Download PDF
Appl Clin Inform 2018; 09(03): 588-594
DOI: 10.1055/s-0038-1667121
Research Article
Georg Thieme Verlag KG Stuttgart · New York

Going Mobile: Resident Physicians' Assessment of the Impact of Tablet Computers on Clinical Tasks, Job Satisfaction, and Quality of Care

Megan Sweeney
1   Department of Quality Improvement and Patient Safety, Tufts Medical Center, Boston, Massachusetts, United States
,
Kaavya Paruchuri
2   Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, United States
,
Saul N. Weingart
1   Department of Quality Improvement and Patient Safety, Tufts Medical Center, Boston, Massachusetts, United States
› Author Affiliations
Further Information

Publication History

22 February 2018

06 June 2018

Publication Date:
08 August 2018 (online)

Also available at
   Permissions and Reprints

Abstract

Background There are few published studies of the use of portable or handheld computers in health care, but these devices have the potential to transform multiple aspects of clinical teaching and practice.

Objective This article assesses resident physicians' perceptions and experiences with tablet computers before and after the introduction of these devices.

Methods We surveyed 49 resident physicians from 8 neurology, surgery, and internal medicine clinical services before and after the introduction of tablet computers at a 415-bed Boston teaching hospital. The surveys queried respondents about their assessment of tablet computers, including the perceived impact of tablets on clinical tasks, job satisfaction, time spent at work, and quality of patient care.

Results Respondents reported that it was easier (73%) and faster (70%) to use a tablet computer than to search for an available desktop. Tablets were useful for reviewing data, writing notes, and entering orders. Respondents indicated that tablet computers increased their job satisfaction (84%), reduced the amount of time spent in the hospital (51%), and improved the quality of care (65%).

Conclusion The introduction of tablet computers enhanced resident physicians' perceptions of efficiency, effectiveness, and job satisfaction. Investments in this technology are warranted.

Keywords

tablet computers - interns and residents - information technology - health care informatics

Protection of Human and Animal Subjects

The hospital institutional review board (IRB) reviewed this project in advance and determined that it was a quality improvement and educational project exempt from IRB review and from applicable federal regulations governing human research.


Supplementary Material

 

