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Embracing Apple iOS in Healthcare

Futura Mobility | April 2015 Introduction Clinicians, especially doctors, are pressuring IT departments to adopt the use of iOS devices in the healthcare environment. It’s a clear reflection of the staggering consumer demand for Apple® products. In addition, Ap- ple is proactively entering the Enterprise channel as well as piloting its HealthKit app in over 60 percent of the top 23 U.S. hospitals. According to a Reuters report, Apple has an “incredible team of experts in and fitness” and is “talking to medical institutions, healthcare and industry experts on ways to deliver its services.” Apple is coming for healthcare and it’s moving swiftly. How prepared is your IT department?

Historically, IT departments have been slow to embrace Apple iOS devices, often preferring Android devices and the long-familiar Windows® environment. To many IT decision-makers, Android offers a lower cost and quicker custom app deployment, whether through the GooglePlay store or through the hospital’s mobile de- vice management (MDM). Yet, despite Apple’s upfront requirements—whether cost for the device or approval for custom apps in the Apple App Store™—it offers more long-term support. For example, ® are in rotation longer than most Android devices, with a three-year-old iPhone model being offered as a free option through some cell phone carriers. Apps also have a long life in the App Store. If a start-up company launches a new app in the store today and then goes out of business tomorrow, that company’s app will still be supported in the App Store for up to three years.

Another common reason cited for IT departments’ preference of Android or Windows-based devices is that they are available as purpose-built, rugged smartphones with integrated bar code scanners. Ruggedization in the healthcare environment is important because devices need to be protected from drops on hard, concrete floors and must be able to resist frequent cleanings with strong hospital disinfectants. For Apple iPhone, protec- tive sleds provide this ruggedization along with enhanced bar code scanning, improved battery life and other capabilities that allow these consumer-grade devices to function like enterprise-grade mobile computers and bar code scanners. Typically these sleds do not add heft or bulk so clinicians get to use the familiar, preferred iOS environment while protecting their devices.

Programs allowing employees and medical staff—includ- ing doctors who work independently—to bring their own devices (BYOD) to work continues to grow, with 88 per- cent of healthcare offering a BYOD program. Many clini- cians choose to use their own iPhones because they are familiar with them and trust them. Clinicians want to use iOS devices in hospitals because these are the devices they know and trust. They are intuitive and easy to learn, and, even with sleds, they are easily carried and used. Doctors in particular are bringing in Apple devices with 65 to 75 percent of them using the newest iPhone mod- els. Although a BYOD program allows clinicians to use the device(s) of their choosing, it can also create a situation where IT departments must ask clinicians to install and use the hospital’s software on their phones. If they refuse, this can put secure communications at risk, especially if the clinicians then use the native text app on their phones to communicate with each other.

Futura Mobility l 515 Pennsylvania Avenue, Fort Washington, PA 19034 l 215.642.3363 l www.futuramobility.com And, even in hospitals where the IT departments support Apple iOS devices, whether through a BYOD policy or through administering the devices, the mobile apps that clinicians need to do their jobs can be inadequate. The devices are available, the demand is there, but the necessary ecosystem, both in software applications and IT adoption, are missing. But clinicians are still demanding the use of their iOS devices with no signs of slowing down. This may grow, especially with doctors, as consumers turn to Apple for apps such as HealthKit and want their doctors to be able to work with the application. Current Apple iOS Trends in Healthcare

Apple continues to make headlines, both with earnings reports that demonstrate the strength of consumer demand and with announcements furthering its reach into the healthcare environment. As demand for iOS devices heats up in hospitals and Apple pursues more healthcare facilities to use its products, it’s a dicey time for IT departments to ignore these trends.

Consumers love Apple iOS devices. In its Q1 FY15 results, Apple reported “staggering” demand for iPhones with sales reaching over 74 million units. That averages over 34,000 iPhones sold every hour, 24 hours a day, every day of the quarter. IBM’s digital analytics benchmark service found that iOS devices accounted for more than twice the online traffic and almost four times the e-commerce sales than on Android devices during November and December 2014.

