Kate Huvane Gamble, Managing Editor, hsCIO.com
It’s funny how things change. Not too long ago, when I saw a car swerving on the road, I’d immediately assume the driver might be intoxicated or possibly falling asleep, and I’d make every effort to avoid that car.
Now, if I see a vehicle veering into multiple lanes or sidling up to the median, I automatically assume the person is texting, checking e-mail, or doing anything else on a smartphone that can distract a driver. And more times than not, that’s been the case. I’ll see the person fixated on a device, looking up at the road just once every few seconds. It’s extremely frightening, particularly on a highway, where total concentration is required to maintain control of a car.
Don’t get me wrong — I love my iPhone, and I’m in awe of how convenient it is for me to do everything from setting appointments to checking baseball scores. But I realize, sometimes, having that much technology in the palm of my hand can be really distracting, and the temptation to find out what text message or email just came in can be too great.
It makes you wonder if that temptation is posing similar issues for clinicians. In recent weeks, a number of blogs and articles have surfaced suggesting that personal use of mobile devices by physicians is interfering with patient care.
According to a survey by Aruba Networks, approximately 85 percent of hospital-based IT professionals say their organization has a “bring your own device” policy allowing staff to use personal mobile devices. For most hospital CIOs, the top concern in having physicians carry their own smartphones is security — which makes perfect sense considering the risks involved. But what’s also very important is the fact that smartphones, for all the good they do, can affect the ability to provide quality patient care.
In a Kaiser Health News article, John Halamka, MD, CIO at Beth Israel Deaconess Medical Center (and a self-proclaimed technophile), went so far as to say that when it comes to the healthcare environment, the distractions caused by mobile technologies can be “a matter of life and death.”
Physicians who carry mobile devices receive alerts for incoming text messages, e-mails, Facebook messages, and Tweets — distractions that can quickly add up. “I think all of us who use mobile devices have what I will call continuous partial attention,” he wrote in the article. “We’re engaged in our work but at the same time we’re checking that e-mail or we’re glancing at that instant message.” And whereas in the past, laptops separated physicians’ personal and professional lives, with the BYOD trend, “you see the blurring of that separation.”
Halamka believes that more education is needed to help guide physicians with the use of mobile devices, and that hospitals need to implement — and frequently update — policies to stay up to speed on clinician’s mobile habits, taking note of what type of apps and software are being used, and how often.
Medical schools like Georgetown and Stanford University are hoping to nip potential problems in the bud by offering courses to help students learn how to tap the potential of smartphones without losing the human connection with patients. According to an AP article, one program at Georgetown is using actors to portray patients who provide feedback on how well or poorly students integrate technology into their workflow.
At Stanford, a set of guidelines have been developed for docs who use mobile devices:
- Face the patient
- Excuse yourself to check the screen
- Put away devices when you’re not using them
- No personal Internet use in front of patients
For younger docs who grew up texting while multitasking, it may be difficult to realize how intrusive patients might find the devices — particularly older patients who have long grown accustomed to interacting face-to-face with physicians without the use of any gadgets.
For this reason, it’s critical that policies are in place to help guide smartphone use in hospitals and avoid the blurring of lines between what’s acceptable device use and what could be perceived as disrupting — or even dangerous. Because in today’s competitive environment, the last thing you want is for patients to see docs swerving all over the place.
ToddFRichardson says
While I don’t disagree that Mobile Devices can present a distraction and potentially be an issue impacting Patient Care, I would contend that we should look to our ‘Standards of Conduct’ policy to cover the issue, rather than creating yet another policy specific to Mobile Devices. I don’t have a policy on the appropriate time to read personal books (which may be distracting), or the appropriate use of Pens, which could be used to doodle in a meeting and be distracting… or other items such as iPods, iPod Touch, Kindle, the list goes on… Please understand I am not advocating for the inappropriate use or saying we don’t deal with it, but specific Policy Writing is not the answer. We already have too many policies that nobody can find, nobody knows what they say and people don’t follow them. It’s an issue of Conduct and that’s already covered…we need to concentrate on education. Tfr
Kate Gamble says
Todd,
Thanks for the comment. I appreciate getting the perspective of a CIO on this, and I can understand not wanting to create another policy that could gets swept under the rug.
My question to you is, who does it fall under to ensure that the Standards of Conduct are updated and enforced? Does it vary by organization?
It’s a really interesting topic. Thanks for your take!
ToddFRichardson says
Kate,
Standards of Conduct comes from the HR department, as it outlines the expectations of our employees. Provided that it is well written, it covers overall expectations and of behavior, and should stay away from trying to publish the exhaustive list of do’s and don’ts… It may provide examples to get the point across, but if written well, it won’t be required to change as a new specific item comes up. As for enforcement, it is probably the single most useful policy in the book for a manager. A good SOC policy provides a manager with the very tool to use with staff who are being difficult and require disciplinary action. In much the same way that my Acceptable Use Policy covers a broad range of issues and provides a high-level set of expectations, it also serves to keep me from writing separate policies for “Internet Use”, “Use of Mobile Devices”, “Email Use”, etc… So many organizations get into Policy Frenzy and fail to realize that what they are passing off as Policies are actually Standards, Guidelines or SOP’s. A practical danger of this, is that Regulators love to catch organizations guilty of ‘Not following their policies’… If you have a million policies, nobody can even keep up with them, much less follow them. Take ‘Email Retention’ as an example. With so many litigation issues in healthcare, we are in a constant state of Start/Stop when it comes to email purging. If you have a 90 day retention period, the technology guys will be stopping and starting so often, they will be 100% likely to delete something they shouldn’t have, or kept something they should have deleted. Once you are guilty of not following your policy…you are Guilty.. Tfr