Nurses turning to un-authorized smartphones to meet data demands

[Erica Absetz <eabsetz () opensecurityfoundation org>]

http://www.networkworld.com/news/2012/122112-nurses-smartphones-265330.html

Network World - A new study finds that more than two-thirds of nurses
are using their personal smartphones for clinical communications. Yet
95% of nurses in the sample say hospital IT departments don't support
that use for fear of security risks.

The report, "Healthcare without Bounds: Point of Care Computing for
Nursing 2012," bySpyglass Consulting Group, points to the collision of
healthcare information demands on nurses, and the limits of mobile and
wireless technology, at the point of care -- typically the patient's
bedside. Nurses in the survey decry the lack of IT support; and IT
staff are frustrated by the unsanctioned and often explicitly banned
use of personal devices for clinical communications.

The report is based on in-depth phone interviews with 100 nurses in a
variety of healthcare organizations in 33 states, focusing on the
information requirements of nursing and the use of mobile and wireless
technology to meet those requirements. About half of the respondents
were registered nurses with a Bachelor of Science in nursing; nearly
40% were registered nurses with a Master's degree in nursing
informatics.

The majority of nurses in the survey complain that hospital
administrators are pressuring nurses to document care ever more
thoroughly, to satisfy the growing number of government mandates,
maximize reimbursements from third-party payers, and protect the
hospital from lawsuits, according to Gregg Malkary, founder and
managing director for Spyglass. The complete market study, "Healthcare
without Bounds: Point of Care Computing for Nursing 2012," is
available from Spyglass for $2,495.

The rising healthcare information demands are creating resentment. For
example, a majority of nurses in the survey complained that they're
being reduced to mere data collectors to satisfy "meaningful use"
requirements, which are federal rules that healthcare providers must
meet to qualify for federal incentive funding under the American
Recovery and Reinvestment Act of 2009. Failure to do so can lead to
big cuts in Medicare and Medicaid reimbursements, according to
Malkary.

He found that a majority of nurses interviewed say the "meaningful
use" requirements are almost entirely physician-centered, ignoring
data needed by nurses. And they say they're becoming simply extensions
of the IT group's own requirement to achieve compliance with
meaningful use rules.

It's this information demand that drives 69% of nurses in the survey
to rely on their personal smartphones at work. "These solutions fill
in critical communications gaps BUT they are not sanctioned by
hospital IT," notes the Spyglass report.

In fact, such use is actively banned in many cases. One IT systems
analyst at an academic hospital told Malkary, "Nursing administration
has mandated that personal communications by nurses during normal work
hours is not acceptable. Nurses found to be using their personal
devices during work hours will be disciplined."

The widespread use of personal smartphones is due partly to the fact
they don't require extensive integration with IT infrastructures.
Tablets are more likely to require "significant integration,"
according to the report.

At the same time, these nurses are deeply dissatisfied with current
tablets, includingApple's iPad, which is spreading rapidly in the rest
of the enterprise market. Asked if the Apple iPad was "ready to
transform nursing care at the patient's bedside," nearly all of
respondents -- 96% -- said "no." They gave the iPad good grades
compared to traditional,Windows-based tablet PCs -- for being lighter,
more intuitive, and having a longer battery life. Yet the Apple
tablet, and its Android rivals, can't be properly cleaned and
disinfected, lacks durability, and is weakened by the dearth of native
clinical applications.

"Nurses interviewed believe that the Apple iPad would not be the ideal
device for a bedside nurse because the bedside nurse has more
extensive documentation requirements that require a fullsize screen,
keyboard and mouse," according to the report.

Malkary goes so far as to say that nurses have "rejected" tablets for
nursing workflows.

One in 4 of the survey respondents reported being dissatisfied with
the quality and reliability of their facility's wireless LAN.

Security concerns by hospital administrators and IT groups are
well-founded. Mobile devices can be lost or stolen, employees are
often resistant to the use of strong password protection and data
encryption, and can download personal apps that may be either insecure
or designed as malware.

Among the Spyglass recommendations:

much more proactive and vigorous efforts by IT to identify hospital
workers' requirements for mobile technology
define enforceable policies and procedures for personal devices on the
hospital network
expand help desk resources with skilled personnel dedicated to mobile
technology support

John Cox covers wireless networking and mobile computing for Network World.
Twitter: @johnwcoxnww
Email: john_cox () nww com
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