Many IT departments are taking notice. According to a 2015 CHIME Foundation Mobile Usability Survey of high-ranking IT healthcare executives, nearly 77 percent of respondents indicated they are interested in learn- ing how to integrate and/or optimize Apple iOS mobile devices within their organizations. In the corporate market, ChangeWave Research found that among IT buyers planning to purchase smartphones in the first quarter of 2015, 77 percent intend to purchase iPhones. Among businesses planning to purchase tablets, the intent was even stronger at 78 percent. This is a big win for employees who prefer the intuitive, familiar iOS interface they enjoy on their personal devices.

However, this shift is not reflected in most healthcare environments. In a study released by Spyglass Consulting Group in January 2015, nearly 70 percent of surveyed doctors felt that hospital IT departments are making inadequate investments to address mobile access to patient records and communication needs. They also cited poor mobile EHR tools as an issue. Although IT departments may rely on third-party applications for mobile EHR, clinicians still tend to view this as issues to be solved by the hospital.

The same study showed that even in hospitals where IT is making investments to support mobile needs, clini- cians find they aren’t addressing their mobile requirements. The mobile solutions provided are considered dif- ficult to use and are not well integrated with their workflow processes.

Because of these issues, many clinicians are developing communication work-arounds using their own de- vices. At a minimum, they are using their iPhones for texting and as web portals to look up information. This can cause security breaches and HIPAA issues. There’s also the issue with BYOD devices of healthcare IT departments asking clinicians to install software on their phones. In particular, nurses, usually employees of the hospital, have shown some resistance to installing an employer’s software on their personal phones. This can exacerbate the risk of potential security and HIPAA issues. Perhaps creating even more risk, in the 2015 CHIME Foundation Mobile Usability Survey, 73 percent of respondents reported their hospital does not cur-

Futura Mobility l 515 Pennsylvania Avenue, Fort Washington, PA 19034 l 215.642.3363 l www.futuramobility.com rently have a HIPAA-compliant mobile solution for use on mobile devices.

However, software companies are addressing these issues by providing healthcare organizations secure com- munication applications. One such company is Practice Unite®, which provides a platform for HIPAA-com- pliant mobile communication and collaboration applications. Jersey City Medical Center adopted a simple, customized secure mobile solution from Practice Unite, which consolidates communications and provides an up-to-date directory of doctors and staff. With the app, clinicians exchange secure texts and images, including consults, and can also initiate voice calls through the app. Not only are the communications between clinicians secure and convenient, the use of the Practice Unite solution has reduced the length of the hospital stay by one day for 10 to 20 percent of patients. It also reduced emergency department patient waiting time before discharge or admission by 20 percent.

In addition to secure communications, apps like those from Practice Unite can also integrate with other work- flows, including lab and diagnostic results as well as interfacing with electronic health records (EHRs). This is the type of mobile communication solution clinicians want – and they are asking to use it on the devices they prefer.

Apple is not overlooking this demand. In fact, the company has recruited informal healthcare advisors, includ- ing Sumit Rana, chief technology officer at Epic Systems, and John Halamka, chief information officer of Beth Israel Deaconess Medical Center and Harvard Medical School, to discuss health data privacy. These advisors are also being tapped for introductions to the industry. With its HealthKit app being piloted in 14 of the top 23 U.S. hospitals, Apple is showing serious commitment to the healthcare industry.

Apple iOS Devices in Action Even before Apple launched its HealthKit app or hired healthcare industry advisors, hospitals around the globe have deployed iOS devices to streamline workflows, improve communication and provide faster access to medical records—and keep it all secure.

Here’s a look at some of the current ways iPhone, iPad® and iPod touch® devices are being used in hospitals.

iPhone Examples

Memorial Hermann Healthcare System The IT department deployed iPhones to physicians in all of its 11 hospitals in Houston, TX. iPhone offers built-in support for Microsoft Exchange ActiveSync, so the devices fit with the hospital’s existing infrastructure. They also activated security features such as remote wipe and pass- code protection to keep patient information secure. Doctors praised the easy yet secure access to everything from patient information and diagnostic tools to reference materials. And the IT department found the iPhone’s intuitive iOS helped doctors get up to speed quickly – without an instruction manual. In addition, obstetricians have used the iOS devices and the AirStrip® OB app to monitor patients through the stages of labor, even remotely. Because the obstetricians can use the unique landscape mode of the iPhones to view heart tracings, they consider the devices to be “indispensible.”

