Unibased Systems Architecture: Industry News: Remote Access Is Not Mobile Access

Source: HISTalk Readers Write 1/17/11
Written by: Cameron Powell, MD

Healthcare organizations are quickly learning that both remote and mobile access strategies are required. See Table 1.

Remote access lets providers work in the hospital computing environment when they are not on location. This includes accessing the EMR and clinical applications via a PC or laptop from office or home. Secure the session with something like VPN, add the necessary authentication and encryption, and clinicians can use their Windows desktop and a browser to interact with hospital applications.

Offer mobile access when you need to empower providers to perform specific tasks anytime, anywhere. This would include visual assessment of images and waveforms, checking lab values, reconciling medication lists, checking allergy status – all while on the go. Providers want the data transformed into meaningful chunks; they don’t want to navigate the medical record from their Droid in order to make timely treatment decisions. Mobile data should be provided via native applications, built to run securely on a specific device and operating system.

Some organizations have considered using Citrix to provide interpreted or emulated application access to the EHR or CIS via a mobile device. Accessing patient monitoring data via a non-native solution is discouraged, because visual distortion is almost certain when things like medical aspect ratios cannot be controlled. [1] Further, the FDA is mandated to regulate mobile devices. [2], [3]

Mobile versus Remote Access

Consideration	Mobile Access	Remote Access
Accessibility	Single, personal mobile device Anytime, anywhere cellular or Wi-Fi access	PC, laptop, or workstation-based, even if it’s a workstation on wheels
Interface	Native Application – Designed to run in the computer environment (machine language and OS) being referenced (i.e.: Android, iPhone, Blackberry, etc.)	Citrix or web access to desktop applications
Data Transformation	Improves clinical decision making at the point of care through data transformation – does something with the data. Adds meaning with graphing, trending, colors, visuals cues, etc.	Looks and functions like the desktop electronic health record (EHR). Presents data in the same fashion as the computer program being accessed.
Added Value	Works with clinician workflow by delivering in meaningful ways. Incorporates evidence based medicine and knowledge-based prompting.	Supports office- or home-based access via computer.
Meaningful Use	Physician usage quickly ramps up, is sustained over time.	Initial usage spike, unsustained; often drops off after weeks/months. Physicians will seldom help organizations achieve data access/sharing objectives when they have to go to the data.