In a recent note, I discussed the two-screen revolution that seems to be gaining traction (see: iPad Helping to Launch a "Two-Screen Revolution"). The basic idea is that many of us we will soon be operating with two screens, the large one being a TV or PC monitor and the small one being a tablet computer such as an iPad for simultaneously browsing the web. The large screen provides generalized, standard content and the smaller one provides customized, complementary information. I have been thinking about how this computing model relates to physicians and I think I can now describe how it may work in a hospital or large clinic.
Consider the process that occurs when a physician accesses the electronic medical record of a patient using a computer monitor. He or she, using an iPad, can also simultaneously review the medical literature about some interesting aspect of the case or the hospital drug formulary to find an appropriate drug dose for the patient. Alternatively, the physician can access the patient's imaging studies from the PACS while reviewing the textual radiology reports in the EMR. Ideally, many of these processes would be more tightly integrated with the EMR. This is often not possible because many of the EMR vendors will not allow second-party applications to run on the EMR server or be interfaced with the EMR. Such second-party software can highlight gaps in the EMR functionality and also reduce its response time.
At this point, I want to make a point about the idea that physicians are resistant to the deployment of EMRs (see: The Truth About EMR - Physician Resistance). I believe that one of the major barriers to EMR adoption, aside from poorly designed user interfaces (UIs), is that most physician lack a major personal stake in the development of a comprehensive clinical database. EMRs tend to be static, based on outdated software, and offer few useful tools to physicians other than the ability to order tests and drugs and regurgitate prior clinical records. Hence the growth of EMRs scribes who are being hired to input clinical data into the systems (see: The Emergence of EMR Scribes as a New Category of Hospital Employees). By way of contrast, the two-screen revolution provides physicians with a more significant value-proposition for the EMR. However, this does not guarantee that they will begin to relish the role of a data-entry clerk for the EMR.