Mount Sinai Hospital in Toronto The research and teaching hospital also deployed iPhones for its doc-

Futura Mobility l 515 Pennsylvania Avenue, Fort Washington, PA 19034 l 215.642.3363 l www.futuramobility.com tors and integrated the devices with its existing Microsoft Exchange server as well as its passwords and VPN certificates. In addition, the hospital developed an in-house app, which brings together clinical data, refer- ence materials, patient information and 66 different applications from within the hospital’s network. Doctors now have mobile access to the exact same information available on the hospital computers, including patient records, test results, vital statistics and medical research. The IT department used the iPhone Configuration Tool to distribute the app directly to the deployed iPhones.

iPad Examples

St. Louis Urgent Care Every staff member on every shift at both the Downtown St. Louis Urgent Care and its sister location Eureka Urgent Care has access to an iPad. The iOS devices are used in conjunction with the drchrono EHR app. From the moment patients enter the doors until they are discharged, the are used to securely capture, track and share patient information, including test results and x-rays. The Urgent Care loca- tions have moved away from paper-based medical records, which has saved significant time and expense. In addition, the two locations have improved their efficiency, stating they can often get patients precisely the care they need in less than 20 minutes.

The Ottawa Hospital in Canada The hospital deployed iPads to doctors and nurses and also developed several cus- tom applications. The Ottawa Hospital IT department found that developing apps on the iOS platform could take only days or weeks as opposed to months (or even years) with other platforms. Their custom apps included one for workflow, which fa- cilitates accessing patients’ clinical informa- tion, viewing images such as X-rays and CT scans and ordering tests and prescriptions. They also developed three individual apps: one for pain study; a hand hygiene app to measure compliance; and a patient rounds app with standard questions for nurses to ask on a daily basis. By using the iPads and apps, the hospital estimates that physicians save two hours per day in their clinical care activities.

Multiple iOS Device Examples Zhejiang Ruian Hospital The largest comprehensive hospital in Ruian City, Zhejiang Province of China deployed their new mobile healthcare system by using Apple iPod touch devices encased in Honeywell Cap- tuvo enterprise sleds. Specifically, the hospital used the Captuvo SL22 with the iPod touch 5, which integrated Honeywell’s 2D bar code reading technology with the user-friendly iOS interface. These devices were used in medication administration, specimen collection and remote patient monitoring. Zhejiang Ruian Hospital also used the combination of the scanning technology and touch-screen devices to completely eliminate all manual records. To ensure accuracy and safety, the iPod touch device requires multiple confirmations from staff at each medial step.

Futura Mobility l 515 Pennsylvania Avenue, Fort Washington, PA 19034 l 215.642.3363 l www.futuramobility.com Mayo Clinic This innovative, leading hospital distributed more than 15,000 iOS devices, including iPhone and iPads throughout its network. They have also developed an in-house application for one mobile interface for clinicians to tap into for electronic medical records and hundreds of internal systems. The hospital estimates this saves physicians at least one hour each day. In addition, the IT department found the iOS ecosystem provided a high level of security, including encryption, a VPN environment and the ability to write applications that leave no confidential data on the device.

Rehab Care With over 1,200 locations, this hospital-based rehabilitation facility uses iPhones and iPads to streamline administrative functions, from capturing patient pre-admission paperwork to recording point-of-care information by nurses and physical therapists. Rehab Care’s Information Services team developed a cloud- based iPhone application in about one week and used that to eliminate their manual, paper-based patient pre- admission screening process. The facility also deployed iPads for daily workflows, including accessing clinical applications and documentation from diagnostic and imaging tools as well as nursing notes and patient intake information.

Challenges for Apple iOS Use in Healthcare Even with the extremely high demand of consumers for the Apple iOS devices—and the subsequent insistence of clinicians to use them in the healthcare environment—challenges within the Apple ecosystem do exist. Clinicians, particularly doctors, are aware of these issues. However, that has not slowed their desire to use iOS devices, particularly iPhone and iPads, as key components of their daily work.

One challenge for the adoption of Apple in healthcare is the resistance of hospital IT de- partments. This is attributed in large part to IT favoring Android. Several reasons for this preference include the lower upfront cost of Android devices, the familiarity of using a Windows environment (rather than iOS) and the fact that companies can build their own An- droid devices and software.

