As a practicing otolaryngologist and the chief medical information officer for University of Iowa Health Care in Iowa City, Douglas Van Daele, MD, sees how mobile devices and their associated technology can help transform patient care. But his dual perch means he can see the downsides as well, particularly with smartphones, whose prevalence in the health care setting has skyrocketed in recent years.
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September 2012“They are great inventions, and they have enormous potential for information, but they do clearly have some risk,” he said. “In a similar way to when you’re being distracted while driving, if you’re actively caring for a patient and you’re getting many different messages about other patients, it can be a tremendous source of risk.”
Therein lies the dilemma for otolaryngologists: Physicians are increasingly incorporating lightweight computers, mobile phones and tablets into the delivery of health care. But that melding of humans and technology comes with the potential for distraction.
Unintended Consequences
A raft of ENT-specific research on the dangers of interruptions due to mobile devices has yet to emerge. But anecdotal evidence and initial studies from other specialties show the potential for distraction—and for medical errors (BMJ Open. 2012;2:e001099).
“I don’t think we fully understand how best to use [mobile devices] in practice,” said Robert Wu, MD, MSc, FRCPC, research director at the Centre for Innovation in Complex Care at Toronto General Hospital. “Just like any technology, we’re learning there are unintended consequences.”
Dr. Van Daele believes there are multiple pitfalls to using mobile technology in a medical setting. While an obvious one is the momentary distraction that comes with the buzz or beep of an incoming phone call, text message or e-mail, a less apparent consequence may be the risk of confusing medical records. Many devices allow you to toggle easily between applications or programs. The risk of distraction can become more dangerous, he said, when an otolaryngologist is reviewing or updating records for a critically ill patient or an airway patient. “Let’s say you’re getting information from the electronic record in one way, and now you get a text about a patient and/or a page about a different patient,” Dr. Van Daele said. “There’s a risk there of pulling together disparate information about different patients into one patient.”
—Ronald Kuppersmith, MD
Prioritize the Situation
Ronald Kuppersmith, MD, of Texas ENT and Allergy in College Station, Texas, said that while mobile devices may have the potential for distraction, they are no more distracting than pagers or other devices that have been standard issue for ENTs for many years. “The issue isn’t necessarily the technology,” added Dr. Kuppersmith. “People using the technology have to use it appropriately. You can use it to your distraction, or you can use it to your advantage. It’s your choice. It’s your choice and your responsibility.”