Providing personal mobile computers to medical residents reduces delays in patient care, enhances their access to electronic records and helps them to train, according to research published in the Archives of Internal Medicine .
In November 2010, researchers gave Apple iPads to 115 University of Chicago internal medicine residents. The residents were able to access electronic patient records, the hospital’s paging system to order tests, and medical publications for reference information.
When researchers surveyed the residents in 2011, three out of four said that the iPads allowed them to finish tasks faster, gave them more time for direct patient care, and helped them participate in educational activities. The hospital spent about $650 on each iPad, including insurance, protective covers, straps, and software. The tablets had access to the hospital’s wireless network but were not allowed to store records. They were also password-protected.
Before getting the iPads, the residents reported that increased workloads and limited work hours created work compression and competition between work and their education goals. In particular, they reported spending most of their time updating medical charts, documentation, and ordering tests—at the expense of direct patient care or education.
The research also showed that the implementation of electronic health records (EHRs) actually increased time away from a patient. Interns spent more time searching for a computer or working on the computer at the expense of time at the bedside.
“Residents face a vast and increasing workload packed into tightly regulated hours,” said the study’s first author, Dr. Bhakti Patel, a pulmonary critical care fellow at the University of Chicago School of Medicine. “They spend much of their time completing documentation and updating patient charts. This study indicates that personal mobile computers can streamline that process.”
When residents were asked how their work was affected by having an iPad, nearly 90 percent said they routinely used it for clinical duties; 78 percent said it made them more efficient; and 68 percent reported that it averted patient care delays.
Researchers also collected data from the hospital’s EHR system, comparing intern order placement for a three-month period prior to issuing the iPads and after. The iPads helped residents submit 5 percent more orders before 7 AM rounds, when they update senior physicians about overnight admissions. And they placed 8 percent more orders before handing off their responsibilities and leaving the hospital by 1 PM, as required by duty-hour rules.
“We were encouraged to see that this technology could enhance patient care in the setting of restricted resident duty hours,” Dr. Christopher Chapman, the current chief resident of the internal medicine residency program at the University of Chicago Medicine, said in the research letter.