However, the lower upfront cost of Android devices can be misleading. At closer investigation, iOS devices are actually in rotation longer than Android devices. For example, although Apple released the iPhone 6 in the fall of 2014, users can still buy an iPhone 4 fully refurbished today. When a new iPhone model is released, the current model will become the sub-premium offering the following year and then the “free” offering two years later. Apple devices are quality products, guaranteed for at least three generations. Android consumer devices tend to last a few months and then dis- appear. Other devices come and go with a mentality of “it’s all about the next big thing.” An iOS device is a consumer-grade device but there’s planned support for previous models as part of new rollouts from Apple.

In addition, software built for a custom Android device is available only for that device. If the device is no longer used, the software will have to be rebuilt from scratch. Developers can build an app for iOS and it can be used

Futura Mobility l 515 Pennsylvania Avenue, Fort Washington, PA 19034 l 215.642.3363 l www.futuramobility.com for iOS devices, put in the app store, etc. It becomes difficult to build a software business case to develop software because it means building only toward that one product.

Enterprise developers also like Android because it can be faster to de- ploy through the Play Store, which takes two or three days for Google to approve. In some cases, the app can be deployed directly to phones through the enterprise MDM (Mobile Device Management). With iOS, apps must go through App Store, which can take two or three weeks for approval. However, iOS has a tighter framework within which developers can work and, significantly, the user experience is better on an iOS app.

In addition, some healthcare IT departments have found it’s easier to de- velop a custom app in the iOS environment. For example, the Mayo Clinic developed a robust in-house application to provide one mobile interface for clinicians to use for accessing electronic medical records and hundreds of internal systems. The IT team found the iOS process more efficient because what they developed for one device will run on all the iOS devices. The ecosystem and development was so smooth they created several other iPhone and iPad apps, including a point-of-care resource for the entire Mayo Clinic Care Network members and a patient app, which lets patients securely access their electronic medical records (EMRs) as well as exchange messages with physi- cians.

One of the largest challenges cited by doctors using iPhones and iPads is the lack of fully optimized mobile EHR apps for Apple iOS as well as IT’s lack of trust in the startup companies that provide alternatives. The ability to access EHR apps via iOS devices is especially key. In the 2015 CHIME Foundation Mobile Usability Survey cited earlier, the IT executives who responded indicated more than 82 percent of clinicians have access to their EHR via mobile devices.

In a study via Electronista, 71 percent of doctors say EHR apps need to be more “touchscreen friendly.” Many stated that the current EHRs available for iPads simply replicate a paper-based medical record rather than create a mobile, interactive version. The good news is that more than 100 EHR vendors reported that they are currently working to enhance or develop optimized apps for Apple iOS devices, including iPhones and iPads.

Some of the vendors providing mobile EHR apps as well as applications that integrate with EHR systems are startup companies. The fear by many IT departments is that they will purchase these products and then the ven- dors will shut down, leaving them without support.

What many IT departments don’t consider is the built-in support from Apple. If a startup company is gone tomor- row, but has an app in the Apple App Store, that app still lives on in the store and is available near-infinitely. There may be new architecture in three years and without updates to the app, it won’t be able to be used on new architecture. However, it’s still available for three years. So, if a start up or web developer disappears tomorrow, that app can still be used for three years. That’s a huge security blanket. It’s more insurance than people realize.

Futura Mobility l 515 Pennsylvania Avenue, Fort Washington, PA 19034 l 215.642.3363 l www.futuramobility.com Top EHR Apps and iOS Availability Company App Name iOS App App for App for Integrate Mobile Name Available Iphone Ipad with EHR? Optimized Web Access Allscripts Sunrise™ Mobile Care (mobile version of Sunrise X X X X Clinical Manager™)

Allscripts Wand for Touchworks X X X EHR Cerner Cerner PowerChart Touch X X X X Inpatient Epic Canto X X X

Epic Haiku X X X McKesson McKesson Patient Folder Mobile X X X X Defficiency Completion MEDITECH Mobile X Rounding Siemens Sorian X Clinicals

*Mobile optimized web access means the website is specifically designed for use on an Apple iOS device such as iPhone or iPad. This simplified version of the website fits the display size of the specific device and offers a better mobile user experience through faster page loads, fewer graphics and reorganization of content for easier navigation.