  • References

  • 1 Ozdalga E, Ozdalga A, Ahuja N. The smartphone in medicine: a review of current and potential use among physicians and students. J Med Internet Res 2012; 14 (05) 128
    CrossrefPubMedSearch in Google Scholar
  • 2 Ventola CL, Ventola CL. Mobile devices and apps for health care professionals: uses and benefits. P&T 2014; 39 (05) 356-364
    PubMedSearch in Google Scholar
  • 3 Landreani F, Caiani EG. Smartphone accelerometers for the detection of heart rate. Expert Rev Med Devices 2017; 14 (12) 935
    CrossrefPubMedSearch in Google Scholar
  • 4 Chou D. Health IT and patient safety: building safer systems for better care. JAMA 2012; 308 (21) 2282
    PubMedSearch in Google Scholar
  • 5 Staggers N, Weir C, Phansalkar S. Patient safety and health information technology: role of the electronic health record. In Hughes RG. , ed. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Chapter 47. Rockville, MD: Agency for Healthcare Research and Quality (US); 2008
    Search in Google Scholar
  • 6 Chu LF, Erlendson MJ, Sun JS, Alva HL, Clemenson AM. Mobile computing in medical education: opportunities and challenges. Curr Opin Anaesthesiol 2012; 25 (06) 699-718
    PubMedSearch in Google Scholar
  • 7 White T. Will iPad transform med school? Stanford Medicine News Center; September 13, 2010. Available at: https://med.stanford.edu/news/all-news/2010/09/will-ipad-transform-med-school.html . Accessed January 11, 2018
    PubMed
  • 8 Lobo MJ, Crandley EF, Rumph JS. , et al. Pilot project of iPad incorporation into graduate medical education. J Grad Med Educ 2013; 5 (01) 142-144
    CrossrefPubMedSearch in Google Scholar
  • 9 Charani E, Gharbi M, Moore LSP. , et al. Effect of adding a mobile health intervention to a multimodal antimicrobial stewardship programme across three teaching hospitals: an interrupted time series study. J Antimicrob Chemother 2017; 72 (06) 1825-1831
    CrossrefPubMedSearch in Google Scholar
  • 10 Korbage AC, Bedi HS. Mobile technology in radiology resident education. J Am Coll Radiol 2012; 9 (06) 426-429
    CrossrefPubMedSearch in Google Scholar
  • 11 Sharpe III EE, Kendrick M, Strickland C, Dodd III GD. The Radiology Resident iPad Toolbox: an educational and clinical tool for radiology residents. J Am Coll Radiol 2013; 10 (07) 527-532
    CrossrefPubMedSearch in Google Scholar
  • 12 Berkowitz SJ, Kung JW, Eisenberg RL, Donohoe K, Tsai LL, Slanetz PJ. Resident iPad use: has it really changed the game?. J Am Coll Radiol 2014; 11 (02) 180-184
    CrossrefPubMedSearch in Google Scholar
  • 13 Gonzalez NR, Dusick JR, Martin NA. Effects of mobile and digital support for a structured, competency-based curriculum in neurosurgery residency education. Neurosurgery 2012; 71 (01) 164-172
    CrossrefPubMedSearch in Google Scholar
  • 14 Dimond R, Bullock A, Lovatt J, Stacey M. Mobile learning devices in the workplace: as much a part of the junior doctors' kit as a stethoscope?. BMC Med Educ 2016; 16 (01) 207
    CrossrefPubMedSearch in Google Scholar
  • 15 Sung YT, Chang KE, Liu TC. The effects of integrating mobile devices with teaching and learning on students' learning performance: a meta-analysis and research synthesis. Comput Educ 2016; 94: 252-275
    CrossrefPubMedSearch in Google Scholar
  • 16 Bullock A, Webb K. Technology in postgraduate medical education: a dynamic influence on learning. Postgrad Med J 2015; 91 (1081): 646-650
    CrossrefPubMedSearch in Google Scholar
  • 17 Niehaus W. Informatics and technology in resident education. PM R 2017; 9 (05) S118-S126
    CrossrefPubMedSearch in Google Scholar
  • 18 Vetter SY, Schüller S, Hackbusch M. , et al. Tablets for image review and communication in daily routine of orthopedic surgeons – an evaluation study. J Digit Imaging 2018; 31 (01) 74-83
    CrossrefPubMedSearch in Google Scholar
  • 19 George P, Newey CR, Bhimraj A. The tablet device in hospital neurology and in neurology graduate medical education: a preliminary study. Neurohospitalist 2015; 5 (01) 15-21
    PubMedSearch in Google Scholar
  • 20 Bullock A, De Jong PGM. Technology-enhanced learning. In Swanwick T. , ed. Understanding Medical Education: Evidence, Theory and Practice. 2nd ed. Chichester: Wiley Blackwell; 2014: 149-160
