Healthcare Robotics: Patently Incredible Inventions

With a Greenway app for the Windows 8 tablet, Pediatric Associates of Bellevue, Wash., has the opportunity to sign up patients as soon as they come into the world.

"The biggest benefit has been when the doctors go out to see patients in hospitals, particularly new babies," Brock Morris, CIO for the 85-doctor practice, told us. "They can create the account, so to speak, and begin to document the patient the very first time on newborn babies."

That was one of the benefits that emerged from an initial test in February. Six doctors were asked to try the PrimeMobile app, developed for Windows 8 by Greenway Medical Technologies with help from the practice and Microsoft. Greenway recently received a 2013 Intel Innovation Award for the care delivery app.

Since Pediatric Associates went live with Greenway's web-based EHRs in 2010, it has had its staff accessing the application on Windows tablets (originally Toshiba devices that were convertible between laptop and tablet modes). However, it is finding that doctors and physician's assistants can be more productive with apps specifically designed for mobile users.

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In the last few months, Pediatric Associates has been moving toward routine use of the app on Microsoft Surface 2 tablets.

Based on "extensive time-and-motion studies," physician's assistants logging the data were saving about a minute per visit, Brock said. "We typically run 10-minute sick appointments, so if you figure you're saving a minute of time over a 30-patient day, that means you could gain at least one appointment -- or potentially three." Whether the practice would use whatever time savings materialize that way remains to be seen -- less time spent entering data could also translate into more time for interaction with each patient -- but either way, there's the potential for a real gain.

As Pediatric Associates begins to use the mobile app more routinely, it is targeting the ability for doctors to add vital signs, medical history, and allergy information "right at the point where they are being collected." Otherwise, the doctor is often in the position of writing the information down with the intent of logging it into the system later -- which might not always happen.

Pediatric Associates does have an ulterior motive for focusing on Windows, based on its proximity to Redmond. "Our location makes that an attractive device. A lot of parents of our patients are Microsoft employees." It's not uncommon for the parents to volunteer that they worked on some of the base technology the doctors are holding in their hands. "But the device form factor and performance was also very attractive to us, particularly the new form factor with the snap-on keyboard."

The practice is also working with Greenway to improve the application modules for templated medical note taking and recording immunizations.

"We believe the only way to build a successful EHR is to partner with our customers," said Johnathan Samples, executive vice president of innovation at Greenway. By working with Pediatric Associates, Greenway can better tailor the app to the practical needs of physicians and practice staff.

Greenway also offers versions of PrimeMobile for iOS and Android, aiming to deliver the same basic set of functions on each mobile client. The Windows 8 version represents a return to that platform. Previously, Greenway had done some work with Windows tablets in the era of Windows CE, the slimmed-down variant introduced in the 1990s for use on non-PC devices. However, it didn't invest there in recent years, Samples said. Greenway did create a Windows 7 Phone app, but nothing for tablets.

With Windows 8, Microsoft put enough emphasis on enabling mobile apps to rekindle Greenway's interest. A lot of its largest enterprise customers also like the idea of Windows 8 as a mobile solution because they have experience managing Windows clients, and they find iOS and Android much more challenging, Samples said.

The mobile client "has probably about 75% of the functionality" found in the web app targeted at desktop users, but that percentage is steadily growing. "Two or three years down the road, we think most physicians are going to be using a tablet at the point of care, not a desktop machine."

Brock described physician response to the app. "The doctors say things like that it improves their cool factor," he said. "There's a change in the interaction when doctors are using mobile devices and new apps. In the demographic we're working with, it's what parents expect."

David F. Carr is the editor of Information Healthcare and a contributor on social business, as well as the author of Social Collaboration For Dummies. Follow him on Twitter @davidfcarr or Google+.

Though the online exchange of medical records is central to the government's Meaningful Use program, the effort to make such transactions routine has just begun. Also in the Barriers to Health Information Exchange issue of InformationWeek Healthcare: why cloud startups favor Direct Protocol as a simpler alternative to centralized HIEs (free registration required).