Healthcare has come a long way from paper medical records, but most electronic health record (EHR) software still works best on a PC. Still, it’s neither efficient nor enjoyable for doctors and nurses on the move to be locked to a workstation to enter and review patient data. Rather than vying for a few available desktop workstations or wasting time logging in and out of shared workstations, mobile EHR apps are the key to improving healthcare providers’ productivity and workplace satisfaction.
While mobile apps for EHRs exist, most have been geared foremost to Apple iOS devices. EHR software vendors’ decision to focus on iOS development is rooted in two factors: most Android devices’ (often deserved) reputation for being unsecure, and that upwards of 90% of doctors use iPhones, according to David Y. Ting, MD, (right) an internist and pediatrician and Chief Medical Information Officer (CMIO) for the Massachusetts General Hospital Physicians Organization. The latter may be a “chicken and the egg phenomenon, where they are using iOS devices because the vendors produced iOS apps” first, says Ting.
Dr. Ting, and his Mass General colleagues Louis Ercolani, MD, a nephrologist and Mass General’s assistant CMIO, and Garry Choy, MD, a radiologist and assistant CMIO, have been testing PRIV, BlackBerry’s secure Android smartphone, as a productivity device and a secure alternative to most other Android smartphones, as well as on its ability to drive Mass General’s Epic EHR, which is the most-used EHR in the U.S., and the Android version of Epic’s Haiku mobile app. Dr. Ting is a long-time BlackBerry fan (addicted to his trusty BlackBerry Passport, on which he’s and side-loaded Haiku using a popular Google Play hack from the CrackBerry forum) and has been using PRIV for the past few months. Dr. Ercolani converted from iPhone to PRIV and doesn’t want to go back. And Dr. Choy uses iPhone, carries PRIV as an additional device, and remains a big Blackberry fan.
These doctors are in good company among professionals who find PRIV the cure for their productivity ills. Read about other PRIV fans, including this life-saving oncologist, this cutting-edge legal professional, this landscaping and construction business owner, this punk rocking media pro, this author, marketer, and entrepreneur, this aerospace engineer, and this TV chef.
Walker: Please tell me about your history with BlackBerry and other devices.
Dr. Ting: PRIV and the BlackBerry Passport have made it much more pleasurable to interact in a mobile way with the Epic EHR, to manage patient data, to manage orders, and review patient data at a time and place of my choosing. That points the way to where we could be going in terms of providing physicians with the kind of hardware and software solutions that make it less burdensome to take care of patients.
Dr. Ercolani: I always had been an Apple person, but I must say that my heart is moving over to the Android environment. I previously worked briefly with an Android phone, but wasn’t really happy with it. I must say the PRIV has really changed my mind about that.
Dr. Choy: Compared to an iPhone, I would say the PRIV screen is better. Also I like the physical keyboard and the camera seems a little bit better. The form factor is pretty equivalent when the keyboard is closed. I like the way it feels and I think the weight is good. It’s my first Android device, and it’s been a great introduction to Android.
Walker: What are you looking for from mobile devices in healthcare?
Dr. Ting: My real interest in BlackBerry has been in seeing if there are ways that technology and process can decrease administrative burden on our physicians in taking care of their patients. Nationally, anywhere from 30% to 60% of physicians are burned out.
When we surveyed our own physicians about the most burdensome things that contribute to their burnout, #1 or #2 always is interacting with the electronic health record. My team has been looking at solutions that make it easier to interact with the EHR and do it at a place of their choosing. Our physicians are feeling locked in like prisoners to their desktop PCs, to their exam rooms, to their clinics, and to schedules that are no longer their own.
Dr. Ercolani: Our EHR with Epic is so integrated now in nurses’ workflow, and it requires that nurses be actively on the computer to update their notes and vitals into electronic flowsheets. It’s actually quite difficult [for hospital nurses and physicians] to be able to find a computer to input patient information. Having a mobile device to be able to move around, to be able to see things, see orders, and check things, really makes a difference.
Walker: I know data security is a critical issue for hospitals. What is your impression of PRIV’s secure Android, particularly as it functions with your Epic EHR, and PRIV’s DTEK security app?
Dr. Ercolani (pictured here, holding his PRIV): I work with the developers at Epic on its Haiku mobile EHR app. It would be very nice to be able to sign off on orders on the run. The concern that comes up in that group around this feature always revolves around one thing, and that’s security. I could make the argument with Epic that your device is much more secure, whereas other Android devices are in general not so secure. I don’t see any reason why this hasn’t been developed as a more robust application for Android so that we can actively do ordering and follow-ups in Haiku. Really, in terms of what you’ve done to bolster the Android ecosystem, to secure it, is really quite exceptional.
Dr. Ting: The concern has been Android has been so open that it’s been perceived as not as secure a platform as iOS. And I think PRIV and DTEK, and really what’s behind that in the BlackBerry security infrastructure, starts to change the game in terms of looking at Android as a secure platform for development.
