Mobile clinical devices are like bowls of porridge

Nov. 10, 2011

When it comes to documentation at the point of care, clinicians have a few different options — but which one is the best solution? Computers on

When it comes to documentation at the point of care, clinicians have a few different options — but which one is the best solution? Computers on wheels (the infamous COWs) offer mobility with the added benefit of storage space for medications and other supplies, but many clinicians find them to be cumbersome and difficult to maneuver, particularly in small rooms. There are also concerns of infection risk with moving the carts. As a result, they often end up abandoned in hallways or stationed in the same patient room, which can lead to dangerous work-arounds.

Because of these reasons, some clinicians prefer laptops, which seem to offer greater mobility. But even these devices can get heavy during an 8 to 12-hour shift and can be awkward to carry (if they aren’t equipped with a handle). Plus, battery life is often an issue.

Clinicians can go even smaller — and lighter — and opt for a PDA, but these devices also rely on a great deal of battery power, and the information on the small screen can be difficult to read. According to Marion Ball, who I spoke with a few months ago about this issue, the average age of nurses in the United States is between 45 and 50. So we’re talking about workers who don’t exactly have 20-20 vision and aren’t always able to lug around (or steer) heavy equipment all day.

When it comes to mobile clinical devices, what’s the best option?

It reminds me the story of Goldilocks and the Three Bears — one device is too small, one is too large… and it seems that no device is “just right” for everyone. Dr. Ball, a former nurse who is now a professor at Johns Hopkins School of Nursing (and a member of the HCI editorial board) believes that many clinicians are in search of a better method of documenting patient information while on the go, and that a number of facilities are going through a process to determine what is the ultimate point-of-care device.

So my question is, how do hospitals handle this issue? Do health systems — particularly those with multiple facilities — have one standard device that is used, or do they customize solutions to meet different needs and preferences? And if so, how does the network infrastructure support this?

It seems like this could really be a giant headache for CIOs. If you’re a CIO who has dealt with this issue or is currently trying to determine the best solution, please e-mail me. I’d love to hear from you.