Bring Your Own Device: A Look at the Future (or Present) of Nursing Technology
Recently I observed several staff nurses using smartphones during their shift. They used them to scan medications, communicate with other staff members, receive calls from providers/ancillary departments and even look up drug-dosing information. What I witnessed is an ever-growing trend across hospitals: nurses in large numbers are adopting the use of smartphones - often their own personal devices - at the point of care. And, this happens whether their employer supports it or not.
This finding was highlighted in a white paper from the Menlo Park, Calif.-based Spyglass Consulting Group. The report is what Spyglass Managing Director Gregg Malkary called an outgrowth of a similar study performed in 2009. Malkary said the results demonstrate a definite change in attitude among nurses in the past five years. In fact, Malkary said most hospitals have rejected a BYOD approach for staff nurses out of hand; one factor, he said, is the potential for administrators and nurses' unions to get tripped up over simple affordability of smartphones. But more than half the hospitals in the report responded that they plan to either evaluate or invest in enterprise-class smartphone solutions over the next 18 months.
In the meantime, though, it appears nurses, dissatisfied with landlines and overhead paging, will increasingly use their personal devices. The study found that 67% of hospitals reported their nurses used them and 91% of hospitals said they were aware of this usage but did not have the time, tools or resources to monitor such usage.
"I suspected nurses were using their devices," Malkary said. "I just didn't realize how widespread it was. And it's not just nurses, it's doctors as well. Nobody wants to use a secure text messaging app. They don't want to have to use two apps, they want one, and the prevailing attitude is that unsecured SMS is just fine. They know it's a violation, but it's more fluid, they know everyone else's smartphone number, and they can coordinate care. They're leveraging consumer grade tools to facilitate closed loop communication, and to support multidisciplinary care. Unfortunately, it's outside the firewall."
The "look the other way" approach does not have long to live, though, according to Malkary. The HIPAA Omnibus ruling of 2013, he said, provides a strong incentive, such as million-dollar-plus fines per incident, to get mobile governance policies in order sooner rather than later. The good news, he said, is that both hardware and application vendors are stepping up to provide durable devices - he mentioned the Motorola MC40 and Spectralink Pivot as examples - and secure software from vendors such as Voalte and Extension Healthcare.
There are many challenges to nurses "bringing their own device." Often, a hospital's IT department may ban such devices outright, since it can be difficult to monitor and distinguish reasonable personal usage from HIPAA violations, network security issues, and inappropriate usage. Furthermore, most smartphones now incorporate cameras, which if misused could be another HIPAA violation.
However, in light of all the challenges and concerns, it is worth noting that most hospitals permit and support patients bringing and using personal wi-fi devices. Doctors would be outraged if they were told they couldn't employ the tools that they found most effective. Somehow, we in healthcare must devise the tools and policies that respect and support nurses while addressing the legitimate needs of security, privacy and efficiency.
More information about BYOD here: