Aug 8th 2013

Athenahealth-owned Epocrates published its mobile trends report for 2013 this week. Epocrates has impressive reach in the clinician space. Its reports on mobile usage and trends are worth looking at.

The survey and report included over 1,000 clinicians — MDs, PAs, and NPs. It says that respondents spent 93 percent of their time “providing direct patient care.” The activities included in “direct patient care” must include charting, billing, and a whole bunch of things, which is a sad thought.

Most people, even without specific numbers, would expect that the vast majority of clinicians use smartphones daily, most of them iPhones. An incredibly high percentage of physicians use tablets, most of them iPads. That reflects what the national sales director for a HIT vendor last told me last week. His company supports iOS only and gets little pushback for not offering an Android app.

The interesting trends from the report:

  • Smartphone usage for professional purposes was 78 percent in 2012, 86 percent in 2013, and is projected to be 94 percent in 2014.
  • Tablet usage for professional purposes was 34 percent in 2012, 53 percent in 2013, and is projected to be 85 percent in 2014. This is a massive growth trend, but it would be higher if more EMR vendors offered mobile-optimized apps and not virtual terminal access to desktop screens.
  • The combined usage of desktop, smartphone, and tablet by providers was 28 percent in 2012, 47 percent in 2013, and is projected to be 82 percent in 2014. This impressive trend was the main finding of the report. The report used the term “digital omnivores” to describe respondents that use all the different platforms. Clinicians are a mobile workforce, and like almost all other modern professionals, are increasingly utilizing mobile for search and communication. This isn’t surprising. But clinicians also have some serious documentation requirements that mandate the use of a computer.
  • Clinicians communicate more with mobile than with desktop. This isn’t surprising, but I wonder if this is mostly SMS-based communication rather than “HIPAA-compliant” messaging services and apps. My guess is that it’s mostly SMS (or iMessage if it’s mostly Apple- to –Apple, or A2A.)

The “digital omnivore” finding is really the most impressive trend, though again it’s not surprising. Most days I use a phone, a tablet, and a computer and I know a lot of people who do as well. I bet you do too. For me, the tablet gets the least amount of usage, in part because I’m just faster with my phone. That said, I don’t use an EMR or read many scientific papers any more, so my mobile needs are a bit different than a practicing clinician.


But really, 28 to 82 percent in three years is a staggering increase. It speaks to the increasing mix of health IT tools that providers are using on a daily basis. It reminds me of much of the talk from last month at the mHealth World Congress event in Boston. Several speakers commented on how all form factors — phone, tablet, desktop, eventually Glass — are converging. Soon we will will be calling events “digital health” conferences and not “mHealth” conferences. I agree, at least when it comes to apps and software (sensors and other connected hardware will always be uniquely mobile.)

Smart developers and vendors build software that works seamlessly across different screen sizes. That’s an understatement to say “works seamlessly.” Developers should build software that leverages the unique strengths of each form factor. This is what we’ve come to expect outside of healthcare with apps from companies such as Facebook, Twitter, and Google.

We don’t have that in healthcare. Most EMR vendors are slow to deliver on this. The “digital omnivores” in this report are clinicians who use desktop for charting and looking up data in an EMR, then use mobile for search, some decision support, and communication. EMRs could do so much more if they were available as mobile-optimized mobile apps. Doctors are probably never going to complete the majority of their EMR notes on a phone, but EMR inboxes and lookups for commonly used patient information could be optimized for mobile.

A lot of great third-party app development is being done by companies like Twitter (Tweetbot, HootSuite) and Google (Sparrow, Mailbox), enabled by opening up their data and platforms to approved vendors. Kyle had a great post on EMR APIs earlier this week if you want some context for this. By opening up data, developers can build compelling front-end mobile and web apps.

We still have a very long way to go, but the report highlights the increasing appetite of clinicians to use different devices in different settings. Hopefully more talk about this will spur more innovation of solutions that are nimble and can be easily deployed and optimized for different size devices.


Travis Good is an MD/MBA involved with health IT startups. More about me.


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