Dr. Ercolani: I find Epic’s Android version of Haiku to be very, very clean and much easier to navigate, actually than the iPhone version, so that’s a big, big plus for me to do my work. The thing about DTEK that’s very positive is that it very clearly shows you what apps are accessing things that you may not want them to access, like your contact list, your applications. What DTEK represents is a peace of mind, that you know what your apps are trying to access.
Walker: What are your PRIV favorite features so far?
Dr. Ercolani: What I really like best is your Hub [that consolidates all of your emails, texts, phone calls, BBMs, contacts, and calendar into a single application]. I like the way it organizes information for me as it comes in, whether it’s a text message or an email. It’s a very, very strong feature and something that I have not seen before that is very helpful for our very busy workflow.
Dr. Choy: I like the BlackBerry flavor of Android. The fact that there’s BBM on it, that there’s native BlackBerry apps, so you still have that BlackBerry feel, but it’s Android. I also like the camera, and I’ve discovered that if you use the keyboard and you hit the spacebar, it takes a picture or starts a video recording. I think that tactile trigger of taking a picture or a recording is very useful and intuitive.
Dr. Ting: PRIV represents one of the exact reasons that I like the idea of the open development platform, because you see hardware that goes beyond simply the typical smartphone format. You have a physical keyboard and it not only gives you the input possibilities, but also the scrolling and cursor control. I love how you can slide your fingers across the surface of the physical keyboard and control the vertical and horizontal scrolling of the screen, and if you double tap on the slide-out keyboard, the entire keyboard becomes a mouse pad which you can use to precisely position a cursor on the display. You can work without having your finger all over the screen. It’s an example of how BlackBerry has been able to take innovative functions that are seen in its other devices and port them over to Android.
Hub, Hub, Hub. That’s the big distinction here, aside from the physical keyboard. I’d love to see BlackBerry continue to move in that direction, to optimize the Hub experience on Android. Add together the fact that PRIV runs full Android and Android apps, as well as the BlackBerry flavor – that’s really the big, big power of this device.
Walker: How about using it in your work – has it helped you in your day to day?
Dr. Choy: I use it for productivity, for email and for managing my calendar, for backup to our camera when I need to take a picture. I’ve used an iPhone and the virtual keyboard is also scaled pretty well.
Dr. Ting: Beyond simply interacting with Haiku, there’s a huge advantage in using what in the BB10 world was BlackBerry Assistant, and seeing many of those features coming over to PRIV in the BlackBerry Hub. It is extremely useful to be able to manage text messaging, my phone, and my multiple email accounts all in one place. It means that I don’t have to switch from app to app to see communication that comes in, and it allows BlackBerry to stand out among other Android solutions.
One thing that I anticipate using more is secure text messaging. [Mass General is] moving to implement Imprivata’s Cortext for secure messaging and there’s an Android version of the application. And, of course, I appreciate PRIV’s ability to integrate Outlook, Office 365, OneDrive, and to have those available on the mobile device.
Dr. Choy: I’ve used it for both work [as a radiologist] and personally. It’s truly responsive, and the Hub is really good at accessing anything on the phone. If you want to email or text a picture, it’s easy to attach within the Hub.
Dr. Ercolani: I like the camera and [particularly] the update that allows us to do slow motion. I run the dialysis unit, but interact with a lot of the rehabilitation staff, as well. I think the advantage of having this kind of a camera is that you can capture things in slow motion to see how people are going through their exercises to recover from an injury. This could be very helpful to the staff and the patients themselves.
Dr. Ting: I’d say the optics are some of the best I’ve seen. It’s several steps above the Passport, and echoing what the others have mentioned, the shutter speed is a step up from most mobile phone shutters. I’m an amateur photographer and I have high-end DSLR equipment, and the PRIV optics are really good for a smartphone.
Walker: How easy or difficult was it to set up PRIV initially?
Dr. Ercolani: It was so secure it was a little bit more difficult to get going because of the security features in the PRIV, being able to set up my email accounts and some of my other accounts. But I feel very, very confident about the security of information and data on it. It’s just a matter of having a little bit more information about how to set it up in our particular environment. Once it was going, it was great.
Dr. Ting: I thought it was really a straightforward setup. Compared with the typical Android setup, it was comparable or easier.
Dr. Choy: Yes, I agree. It was pretty easy to set up, having gone through the BlackBerry setup. It connected well to our internal network.
Walker: How has it been moving from BB10 to Android?
Dr. Ting: Well, it’s bittersweet because I would say BlackBerry Passport to me represents the pinnacle of where mobile devices could go. The BB10’s BlackBerry Assistant is so beautifully integrated with Bluetooth and gives me the possibility of working on my hour-long commute without ever taking my eyes off the road. It is just such a beautiful platform.
I understand that healthcare needs to move to secure Android for the apps. I’ll probably never be able to get Passport to the same level of integration with the hospital systems as I can with an Android device. So that’s where I know that ultimately I’m going to be 100% on the PRIV. PRIV provides a beautiful, bright, huge screen, and as far as I’ve seen, it handles easily any Android applications that you throw at it. And, because of the slide-out keyboard, the thin form factor, the quality of the device build, I think that I’ll move to PRIV without any trouble.