We are just beginning to understand how mobile computing technology could revolutionize—and I know this sounds a bit trite—but I mean really revolutionize health care delivery, both in the United States and globally. In the next series of articles, I’ll be discussing the world of mobile computing and its impact on health care.
Let’s start with the basics. How mobile are we? It turns out that the world is amazingly connected. Current statistics indicate that there are 5.9 billion mobile subscribers worldwide. In other words, 87 percent of the world’s population can be reached through some type of mobile device. Not surprisingly, China and India lead the way in the growth of mobile device use, and, of all devices, smartphones are gaining in market share the most rapidly.
What has allowed for this exponential growth, especially in third world countries? One word—infrastructure. I remember my first trip to Vietnam in the mid-1980s. All I saw was a sea of bicycles and the occasional motorbike. My recent trips revealed only an occasional bicycle—and a sea of motorbikes. It wasn’t unusual to see an entire family of four on one motorbike, so although people weren’t necessarily moving much faster, they were moving better.
I also remember looking at a mass of tangled wires outside my hotel room, so haphazardly put together that it was beyond me how anyone could figure out which line went where. Now, mobile telephones and cell towers have bypassed that infrastructure, because you can take your phone with you.
Phone companies quickly discovered that people wanted to use data and messaging as much as they wanted to “talk” to one another, and the industry standardized communication protocols for managing short amounts of text—160 characters—between fixed and mobile phones. This standard is known as the short message service (SMS) and is incorporated in almost all mobile phones sold worldwide. In 2011, an estimated 5.9 trillion messages were sent. While the volume of messages will increase in the coming years, SMS as a percentage of all messages is decreasing due to the other types of messaging applications now available.
Last year I became acutely aware of the power of this technology. I was at dinner with a number of otolaryngologists and their spouses when someone at the table received a text message that said Osama Bin Laden had been killed. We looked at one another in disbelief, until five or six of us received similar texts from family and friends within a couple of minutes. This made me aware of how connected we have become.
Now, SMS protocols are taking a back seat to an entirely different type of communication, one that involves not only unlimited text but also different types of media. This new standard of messaging, known as multimedia messaging service, can share all types of media among mobile phones. Its most popular use is to exchange pictures between camera-equipped mobile phones, but it can also be used for a wide variety of entertainment, including videos, text pages and ringtones. Streaming music and videos delivered through the Internet, which require a great deal of bandwidth, are becoming very popular.
Mobile Internet usage is predicted to overtake desktop usage by 2014, as it has already overtaken local demographic searches. Mobile network providers are developing 3G and 4G networks to accommodate our insatiable consumption of data and, boy, are they charging for it!
Adopting the Technology
All of this is very interesting, but how far along are physicians and other healthcare providers in adopting this technology? It turns out that we are doing quite well. Monique Levy, VP of research at Manhattan Research, recently said that 62 percent of all physicians have some type of tablet device and that the iPad was the dominant device. In a recent article on the LANDesk blog, Steve Workman noted that 81 percent of all physicians now have smartphones, and 75 percent of us own an Apple device. In fact, 79 percent of us who use a mobile device for clinical use prefer an iPad. As it turns out, if you have a smartphone, a tablet and a desktop computer, you will actually increase your usage of the Internet and not cannibalize the use of one device.
But what about our patients? Are they adopting this technology? They are: Sixty-two percent of our patients have adopted some type of tablet device, and their use of smartphones is very high as well. The question then becomes, how are we using this technology to communicate with our patients, and is it an asset or a liability?
Stay tuned—that is the subject of my next column.
Rodney Lusk, MD, is director of the Boys Town Ear, Nose and Throat Clinic and Cochlear Implant Center at Boys Town National Research Hospital in Omaha, Neb. He has been working with EMRs since 1996. He may be reached at firstname.lastname@example.org.