Mobile computing in long term healthcare - updated

**Note: All information contained in this blog post is current as of 7/13/2010

I was recently talking with an acquaintance when they asked me what I thought the next big thing in business would be.  I’m positive they were waiting for me to say the new thing in business would be some sort of new synergy.  Instead, they were a little confused when I said that both laptop and desktop computer would no longer be used as widely as they are today.  We talked about how most businesses could benefit from looking into deploying mobile computing.  While there are some specific instances where a desktop computer is necessary, the majority of people will be able to function with a lower powered portable computing device allowing them to work where they are at when they need to work.

These devices which we now classify as mobile computing devices range in sizes from a smaller 3.5 inch screen to a larger 9.5 inch screen.  Along with the variety of screen sizes, the hardware powering these devices also widely varies.  Devices which are less than a year old are radically slower in comparison to their newer counterparts but are still viable for use as a mobile computing device due to the release of application receivers which connect to applications on a remote desktop.  With the most recent releases of the newest mobile operating systems – Blackberry, Android, and iOS- there have been multiple applications released to each platform allowing these mobile devices to connect in a variety of ways to remote servers or desktop computers right within a facility.  These applications, though bringing most of the functionality from the desktop counterparts,  allows these mobile devices to connect to their remote servers to run their applications with a specially created touch interface which scales to the device the receiver software is being run on, providing the vendor developed their software this way.

What makes these mobile devices unique is their application outside of the consumer market, and particularly in the long term health care industry thanks in part to the ability to run applications remotely in a hosted environment.  Deploying mobile devices in the long term healthcare industry has multiple advantages to that of traditional computers.  Below is a quick list of these various advantages.

1.  The first advantage is that unlike a traditional computer which is in a fixed location, mobile computing devices can be taken anywhere where data is needed to be accessed or entered.  Since application receivers on mobile devices are almost identical in functionality to those on desktop bound computers, employees have quick access to the remote applications they already know how to use.  Using the application receivers, critical applications and data can be accessed anywhere from a patient’s bedside, a community room where the resident is currently at, or even to the farthest ends of a hallway.  Not having to train end users on new applications plus being able to access information anywhere in the facility reduces the time needed to enter information into the system due to either waiting for a computer to become free or moving from a patients room to the kiosk down the hall to look up vital information on a resident.  Mobile devices, while convenient and time saving, allow caregivers more time with residents to provide them better care.  

2.  The second advantage is that most newer devices are touch screen based.  Touch screen devices are, in their current form, naturally intuitive to use  While initially it may take a couple of training sessions to allow employees to become familiar with navigating the various menus, it usually does not take a person long before they will be comfortable with just reaching out and touching the screen to type, select information, and move the virtual cursor around the screen.

3.  The third advantage of application receivers is that the newest versions which have been recently demonstrated allow, with supported hardware, for video output of the device’s screen  to be displayed on a full size external monitor.  Although connecting these devices to monitors and physical keyboards goes against the spirit of mobile computing, this ability to interact with both allows them to act as thin clients when needed making the devices more versatile by nature than most other computing devices.

4.  The fourth advantage of using mobile devices with an application receiver is that users data is stored securely on the remote servers which they connect to.  All the same security is present when accessing information and applications through the mobile application receiver as when accessing this information on a desktop computer at the facility.  Since the devices themselves do not store the data, as long as the system is configured correctly requiring a password each time a user connects, there is no potential for private data to be exposed if a device is stolen or lost. 

5.  The fifth advantage of using mobile computing device is the battery life of these devices usually ranges from between eight to ten hours of usage on a wifi network on newer devices.  Even if getting an hour or two less than advertised, this will usually be more than enough time to make it through an entire shift.  The device, no matter how many patients, will have times where it will not be  used and could be in standby waiting for the user to access the screen.  The natural evolution of hardware has so far increased the battery life of each successive model, and this trend will only continue to help alleviate battery power problems for heavy users.

6.  The sixth advantage is that as of current, most mobile operating systems are not vulnerable to computer malware.  If an end user does browse the web  the chances that they will be able to infect the device with malware are low.  If something does go wrong and the device get infected or corrupt, most will allow for an easy restoration to factory settings by re-flashing the ROM to the original image.  This will take the mobile device down for potentially as long as an hour but will have it back up and running by the time its done with the restore.

7.  The seventh advantage is that since the device could always be with the nurse, the chances of a resident or visitor walking by and gaining access to the data is minimal.  If concerned, or they are going to be leaving the device out for a while, its possible with the press of a few buttons to log off and shut down the application receiver.  These devices can also be locked down requiring a password to unlock the screen which can be configured to be as simple or complex as required.  This and many other settings are configurable through configuration profiles which can be deployed to the devices from an IT department.

8.  Unlike most laptops and desktops, most mobile devices use solid state storage.  This reduces battery drain while also also at the same time preventing damage which would occur with traditional moving hard drives in a device which is always on the move.  While the capacity is much smaller than a traditional laptop hard drive, the use of the application receivers for deploying applications brings the amount of required local storage down considerably.