Ruggedizing Apple iOS Devices for Healthcare

With hard, often concrete floors, and strict cleaning protocols, hospitals are rugged environments. This is an important factor as IT departments determine which devices to deploy in the enterprise. Custom-built Android devices are popular choices for rugged environments, which is one reason IT departments favor them. How- ever, more than 70 percent of the healthcare organization IT executives who responded to the 2015 CHIME Foundation Mobile Usability Survey indicated they would be “very inclined” or “more inclined” to use Apple iOS devices if they could ruggedize the devices and integrate scanning capabilities.

It is absolutely feasible to ruggedize Apple iOS devices to withstand the physical demands of a healthcare facility.

Sleds are external devices that encase iOS devices and allow scanning as well as easy installation and re- moval, making them ideal for enterprise deployment or BYOD environments. Apple is the only company that makes iOS, so the investment in a sled will last the lifespan of the iOS device. Sleds are available for a range of Apple iOS devices, including iPhone, iPod touch and iPad mini from several manufactures, including Code Corp, Infinite Peripherals and Honeywell Scanning & Mobility.

Futura Mobility l 515 Pennsylvania Avenue, Fort Washington, PA 19034 l 215.642.3363 l www.futuramobility.com The use of sleds transforms Apple devices into powerful enterprise solutions with barcode scanning capabili- ties; more durability, including the ability to withstand drops and frequent cleanings; and increased battery life.

Sleds offer barcode scanning that is far superior to the iOS integrated camera. For example, the Honeywell Captuvo SL22h and SL42h sleds feature Hon- eywell Adaptus™ Imaging Technology 6.0 for barcode scanning that enables fast and accurate reading of linear and 2D barcodes. The SL22h is the sled used by Zhe- jiang Ruian Hospital to implement its mobile healthcare system and eliminate manual records. These sleds have been specifically enhanced to rapidly capture even the most challenging high density and poor quality barcodes found in hospitals, such as clear IV bags and micro-2D barcodes on medications. This saves clinicians time and improves patient safety.

In addition to aggressive scanning capabilities, moisture-sealed sleds utilize disinfectant-ready plastics and a sealed screen protector. Clinicians have an unobstructed view of information and an uninhibited ability to interact with the phone through excellent touchscreen response. With the disinfectant-ready plastics, the sled- encased devices can be cleaned and sanitized using a wide range of cleaning and disinfectant products to prevent the spread of germs.

Traditional battery life is greatly improved by the use of sleds. For example, the Honeywell Captuvo SL22h and SL42h sleds mentioned above also come with a hot-swappable and user replaceable battery to eliminate downtime and the need to recharge the device mid-shift. This allows clinicians to stay up and running without requiring spare devices or wasting valuable time waiting for a recharge.

Sleds can also provide additional advantages, such as being lighter than legacy handheld computers. Many sleds are also designed to reduce user fatigue by offering single-handed functionality for clinical staff perform- ing a variety of tasks, including medication administration, specimen collection and remote patient monitoring. They can also allow for device consolidation. Rather than traditional methods of using multiple devices for communication, such as landline or VoIP phones, call buttons, pages and/or overhead announcements, sleds like the Captuvo SL42h give clinicians a single, more powerful tool to communicate with and manage patient care activities. This reduces the cost of hardware as well as IT support required to mange multiple devices per clinician.

Looking Forward with Apple Although Apple products are used in the enterprise – especially those where employees are given a choice – the company has not made a large, concerted effort to sell specifically outside of consumers into businesses. However, Apple is making moves to appeal to IT departments by making it easier to link corporate email and provide better data security on iPhones and iPads. In addition, at the end of 2014, Apple entered a trial with AIDC reseller Blue Star Canada to build up its Enterprise channel. Apple has made this commitment with Blue

Futura Mobility l 515 Pennsylvania Avenue, Fort Washington, PA 19034 l 215.642.3363 l www.futuramobility.com Star Canada and will move into the U.S. next.

As previously cited, Apple’s HealthKit is currently being piloted in 60 percent of the top 23 U.S. hospitals, a number that could potentially grow. The HealthKit app makes a critical link between measuring devices, including those used at home by patients and electronic health record systems, like Epic, used by doctors. Leading hospitals such as Duke Medicine, Stanford Children’s and Penn Medicine are integrating data from HealthKit into their electronic medical records so that physicians can reach out to patients proactively when they see a problem that needs attention. In September 2014, Stanford University Hospital launched a trial with Apple to let physicians track blood sugar levels for children with diabetes using HealthKit on iPod touch devices. Duke University also developed a pilot using HealthKit to track several measurements, including weight and blood pressure, for patients with cancer or heart disease.

