Clinical Mobility 2018
Leveraging a Smartphone Strategy

Shared-use smartphones—which are checked out to care team members—can consolidate the clinician toolbelt (pagers, wireless phones, barcode scanners) and create efficiencies by enabling mobile access to patient data. As the first smartphone, Apple had a head start as a shared-use device. Older generation iPhones (pre-6s) are most prevalent but have the most shortcomings for rounding workflows. Newer iPhones/applications can solve some existing problems (like Wi-Fi connectivity and native camera barcode scanning), yet other issues remain (see table below). Few have adopted these latest models due to cost, and some have decided to replace older models with Zebra (previously Motorola), a healthcare-grade alternative. Also, two prominent EHR and secure communications vendors now favor Zebra over Apple due to Apple’s inadequacies. Zebra’s MC40 phones provide better durability and an integrated scanner, and Zebra’s newly released TC51-HC is lighter and faster than the MC40. Other healthcare-grade smartphones, like Ascom, Honeywell, and Spectralink, each have challenges and fewer customers to date. Samsung, like Apple, is not healthcare grade and has little consideration.

Corporate-issued personal-use devices (used mainly by physicians and management) do not need to be healthcare grade as they are used mostly for team communication and off-site EMR access. Purchasing decisions are driven by user preference (similar to BYOD), and Apple is overwhelmingly the preferred brand. Nearly every organization that issues personal-use phones offers Apple. Half also offer Samsung, but almost exclusively as a secondary device—few feel they could offer only Samsung without strong opposition. However, supplementing Apple with a BYOD strategy that allows for other devices is a popular alternative.

While initial purchasing for personal-use smartphones was driven by user preference, some organizations are reevaluating their strategy based on Apple’s and Samsung’s strengths and weaknesses for personal use. Apple’s usability and broad application library are key strengths. Its ease of use limits configurability; however, IT professionals say this makes the device more secure. Customers report issues with iOS system updates breaking apps and with poor Wi-Fi connectivity when roaming in a hospital environment—challenges not experienced with Samsung. Samsung’s flexibility, on the other hand, makes it more difficult to secure and makes it less intuitive for the less technical user.

Whether or not oversight is provided, employees’ personal phones are being used to access and share PHI. A BYOD program helps keep these devices HIPAA compliant. BYOD can replace corporate-issued, personal-use smartphones but should not be used to replace corporate-issued, shared-use devices, which must be healthcare grade. Successful BYOD programs include:

• Stipends—help justify usage of approved employee phones.
• Approved messaging app using a secure communication solution (click here for most recent KLAS ratings).
• Remote device security/lockdown using an EMM/MDM (click here for most recent KLAS ratings).
• Means to access EMR (e.g., EMR app, Citrix).
• Ongoing support for various devices/OS; without help, users can become frustrated and revert to bad habits.