Information Security and Healthcare
Mobile computing and wireless communications firm Motion Computing is collaborating with US computer chip manufacturer Intel to create a new tablet PC specifically for the healthcare sector called the mobile clinical assistant. It is now on the market.
“The Motion C5, the first mobile clinical assistant (MCA) that integrates technology from Intel® Health, combines durable design elements with key data capture technologies to simplify workflows, increase productivity and improve overall quality of care. Designed based on input from thousands of clinicians, the C5 brings reliable, automated patient data management directly to the point of care. Get a handle on patient care with the C5. It’s highly portable. It’s lightweight. And, it’s ready to work for you. A convergence of technologies allows you to do everything you normally do during your shift such as perform clinical documentation, administer medication and take pictures using a single device. With Intel® Centrino® mobile technology and integrated high-speed wireless connectivity, the Motion C5 integrates key functions that clinicians require to be productive during the course of the day.”
Now back in October of last year, when this was being tested, an interview with the company’s senior executives produced these quotes (notice the priority):
The new mobile clinical assistant will run using Motion’s existing tablet PC products and is being designed to advance the effectiveness of nurses, physicians and other clinicians. Toal told EHI that there were many questions about the ergonomics of the project that were being addressed and the product itself will probably not be released until mid-2007.
“The key thing that we are learning from staff about our plans to launch a mobile clinical assistant is not worry about the IT itself, but to ensure that we concentrate on the care-giving. The tablet needs to be a clinical aid, capable of improving the quality of care and the amount of time spent on delivering that care
“We have also had to address issues where staff here thought the technology we were using wasn’t mature enough and we have had to implement new technology such as RFID [Radio Frequency Identification Devices] and wireless transmissions in order to keep the product as effective as possible.”
However, Toal feels confident that tablet PCs will become the new norm for mobile medicine in the near future despite fears about durability and safety.
“There will always be barriers, but we are working hard to overcome these. Battery life and security issues are topics which will inevitably be part and parcel of the debate surrounding mobile technology, but I do believe that clinicians will soon be able to carry mini-tablets on them to every patient they see and be capable of producing the best patient care possible. ”
Let’s see. Wireless transmission of sensitive information–yeah, we’ll get to that right after we take care of those pesky ergonomic and battery life issues. And preventing hacking and malware to ensure that the information is accurate? Hmm. Let’s put that on the list of things to do after we make sure it doesn’t add to the weight of the tablet device.
November 7th, 2007 at 8:22 pm
… I suspect that the subject of healthcare privacy needs a shake up from top to bottom. A few questions …
* Is it clear what the customer (that’s us, not the health managers) wants?
* What ‘need’ do these ‘wants’ reflect?
* Do the legislation and ethical requirements reflect this underlying need?
* Is there suitable compliance and enforcement of the legislation and ethical requirements?
* Should we get anaesthetists and paediatric cancer specialists before worrying about privacy and security?
When we have a good answer to those, we may be able to evaluate the technical questions about encrypting data at point of entry; securing information over wifi; ensuring that laptops and tablet devices are not attractive to thieves of information, identity or property (because they certainly will be available to all of those). …
November 19th, 2007 at 7:45 pm
A tablet device is too large and heavy for any kind of pocket (and hospital staff don’t have anything other than pockets), so tends to get treated much as a paper file would: left around on top of drug or record trolleys, unattended in corridors, on patient beds, or just plugged into a base unit for recharging in an often unattended clerk’s area of the ward. At one hospital I was told they had for years had a serious problem with theft of equipment, drugs and so on, reportedly by local junkies, and I understand the same problem exists elsewhere. Ward drug trolleys had to be chained to immovable objects, so tablet devices might suffer similar problems.
If devices are shared, there is no device owner so nobody really takes responsibility for the device (security, recharging and so on). And until costs really come down, I don’t see such devices becoming personal (each ward would require dozens). (Of course many doctors already use their own PDAs, which do fit comfortably in the pocket and are very much personal devices. They don’t get talked about as they are often not hospital equipment or part of a procurement strategy.)
I think hacking and malware come a little way down the list of problems, which tend to be pretty mundane. For example, it’s actually difficult getting a reliable wi-fi connection throughout a hospital ward (partly owing to the built environment in healthcare I guess). If a single set of paper notes is missing, things can be rejigged while they are located, but if you can’t access any patient records at all for several hours across an entire ward (and I’ve seen that happen), the problem is a little more serious.
Picking up a tablet PC from the clerk’s desk and popping into the toilets with it would, in my view, not be a problem in the average hospital ward. Data is stored remotely, but password-sharing is widespread and indeed passwords may be available in the clerk’s area. Many people do not always logout anyway, so as long as the machine has not already auto logged out already, you’re in.
It has to be said that data privacy never seems to have been much of a concern in the paper era: files lie around everywhere for anyone to pick up and read, white boards display sometimes quite personal info to any ward visitor, and telephone conversations about patients take place in the hearing of any passer by. But the difference is in the volume of data to be had for so little effort.
I don’t see any online systems doing away with the traditional informal records that every patient has - handwritten notes tucked into the nurse’s pocket, prepared at shift handover. Or on the SHO’s PDA. Wireless tablet devices promise data input and data availability at the bedside, but I don’t see tablets being used for any serious volume of input. Which may mean people are going to continue writing things down in paper files…