WHITE PAPER 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 health 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, iPhones® 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.