For patients, mobile technology isn't quite as mature yet. Part of Texas Health's connected patient strategy includes various remote home monitoring devices like weight scales and blood pressure cuffs, e-Visits, and personal health records. Eventually, it plans for much of the data from these health devices to feed into its EHR and the patient's PHR. And just as doctors want access to the EHR on their smartphones, Velasco envisions that patients will likely want access to their PHR on their iPhone or BlackBerry, as well.
But just because a clinical application is available in a mobile format or a physician would like to have it doesn't mean healthcare providers should rush to implement it. The same vetting process for any new technology should still be applied.
At Texas Health, all requests get vetted through a business-planning and ROI process that is not just financial in nature, but also takes a quality-of-care perspective. "We use real metrics. None of these are fluffy," says Marx, explaining that 12 months after the go live, they evaluate the ROI measures identified for the technology. "We show the original benefit proposal and we look to see if that value has been realized," he says.
Mobile applications aren't an area where a health system has to jump in headfirst, either. Health systems can approach this incrementally, says Velasco. "We are not talking about huge investments in the technology. You can do small pilots," he says. That is the approach Texas Health took with Airstrip OB. It has been pilot testing the system for about nine to 12 months. "The feedback we've gotten is that this is phenomenal and a huge win in terms of patient safety and clinical effectiveness," says Velasco. "So you expand based on the success you find or don't find with these small trials."
For Texas Health, which has an IT budget of more than $100 million in total, the amount being spent on mobile applications is a small figure today, but Marx expects that figure to climb. "This is the direction and future of healthcare. As we go to accountable care organizations and medical homes, it is in everyone's best interest to have the patients at home. In order to make that happen and increase efficiencies, you have to have this level of mobility in applications," he says. "Today, it is very small percentage of the budget, but will become increasingly large over the next few years."
Helping to fuel that growth is physician demand. The same physicians who complain that they don't like typing on a laptop or PC are walking around with an iPhone, says Velasco. "It is a low barrier for entry," he says. "It really frees up clinical doctors to move about and not have to lug around a laptop or be near full computer."