In January 2015, iOS devices were part of a “first” for the U.S. Food and Drug Administration when the gov- ernment organization announced it would allow the marketing of the first set of mobile medical apps (Dex- com) that allow people with diabetes to automatically and securely share data from a continuous glucose monitor (CGM) with other people in real-time using an Apple mobile device such as an iPhone.

The Dexcom Share™ system displays data from the G4 Platinum CGM System using two apps: one installed on the patient’s mobile device and one installed on the mobile device of another person, such as a doctor. Using Dexcom Share’s mobile medical app, the user can designate people (“followers”) with whom to share their CGM data. The app receives real-time CGM data directly from the G4 Platinum System CGM receiver and transmits it to a Web-based storage location. The app of the “follower” (such as a physician) can then download the CGM data and display it in real-time.

Healthcare experts are predicting more mobile healthcare apps will become FDA-approved for both patient and clinician use. With such staggering consumer demand for Apple products, it’s entirely feasible that con- sumers will pressure their doctors to use iOS apps – and doctors, in turn, will pressure hospital IT departments to adopt the iOS ecosystem.

Apple’s newest product, the ™ is considered the “lynchpin” in the company’s push into health- care. A key component of the watch is its digital fitness tracker, with a built-in heart rate monitor and accel- erometer, that syncs with the HealthKit app. Further proof of Apple’s commitment to using the Watch as part of its pursuit of the healthcare industry: the Watch will also feature the Dexcom app. Analysts are predicting apple will sell more than 5 million watches this year—and those same analysts also point out that the entire global market for “wearable fitness bands” (like FitBit®) was 4.6 million units last year.

One prediction for the Apple Watch is that it “may do for wearables what the iPhone did for smartphones — define and catalyze an entire category.” If this proves to be true, Apple could have a significant impact on healthcare, both for clinicians and patients. ns are steps in the right direction – driving the use of electronic medical records and helping with the overall advancement of healthcare. By achieving meaningful use, healthcare providers win. By improving patient care and reducing the cost to provide care, everyone wins.

Conclusion IT departments must be prepared to adapt to clinicians’ demands for Apple iOS products. As Apple pursues the healthcare industry and continues to innovate with products for both doctors and patients, this pressure will

Futura Mobility l 515 Pennsylvania Avenue, Fort Washington, PA 19034 l 215.642.3363 l www.futuramobility.com continue to grow. And, as vendors improve their mobile EHR apps and more hospitals use Apple HealthKit, IT departments’ preference for Android and the Window-environment will no longer satisfy the mobile needs of clinicians. If IT departments do not adapt to the demands for iOS devices, the hospital risks security breaches and HIPAA issues as clinicians pursue workarounds. With the availability of sleds to ruggedize Apple devices as well as provide aggressive scanning capabilities and improve battery life, iOS is ready for deployment in healthcare environments. Now is the right time for hospital IT departments to be ready to deploy Apple iOS in their healthcare facilities.

Futura Mobility helps healthcare organizations gain the perspective they need for successful mobile projects. Futura Mobility has more than 20 years of experience and 2,500 customers, including one out of every three hospitals in the U.S. Futura provides clients with experienced resources to enable high velocity adoptable mo- bility initiatives coupled with world class support. By leveraging broad mobility expertise across a diverse range of products, services, and support strategies, Futura serves as a complete “one stop shop” mobility partner, increasing operational efficiency and reducing costs for clients. Our full suite of mobility offerings are designed to assist healthcare organizations take advantage of our successful mobility expertise combined with the cutting edge technology of today. Solutions range from strategic planning, mobile application development, wireless infrastructure design, mobility implementation, mobile device management, secure communications platform, and both onsite and remote break/ fix repairs of mobile devices. For more information visit www.futuramobility. com.

Futura Mobility l 515 Pennsylvania Avenue, Fort Washington, PA 19034 l 215.642.3363 l www.futuramobility.com References mHealth News: “Fine art and hardest part of crafting BYOD policy” http://www.mhealthnews.com/news/fine-art-and-hardest-part-crafting-byod-policy?single-page=true

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Futura Mobility l 515 Pennsylvania Avenue, Fort Washington, PA 19034 l 215.642.3363 l www.futuramobility.com