    Search in Google Scholar
  • 21 Khasawneh R, Simonsen K, Snowden J, Higgins J, Beck G. The effectiveness of e-learning in pediatric medical student education. Med Educ Online 2016; 21 (01) 29516
    CrossrefPubMedSearch in Google Scholar
  • 22 Cook DA, Hatala R, Brydges R. , et al. Technology-enhanced simulation for health professions education: a systematic review and meta-analysis. JAMA 2011; 306 (09) 978-988
    PubMedSearch in Google Scholar
  • 23 Baumgart DC, Wende I, Grittner U. Tablet computer enhanced training improves internal medicine exam performance. PLoS One 2017; 12 (04) e0172827
    CrossrefPubMedSearch in Google Scholar
  • 24 Moodley A, Mangino J, Goff D. Review of infectious diseases applications for iPhone/iPad and Android: from pocket to patient. Clin Infect Dis 2013; 57: 1145-1154
    CrossrefPubMedSearch in Google Scholar
  • 25 Dupaix J, Chen JJ, Chun MB, Belcher GF, Cheng Y, Atkinson R. The effect of mobile tablet computer (iPad) implementation on graduate medical education at a multi-specialty residency institution. Hawaii J Med Public Health 2016; 75 (07) 190-195
    PubMedSearch in Google Scholar
  • 26 Mickan S, Atherton H, Roberts NW, Heneghan C, Tilson JK. Use of handheld computers in clinical practice: a systematic review. BMC Med Inform Decis Mak 2014; 14: 56 . Doi: 10.1186/1472-6947-14-56
    CrossrefPubMedSearch in Google Scholar
  • 27 Robinson R. Spectrum of tablet computer use by medical students and residents at an academic medical center. PeerJ 2015; 3 (1133): 3
    PubMedSearch in Google Scholar
  • 28 Ratanawongsa N, Barton JL, Lyles CR. , et al. Association between clinician computer use and communication with patients in safety-net clinics. JAMA Intern Med 2016; 176 (01) 125-128
    CrossrefPubMedSearch in Google Scholar
  • 29 Asan O, Carayon P, Beasley JW, Montague E. Work system factors influencing physicians' screen sharing behaviors in primary care encounters. Int J Med Inform 2015; 84 (10) 791-798
    CrossrefPubMedSearch in Google Scholar
  • 30 Bates DW, Leape LL, Cullen DJ. , et al. Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA 1998; 280 (15) 1311-1316
    CrossrefPubMedSearch in Google Scholar
  • 31 Radley DC, Wasserman MR, Olsho LE, Shoemaker SJ, Spranca MD, Bradshaw B. Reduction in medication errors in hospitals due to adoption of computerized provider order entry systems. J Am Med Inform Assoc 2013; 20 (03) 470-476
    CrossrefPubMedSearch in Google Scholar
  • 32 Nuckols TK, Smith-Spangler C, Morton SC. , et al. The effectiveness of computerized order entry at reducing preventable adverse drug events and medication errors in hospital settings: a systematic review and meta-analysis. Syst Rev 2014; 3: 56
    CrossrefPubMedSearch in Google Scholar
  • 33 Schiff GD, Amato MG, Eguale T. , et al. Computerised physician order entry-related medication errors: analysis of reported errors and vulnerability testing of current systems. BMJ Qual Saf 2015; 24 (04) 264-271
    CrossrefPubMedSearch in Google Scholar
  • 34 Slight SP, Eguale T, Amato MG. , et al. The vulnerabilities of computerized physician order entry systems: a qualitative study. J Am Med Inform Assoc 2016; 23 (02) 311-316
    CrossrefPubMedSearch in Google Scholar
  • 35 Brown CL, Mulcaster HL, Triffitt KL. , et al. A systematic review of the types and causes of prescribing errors generated from using computerized provider order entry systems in primary and secondary care. J Am Med Inform Assoc 2017; 24 (02) 432-440
    CrossrefPubMedSearch in Google Scholar
  • 36 McAlearney AS, Schweikhart SB, Medow MA. Doctors' experience with handheld computers in clinical practice: qualitative project. BMJ 2004; 328 (7449): 1162
    CrossrefPubMedSearch in Google Scholar
  • 37 Patel BK, Chapman CG, Luo N, Woodruff JN, Arora VM. Impact of mobile tablet computers on internal medicine resident efficiency. Arch Intern Med 2012; 172 (05) 436-438
    CrossrefPubMedSearch in Google Scholar
  • 38 Sinsky C, Colligan L, Li L. , et al. Allocation of physician time in ambulatory practice: a time and motion study in 4 specialties. Ann Intern Med 2016; 165 (11) 753-760
    CrossrefPubMedSearch in Google Scholar