Abstract
The objective of this study was to investigate the utility of electronic tablets and their capacity to increase hospital floor productivity, efficiency, improve patient care information safety, and to enhance resident education and resource utilization on a busy Otolaryngology – Head & Neck Surgery inpatient service. This was a prospective cohort study with a 2-week pre-implementation period with standard paper census lists without mobile tablet use, and a 2-week post-implementation period followed with electronic tablets used to place orders, look up pertinent clinical data, educate patients as appropriate, and to record daily to-dos that would previously be recorded on paper. The setting for the study was Duke University Medical Center in Durham, North Carolina, with 13 Otolaryngology residents comprising the study population. The time for inpatient rounding was shorter with the use tablets (p = 0.037). There was a non-significant trend in the number of times a resident had to leave rounds to look up a clinical query on a computer, with less instances occurring in the post-implementation study period. The residents felt that having a tablet facilitated more detailed and faster transfer of information, and improved ease of documentation in the medical record. Seventy percent felt tablets helped them spend more time with patients, 70 % could spend more time directly involved in rounds because they could use the tablet to query information at point-of-care, and 80 % felt tablets improved morale. The utility of a mobile tablet device coupled with the electronic health record appeared to have both quantitative and qualitative improvements in efficiency, increased time with patients and attendance at academic conferences. Tablets should be encouraged but not mandated for clinical and educational use.
References
Chand, D. V., Observational study using the tools of lean six sigma to improve the efficiency of the resident rounding process. J. Grad. Med. Educ. 3:144–150, 2011.
Boruff, J. T., and Storie, D., Mobile devices in medicine: a survey of how medical students, residents, and faculty use smartphones and other mobile devices to find information. J. Med. Libr. Assoc.: JMLA 102:22–30, 2014.
Patel, B. K., Chapman, C. G., Luo, N., Woodruff, J. N., and Arora, V. M., Impact of mobile tablet computers on internal medicine resident efficiency. Arch. Intern. Med. 172:436–438, 2012.
Kaczmarek, B. F., Trinh, Q. D., Menon, M., and Rogers, C. G., Tablet telerounding. Urology 80:1383–1388, 2012.
Anderson, C., Henner, T., and Burkey, J., Tablet computers in support of rural and frontier clinical practice. Int. J. Med. Inform. 82:1046–1058, 2013.
Sclafani, J., Tirrell, T. F., and Franko, O. I., Mobile tablet use among academic physicians and trainees. J. Med. Syst. 37:9903, 2013.
Luo, N., Chapman, C. G., Patel, B. K., Woodruff, J. N., and Arora, V. M., Expectations of iPad use in an internal medicine residency program: is it worth the “hype”? J Med Internet Res 15:5, 2013.
Walsh, C., and Stetson, P., EHR on the move: resident physician perceptions of iPads and the clinical workflow. AMIA Ann. Symp. Proc. / AMIA Symp. AMIA Symp. 2012:1422–1430, 2012.
Niehaus, W., Boimbo, S., and Akuthota, V., Physical medicine and rehabilitation resident use of iPad mini mobile devices. Pm&R 7:512–518, 2015.
Landman, A., Emani, S., Carlile, N., et al., A mobile app for securely capturing and transferring clinical images to the electronic health record: description and preliminary usability study. JMIR Mhealth Uhealth 3:e1, 2015.
Korbage, A. C., and Bedi, H. S., Mobile technology in radiology resident education. J. Am. Coll. Radiol. 9:426–429, 2012.
Korbage, A. C., and Bedi, H. S., The iPad in radiology resident education. J. Am. Coll. Radiol. 9:759–760, 2012.
Lobo, M. J., Crandley, E. F., Rumph, J. S., et al., Pilot study of iPad incorporation into graduate medical education. J. Grad. Med. Educ. 5:142–144, 2013.
Berkowitz, S. J., Kung, J. W., Eisenberg, R. L., Donohoe, K., Tsai, L. L., and Slanetz, P. J., Resident iPad use: has it really changed the game? J. Am. Coll. Radiol. 11:180–184, 2014.
Acknowledgments
The authors would like to thank Laura Ruth of the University of Chicago Internal Medicine Residency Program for graciously providing a copy of their iPad use questionnaire that we adapted for use in this study. The authors would also like to thank the residents of the Duke Otolaryngology-Head & Neck Surgery program for their participation in this study.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Disclosure of funding received for this work
Departmental/Internal.
Conflict of interest
All authors listed above have no relevant conflicts of interest or disclosures to report for this project.
Additional information
Matthew G. Crowson and Russel Kahmke are co-first authors.
This article is part of the Topical Collection on Mobile Systems
Rights and permissions
About this article
Cite this article
Crowson, M.G., Kahmke, R., Ryan, M. et al. Utility of Daily Mobile Tablet Use for Residents on an Otolaryngology Head & Neck Surgery Inpatient Service. J Med Syst 40, 55 (2016). https://doi.org/10.1007/s10916-015-0419-8
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s10916-015-0419-8