To be fair, mobile computing devices do have a few negatives which need to be weighed against the positives before being deployed.  Most of these negatives deal with the initial cost of deploying portable computing devices,

1.  The first negative item is that most of the mobile devices are built using consumer grade material and consumer grade construction.  While they may resist a few falls, dropped enough times they will eventually break and need to be replaced.  While this may not seem like a large problem, if these devices were to be deployed in nursing homes and long term health care facilities one would want these device to be built sturdier.  The more portable the hardware, the more likely it is to be dropped, fall or have a various accidents which causes physical damage. 

2.  The second negative is that there would need to be an increased number of mobile devices deployed, raiding the initial cost of deployment.  While convenient not having to be plugged into a power cable, battery powered devices eventually will run out of power.  To prepare for this, and to allow these devices to always be available to staff, a company will need to determine how many devices will need to be available for each shift to use and how many will need to be charging for the next shift.  This is not an easy formula to figure out initially and this number will vary from facility to facility.  Unlike a desktop computer which can be used between shifts, these devices will constantly be swapping out from being on the charger to in a hand increasing the number of devices needed to be purchased and increasing the initial deployment costs.

3.  The third disadvantage is that if a wireless network is not currently deployed at a facility, then one would need to be setup and maintained, further increasing the initial cost.

So the question remains.  Should long term health care industries look at mobile computing devices for deployment in their facilities?  Yes.  The deployment of application receivers on these devices allows for a controlled environment where the application connects to an already vetted and trusted server allowing for the same controls and restrictions on the remote environment on the mobile device as are present on the desktop.  Like every new tool, there are some negatives which need to be weighed against the positives.  Each company will need to decide, based on their current situation, if the positives for them are enough to deploy mobile devices at this time.  There is not one answer for everyone as each situation is unique and will need to be thoroughly examined before a final decision is made. 

Apple's new moto: We say no to customer service

I find this funny….not in a haha sort of way but in a “WHY I Oughta….!” way.

I’m currently working on a blog post about mobile computing, and how I enjoy and love it.  

Don’t get me wrong, I’m not going to stop using mobile computing.  But after today’s experience I’m rethinking on what platform I’ll be doing this computing on.

This story, like most others right now, involves two red-headed step children in one family.  There is ATT, my current provider and holder of my monthly bills.  There is Apple, maker of my 3g iPhone, and representative of clean evil.

So to setup the story, I’m going to assume a few things:

1. You know when the iPhone 4 pre-launch order/reservation was
2. You know what an iPhone is

While at work on Tuesday morning, I noticed the Apple store going down.  I had arrived at work a little early to start on some work so that when the store came back up, I would be able to take five minutes out of my night to order the phone.  I knew when it was coming up (3am central, 12:00am pacific) and around 3 started refreshing the page every few seconds like every nerd was at that time of the night.  One one of the refreshes the page took a little longer than normal to load and then….the store was up.  I quickly hit the pre-order links on apple’s site and went through the process.

When the site went to hit ATT’s server to verify my account, it couldn’t and asked if I wanted to pick up the phone in store.  I told it yes, and got my reservation.  I noticed when I did, however, that the page said I owed 599 dollars, not the 199 for a contact renewal I should have.

Odd.

I decided to wait through the day to see what the news/forums had to say about this.  I assumed since they couldn’t ping ATT’s server that is why the high price and it would be corrected on launch day when I pick it up.  Until I started reading blog posts/forum posts stating I had to call Apple to correct the problems.

Being proactive, I called Apple’s 1-800 number at night.  

And this is where my hatred for Apple has started to grow.

I called Apple’s number the first time and waded through the prompts figuring out which one I needed and finally selected the correct sequence.  I go through, and then was greeted with a message that there were too busy and couldn’t answer my call.  I thought they were going to say right away and put me in a que.  No, they meant they couldn’t answer my call at all and hung up the phone.  

Odd….

So I called again and got the same message before I got to the prompts.  Again I was hung up on.  No que?  No waiting on hold?

I called a total of 17 times, each time save the last I had a variation of either being told immediately I couldn’t get in line or going through the prompts all the way and then being told to go away by apple’s voice.

Finally on the 17th try I got through, and spoke to a support representative.  He informed me that I would need to call both ATT and the apple store I was picking up the phone from, and that only the place where the phone was being shipped could change it, and they couldn’t at the main support place.  

Odd…..

Flash forward fifteen hours to ten o’clock on the 16th of June.  I call the local apple store where I am picking up my phone.  I was informed by the person on the line that I had to call ATT to correct the issue of pay 600 on the day of pick.  

Odd………

I called ATT and was working with a very helpful representative(let me be clear here, ATT has in my experience always been helpful- im blaming all of the fubar of this iPhone launch mess solely on Apple after my experience today - even the website issue) who went through their supervisor, and even called the ATT store in question to find out from them what she needed to do to help out and fix the issue (the apple store rep didn’t so much as offer to transfer me).  She called, spoke with the same store, and was told I just need to go in on day of pickup and use my social security number and all will be well.

What?

 Apple needs to get their stories straight.  They need to figure out what the correct answer is and give it to their employees.  I know I’m not the only one confused by this as there are others asking and receiving contradictory information on this.  Apple, you need to figure out for your loyal fans - most of whom pay the extra premium to have your hardware and software, and most who are willing to put up with long lines on launch day - what the answer really is and let us know.

Apple - which is it?  Yes/No/Yo?