by adgrooms on November 13, 2019

Almost all of us have a small computer in our pocket that keeps us connected to the world. In some cases, the smartphone can be a very useful efficiency tool, even at work. For example, a study of physicians using smartphones to receive chest pain test results in the ER has shown patients can get discharged faster. Does the smartphone have a role in assisting physicians? When are smartphones an asset and when are they an impediment?

Emergency rooms are often busy, chaotic places. With physicians always on the move, sometimes hopping on a stationary computer to check on patient statuses only slows things down. This may be where the smartphone can jump in and alert a physician about a patient's status. In the study mentioned above, doctors were selected to receive alerts from the EHR system on their smartphone when emergency chest pain patients get troponin lab results. These results determine if the patient can be discharged. The study showed that patients waited an average of 94 minutes after the results of the test, but the physicians using smartphones to get the results were discharging patients at 68.5 minutes, saving 26 minutes. Every minute counts when waiting in an ER.

Emergency room wait times can be notoriously long and any time saved is beneficial to patient safety. EHRs, payers, and regulations have slowed physicians by requiring increased time spent on documentation. Now there is an effort to improve EHR usability and reduce the associated time drain. The benefits of integrating EHR use with a physician's smartphone could go beyond alerts for labs. It could give physicians mobile dictation capabilities. When a physician receives results they could record their observations and submit them without having to find an EHR computer. Information such as patient status and time lapsed since admission could be accessed through an app to help physicians manage their workflow on the run.

The drawback of using smartphones is that alerts add to cognitive load. With the increased availability of information, there is an increased likelihood of information and alert overload. Physicians are already asked to do too much multitasking and not supported with enough time focused on patients. Carelessly adding another component of distraction is likely to do more harm than good. This drawback can be mitigated by providing an opt-out of alerts for extremely busy periods with a choice to turn them back on with a timer or manually. The ability to tune alerts will help focus on the benefit and reduce the drawback. It is also important to have a simple and easy way to turn off all information when not at work. One way to do this is with a phone dedicated solely for work - to turn off after hours.

There are positives and negatives to using smartphones for faster access to patient information in a clinical setting. As solutions are sought for a better EHR experience for physicians, smartphone integration should be considered, carefully, as a viable option.