Once upon a time in the days of Opie and Andy, doctors made house calls. I’ve seen it on TV, so it must be true. Now, a doctor visit usually requires that you do the visiting to a clinic, office, or hospital. An initial appointment may result in referrals for tests or to specialists – more visits, parking lots, waiting rooms. Sometimes your information gets transferred along, sometimes it doesn’t.
Lately, more medical caregivers are carrying laptops or using PCs in the exam room to access patient charts, enter information, and order tests or prescriptions. My primary care doctor connects to a large flat-screen monitor to review my chart and show me lab results, even x-rays. (Meanwhile, my son’s pediatrician carries a manila folder with notes from his first infant exams. He’s now in third grade. My dog’s vet stores his records electronically. Your results may vary...)
Mobile devices are showing up everywhere, healthcare included. There’s even a new word: mHealth. (We had e-everything in the early 2000s, then came along iSomething, so let’s now move further into the alphabet with mWords.)
There are articles upon articles about mobile technology in healthcare, but most focus either on mobile devices in clinical environments or medical apps for smartphones and tablets. It’s all good stuff, but I like to think outside the box. Or at least outside the building.
What if… healthcare professionals could interact with patients more effectively outside of the office? For instance, they could use mobile devices to:
Securely access and update patient records
Order prescriptions, make referrals, and handle other basic documentation tasks.
Use video to collaborate with other medical professionals in real time.
Record video of patient symptoms for later review or comparison to previous interactions.
It seems pretty simple, but even a basic connection to information could amplify what healthcare professionals can do outside the confines of the clinic or hospital.
Why does it matter? What kind of difference could it make?
What if…in the next natural disaster, doctors could go directly to the patients and do more than basic triage? Whether on site or in a designated evacuation center, the combination of a secure network connection and a mobile device like a tablet could be as important as a stethoscope. Setting up a secure network in a disaster zone may sound like the biggest part of the challenge, but it’s not. (Check out the Cisco Network Emergency Response Vehicle, a mobile communication center supported by a highly trained team and designed to establish interoperable communications in emergency situations – within 15 minutes of arrival on scene.)
With more medical resources on scene, hospitals could focus on the critical patients, while doctors in the field could handle the less severe cases onsite. This could work toward decreasing patient wait time; reducing the risk, logistics, and stress of transport; and minimizing overload of medical facilities – not to mention avoiding separating fewer families in time of crisis.
Using tablets and a secure network connection, doctors could access and update patient records, take histories, order prescriptions, and enter referrals or set follow-up instructions. Add in messaging for communications, presence to find available colleagues, and you're narrowing the gap between the resources available in the field and those available in a hospital.
Add high-quality video to consult with specialists to extend the range of care available in the field. Responders could also use video to help identify patients and reconnect families who may have become separated, something that could both facilitate care and reduce stress levels.
In longer-term situations with more established evacuation centers, teams could bring in additional equipment for diagnostics, treatment, and continued connections with the “fixed-site” facilities.
What if… communities could better serve the medical needs of homeless populations? Physical and mental health issues challenge much of the homeless population. Compound that with the lack of healthcare, whether due to an inability to access ongoing services, lack of transportation to clinics, absence of health insurance, or more basically, fear.
Many communities have converted vehicles into mobile clinics specifically to serve the homeless. In a report by the National Health Care for the Homeless Council, 39% of mobile providers cite challenges with clinical information management as a significant obstacle, identifying electronic medical records and broadband access as solutions. Another 18% point to patient follow-up and tracking as problematic. Again, it’s more about information than actual medical care.
With secure mobile access to electronic health records for those patients who have them, providers could offer better continuity of care. Add video to the equation and you can extend the services offered, such as enabling remote consultations with specialists, especially important in mental health evaluations. Likewise, the ability to video or photograph a patient’s injuries or appearance could benefit follow-up, either through identifying individuals or assessing the progression of a patient’s condition or injury.
A large portion of the U.S. homeless population includes military veterans -- I’ve seen estimates from 23% to 40%. It's significant no matter the number. Veterans are eligible for services, yet can’t always get to them. Giving medical teams from the Department of Veterans Affairs the ability to access and update their records, treat and monitor their conditions, and refer them for services and benefits would be a major improvement. Consider also that more than 100,000 new veterans will return in the next two years. With current stats showing the unemployment rate for veterans at 22%, the challenges will increase –homeless or not.
But here’s the best part of these scenarios. The technology to make it happen exists. Mobile tablet devices. Smartphones. Secure access over wireless and mobile networks to access patient records, do remote video consultations, messaging, etc. The parts and pieces are available to create the collaborative systems that could benefit these situations. As with collaboration in general, it comes down to enabling connections between people, sharing information, and responding in real time.
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