"We had been researching tablets and hand-helds for awhile," he says. "The products were finally there so we decided to marry the physician portal and Tablet PC initiatives."Physicians at an Ohio hospital use Tablet PCs to access patient data via a proprietary portal.
April 1, 2004 - Akron (Ohio) General Medical Center, like many hospitals, has been going through a merger over the past few years. Not a merger of different business entities, though, but a merger of major I.T. initiatives.
In mid-2001, 511-bed Akron General began looking at how it could introduce its clinicians to mobile technology. At the same time, the hospital was planning to deploy a Web portal to enable its physicians to have improved, remote access to patient data. By merging the initiatives, Akron General concluded it could achieve better data access for physicians as well as have a good first clinical application for mobile hardware, says Dave Fiser, director of application systems.
"We had been researching tablets and hand-helds for awhile," he says. "The products were finally there so we decided to marry the physician portal and Tablet PC initiatives."
But instead of rushing to implement the latest technologies, Akron General decided to first get some advice from physicians on how exactly its mobile portal should be developed and offered. The hospital surveyed 125 physicians, asking which systems they'd want access to via the new portal. It also asked if any of the physicians wanted to participate in helping evaluate portal designs.
The physician input helped the organization prioritize which applications it should make available on the portal as well as how they could be used in clinical care. And 25 of the physicians indicated they'd help evaluate a pilot portal.
Because the hospital had so many specific requests from each physician, it decided to develop its own customized mobile clinical portal rather than implement one from a vendor, Fiser explains.
In November 2001, it began using the Oracle9iAS portal development tool from Redwood Shores, Calif.-based Oracle Corp. to create its new Web portal. The vendor helped Akron General install the software on the hospital's local area network. The hospital also worked with AdvizeX Technologies LLC, a Concord, Ohio-based consulting firm, to develop new clinical applications for the portal as well as develop an HL7-based interface engine to ensure physicians could retrieve data from existing and new systems, including transcription, radiology, insurance, demographic and others. "We've designed for the physicians something that is very flexible and geared around how they wanted to use it," Fiser says. "And they can customize the portal applications to how they practice. We can offer the portal to several types of doctors and make everyone happy." Akron General also used the single-sign-on functionality included in the portal development tool to ensure physicians had secure access to all the applications in the portal via a single username and password.
Mobile access
The physician survey also helped the hospital determine what kind of mobile hardware it should offer for access to the new portal. The survey indicated physicians wanted to use the portal to access more complex applications, such as the hospital's electronic medical records and picture archiving and communication systems. As a result, I.T. staff concluded it should enable access to the portal on mobile hardware that featured a large screen, such as a Tablet PC.
By December 2002, the hospital had purchased about 30 TC1000 Tablet PCs from Palo Alto, Calif.-based Hewlett-Packard Co. and began showing members of its physician advisory group how to use them to access the portal.
"PDAs were considered too small to present the information physicians wanted to access via the portal," Fiser says. "The size and functionality of the TC1000 fit physicians well. They are lightweight and can easily fit into a briefcase."
Although the hospital planned to take all physician comments into consideration before unveiling a final version of the portal, the doctors chose to immediately begin using the pilot version of the portal. Inside Akron General, physicians use the Tablet PCs to first log onto the hospital's local area network then enter a separate password to access the Web portal. The Wi-Fi network, from San Jose, Calif.-based Cisco Systems Inc., enables physicians to access the portal anywhere in the hospital.
Akron General also offers remote access to the portal. Physicians can install a virtual private network client on their Tablet PCs to access the portal from homes or offices that already have wireless access. Physicians must authenticate themselves on the VPN using SecureID technology from Bedford, Mass.-based RSA Security Inc.
Akron General unveiled an updated version of the mobile portal in June 2003 to physicians participating in its pilot development evaluation. The pilot group of physicians liked the customizable mobile portal so much, Fiser says, that the hospital plans to unveil it to its other physicians by the end of this year. Though it received a grant to pay for the initial batch of Tablet PCs, it's already purchased 31 of the vendor's newer TC1100 models at about $2,000 each with its own funds and plans to purchase 62 more by the end of the year.
The hospital, however, can't offer the mobile portal to other physicians quick enough. Some physicians are purchasing their own Tablet PCs to be able to use it more quickly, Fiser says. And its initial group of 25 physicians that want to help evaluate the portal has grown, he adds.
"At first there were only a few physicians who would regularly come to our monthly meetings. But now there's a standing room only crowd to help us further develop the mobile portal," he says. "And they all show up with their Tablet PCs."
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