Signs barring cell-phone use are a familiar sight to anyone who has ever sat in a hospital waiting room. But the growing popularity of electronic medical records has forced hospital-based doctors to become dependent on computers throughout the day, and desktops — which keep doctors from bedsides — are fast giving way to wireless devices.
As clerical loads increased, “something had to give, and that was always face time with patients,” says Dr. Bhakti Patel, a former chief resident in the University of Chicago’s internal-medicine program. In fall 2010, she helped launch a pilot project in Chicago to see if the iPad could improve working conditions and patient care. The experiment was so successful that all internal-medicine residents at the university now get iPads when they begin the program. Johns Hopkins’ internal-medicine program adopted the same policy in 2011. Medical schools at Yale and Stanford now have paperless, iPad-based curriculums. “You’ll want an iPad just so you can wear this” is the slogan for one of the new lab coats designed with large pockets to accommodate tablet computers.
A study of the University of Chicago iPad project published in the Archives of Internal Medicine found that patients got tests and treatments faster if they were cared for by iPad-equipped residents. Many patients also gained a better understanding of the ailments that landed them in the hospital in the first place.
With a tablet, “if you tell someone they have pulmonary edema, you can pull up an abnormal chest X-ray, which is theirs, and a normal X-ray and say, ‘Your lung is full of fluid, and that’s why you’re short of breath,’” says Dr. Micah Prochaska, a second-year resident at the University of Chicago.
Smartphones, too, are changing medicine. Dr. John Halamka, a Harvard professor and the chief information officer for Beth Israel Deaconess Medical Center in Boston, is a toxicologist specializing in mushroom poisoning. About 300 times a year, he is called to consult on cases. “Wherever I am in the world at any time of day, I will be able to identify the species and, through a remote consultation purely via iPhone, be able to come up with a treatment plan for the patient,” he says.
Even without institutional support, clinicians are using mobile devices more. Halamka estimates there are about 1,000 iPads in use at his hospital every day, none purchased by the medical center.