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reported saving time by using smartphone medical apps, with one in two stating they save 20 minutes or more daily. For a busy primary care physician, that could mean the ability to see two to four more patients per day. T e smaller screen of a smartphone may be fi ne for texts

between clinicians or e-prescribing, when properly optimized. However, when it comes to data entry, all but the simplest point-and-click functionality is tedious at best on a phone.

Benefi ts of the big screen Once tablets were readily available, tasks that previously

required stepping out of the exam room became part of the patient encounter. Many clinicians prefer to complete tasks – such as ordering labs, e-prescribing and light data entry – right in front of the patient to maximize face time. Patients appreciate it when their doctor looks up information relevant to their care. T ey report feeling secure knowing that their clinicians are using modern technology to make sure they are receiving the best care. Tablets allow clinicians to show interested patients their information. T e graphic capabilities of tablets lend themselves beautifully to swiveling the tablet to face the patient to share test results, internal anatomy diagrams, imaging fi ndings, or patient education materials and brief videos. However, clini- cians have to consider how many minutes of a brief visit are worth dedicating to this type of experience; most patients are eager to interact directly with the clinician.

The iPad Mini is a device to watch The iPad Mini lies somewhere between a tablet and

iPhone, at 7.87 inches tall by 5.3 inches wide – the perfect size for a lab coat – and runs all a physician’s favorite apps. T e device has benefi ts that are enticing to the healthcare community, including a medium screen for basic data entry, lightweight portability and the easy readability that all iOS model devices off er. T e size is still small enough to prevent unwanted snooping of sensitive data on the screen, but like its larger counterparts, it is an excellent device to swivel and share information with patients. T e iPad mini also allows physicians to carry a tablet and a smartphone simultaneously, an option I believe more physicians will increasingly favor over the next year.

Mobile is essential As recently as fi ve years ago, many hospitals and other institutions had a blanket ban on cell phone usage. T ose regulations have been abandoned as the many benefi ts became recognized and clinician usage exponentially expanded. Now clinicians use their personal devices, both smartphones and tablets, as workplace tools, expecting them to access lab results or patient charts seamlessly. Today, institutions have a new set

of concerns surrounding security and HIPAA compliance. Each physician having their own device, or multiple devices, also causes logistical problems for internal systems that may not be mobile optimized, requires individual passwords and times out a user after a few minutes of inactivity. Productivity is impaired by these hassles and should be addressed. As mobile device innovation and app development continue to boom, it becomes more important for practice managers and healthcare professionals to fi nd a balance between security and platform standardization inclinations. To maintain the higher level of care that medical apps have helped establish, institutions small and large should create and enforce a set of BYOD guidelines that foster mobile device usage while anticipating new technological developments. Following are suggestions for 2013:

1. Work to expand mobile. Be prepared for an increasingly ambulatory work force. Any time services are being re- newed or upgraded, make sure you are taking native apps and mobile optimization into account for BYOD plans.

2. Standardize registration. Require that mobile devices are registered to access the practice network and stan- dardize a company-approved, two-layer authentication system to be downloaded as part of the process.

3. Set boundaries. State clear and concise rules for when a mobile device can and cannot be used. For example, mobile device use may be limited during a surgical pro- cedure unless it is cleared beforehand.

4. Conform to HIPAA guidelines. Have a policy for mobile device usage to align with HIPAA guidelines surrounding patient privacy, including patient imaging data and secure messaging.

5. Encrypt data. Make sure that data transmitted from one device to another is encrypted.

6. Limit data storage time. Limit the amount of time data is stored on a mobile device before it is automati- cally erased.

7. Start a conversation. Coach physicians on how to have an open dialogue with patients regarding the information they are looking up; patients will be more informed and physicians may gather additional insights. Remind clini- cians to maintain patient eye contact as much as possible.

8. Encourage usage. Keep a list of recommended apps and update them quarterly.

In healthcare, barriers to practicing safe, effi cient medicine

are high for physicians. By choosing their own devices and apps and using them securely, clinicians will save time, reduce errors and increase patient satisfaction by improving face time. T rough the implementation of clear and concise BYOD rules, practice managers and healthcare professionals are able to foster an open dialogue between practice needs and realities. HMT


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