Tuesday, February 2, 2010

A Top Ten List of Medical Uses for the iPad: An Alternate Point of View

The Disease Management Care Blog is not surprised by the fawning adulation of the health information technology (HIT) minions over the illusory potential of Apple's iPad to 'transform' clinical practice. For example, this CIO posting examines its potential to 'revolutionize' healthcare, while this one says it can become the 'No. 1 tablet.' Toss in jargon like 'point of care tool' and 'personal health device' and add some lusty excitment over applications both real and imagined, and it's easy to succumb to the seduction of touching screens instead of patients, managing data instead of diagnoses and being digital instead of doctors. Never mind that a consistent link between electronic record use and health care quality remains as elusive as the CFO-like DMCB spouse's willingness to approve the expense of a dinner in the Circular Dining Room. It's still cool! It's still neat!

Of course, the iPad hoopla (including the Moses themed cover of The Economist) has only fueled that favorite of internet-media-bloggy punditry, the 'Top 10' list. For example, the Top 10 What You Need to Know and... well the list goes on, including a Top 10 list of Top 10 lists. Within the healthcare arena, the readers of KevinMD's blog were subjected to a dose of unreferenced and wholly speculative Top 10 healthcare iPadmania.

Not to be outdone, the DMCB - based on past experience with electronic records, their starry-eyed administrative support teams, questionable outcomes and the cold hard reality of actually taking care of patients - is pleased to offer its own Top 10 list of potential iPad uses in typical practice involving busy doctors and sick patients in a place unknown to many of the electronic record nobility. That place is called 'the real world':

1. Hot Beverage Insulator: The DMCB used to perch a prescription pad on top of its coffee cup to help retain heat between seeing patients. The disadvantage is that, as a result, the liquid often tasted from cardboard. The iPad case promises to be far more inert.

2. Instrument Tray: Office assistants can lay out scapels, scissors, swabs and other doo-dads on the screen for easy access. Compared to the price of medical equipment such as trays etc. in general, the DMCB suspects the iPad will be quite cost competitive.

3. Lunch! The DMCB learned from a wise colleague that no matter where you are in the day, lunch is always on the way. The iPad will be a boon to any physician who needs to place a lunch order during the tedium of patient care.

4. Tricorder: Remember Star Trek's Dr. McCoy and his multi-purpose diagnostic tricorder? If physicians are confident nothing is wrong with the otherwise dubious patient, point the iPad (or better yet, hold it up against the patient's body), peer intently at the screen and announce there is 'NOTHING WRONG.' Your patients will thank you!

5. Light Source: Surely the iPad's screen can be made to go white. When it does, aim that puppy at the patient and no mole, no body fold and no body cavity will not be amply and completely illuminated. All that's needed is a way to affix it to the doctor's forehead a.k.a. 'hands free mode.'

6. Timer: Most physicians and their administrators understand down to the second just how much time should be allocated to each patient to maximize practice income. The iPad will calculate current billings, cash flows, visit intensity and room-to-room pace to optimize maximum physician efficiency. When 30 seconds are left for that Level 4 visit, count on your iPad to buzz annoyingly.

7. Meaningful Use Standards: Like you, the DMCB doesn't really grasp CMS' Meaningful Use Standards' that will be linked to physician payment for EHR use either, but it thinks having an iPad will magically make it happen. Turn that baby on and wait for a check from Uncle Sam

8. Door Stop: Nothing annoys patients more than being put into a room ahead of time and being left to languish while the doctor is behind schedule. Not a problem, the iPad can be used to prop the door open so that patients can see out into the hallway.

9. Pass Time: Or, if patients prefer, they can leave the door closed and curl up with the iPad edu-tainment device, accessing functions like soothing music or really gross pictures of patients afflicted with weird medical diseases.

10. Cool and Cheap (relatively at least): OK, let's assume patients think you should use an electronic record, but you don't want to shell out the tens of thousands of dollars. Pretend to use an iPad during your patient encounters and you will give the appearance of being cool, connected and networked, even though what you're really doing is surfing and checking the Disease Management Care Blog.


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