How a major hospital embraced 'mobile first'

From the mHealthNews archive
By Ephraim Schwartz
08:07 am

When Ottawa Hospital wanted to implement a new computerized physician order entry system it was faced with a choice: Tune the software for desktops and workstations and then adapt it for smartphones and tablets, or go exclusively mobile from the onset.

Canada's largest hospital, in fact, claims it's the first in the world to implement a mobile electronic order entry system for physicians, according to Glen Geiger, MD, chief medical information officer.

Ottawa's move toward mobile-first represents nothing less than a sea change in how healthcare applications will be designed in the future. 

What 'mobile first' really means
Hospital CIOs and administrators who want to drive adoption of patient-facing and internal applications need to consider a number of facets that are de facto requisites today. A touch-screen interface, legibility on a 4-inch screen, a drop-down menu, text that can stand up to viewing in bright sunlight, and even voice recognition are must-have features for any modern healthcare app.

But 'mobile first' means more than having a user-friendly interface. A mobile first strategy refers to the idea of  designing a product or service for a mobile application prior to adapting it for desktop workstations, according to Dipak Patel, Accenture’s managing director of patient access capabilities.

[mHealth masters: David Lee Scher, MD on bright future for wearables. Smartwatches? Nope.]

Prior to embarking on its mobile first strategy, Ottawa Hospital, which has more than 1,000 beds and 1,300 physicians, had PCs in nursing stations, bolted to the wall in the hallways and on carts.

The problem with that setup was doctors wasted a lot of time going to a workstation to input orders. If physicians had the device in hand, they could conduct ordering at the patient bedside and always be able to access records.

Today, the hospital has "extremely high" electronic ordering on a native mobile application. Besides adding incremental value compared to everything else the hospital tried, Geiger said, they discovered that staff preferred mobile to the existing infrastructure — and now those PCs on wheels are highly under-used.

The business case for mobile first
A mobile first strategy doesn't come cheap, of course, at least not for a large facility like Ottawa Hospital.

Geiger estimated that implementing  the mobile first strategy cost somewhere between 5 million and 10 million Canadian dollars. Included in the costs were the purchase of 3,000 to 4,000 iPads, upgrading  the wireless infrastructure in three facilities to insure stability of access, and ongoing development activities for the devices. 


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