functions that each non-wireless respondent group identified potentially most benefiting from wireless and mobile computing technology. Some of the functions performed by a high percentage of current wireless users—especially patient charting by IDNS and hospitals, and prescription writing by physician practices—are the same functions perceived as beneficial by the non-wireless respondent groups. Patient charting topped the list for all non-wireless groups, but ordering and receiving lab results, nurse shift reports and vital signs functions were also cited by a good number of respondents in each group. Additionally, a high percentage of physicians cited prescription writing and automatic billing, and high percentages of physician practices and clinics cited supply inventory. Conclusion Even though wireless technology undoubtedly will enjoy widespread adoption in healthcare over the next several years, the implications of the survey research data are considerable. While many wireless and mobile computing vendors are working on robust solutions for the future, there are indications that healthcare provider groups may need to adopt this technology in a more gradual fashion. Their ability and willingness to adopt the latest solutions may be limited. Emphasizing partial solutions in limited functional areas like prescription writing, or medical reference stored in memory on mobile devices, may deliver greater marketplace success to vendors for the next year or two. Additionally, a continuing commitment to educating healthcare providers is required in order to effectively communicate the benefits of wireless technology. Promoting partial solutions and simpler wireless technologies may speed the realization of improved healthcare quality and decreased costs that many have expected from mobile computing. Editor’s note: The research described in this article was conducted by Zesearch, Inc., independent of any financial support from or commissioning by wireless vendors or suppliers. By mutual agreement with Zesearch, Health Management Technology reviewed the research data and suggested inclusions that we felt would be of the greatest interest to HMT readers. The complete report is available for purchase at www.zesearch.com. © 2001 Nelson Publishing, Inc |
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