I make house calls: A tablet, a stethoscope and the future of medicine

mHealth is the next stage of health information technology evolution for many reasons. Above all, mobile health IT enables physicians to maintain their central and pivotal role in directing patient care and helping those patients achieve and maintain better health.

Given the ways in which healthcare is evolving - including more regulations and financial concerns - the ability to continue managing patient care efficiently is critically important.

This alone makes mobile health essential to the future of healthcare. While health reform has helped accelerate the necessary transition from a paper-ridden past to a digital future, it will take the collaboration of both providers and vendors to ensure patient and physician needs are served in the end.

[Product roundup: 10 mobile apps for evidence-based medicine.]

As I see it, mobile-savvy physicians have half-a-dozen distinct advantages over their office-bound brethren: 

  1. Mobile physicians can provide better care. I follow my patients everywhere, from my office to the hospital and their homes. In fact, I’ve made more that 10,000 house calls since 1984. Many of my patients have diabetes-related disabilities, so it’s not unusual that trips across town to my office would be next to impossible for them. But I know that I can often keep a patient out of the hospital by providing timely care. That simple fact alone - that I can better serve my patients - keeps me going to their homes as needed.
  2. Mobile health requires less equipment. I started making house calls long before I started using technology. Today’s devices and software are catching up with the way I practice. I now carry only two instruments as I move from location to location: a stethoscope and an iPad.
  3. Mobile physicians can stay connected. Being mobile means I can pull up information I need anytime through a secure Internet connection. Log-in is almost instantaneous with the iPad and I can switch easily from screen to screen, so I can stay focused on the patient. Because I’m always connected, I can take care of many tasks right away - before, during or after seeing a patient. At the end of the day, I’m not chained to the office. I can take my device home with me and finish the day’s “paperwork” after spending time with my family.
  4. Mobile health improves continuity of care. Traditionally, care falters anytime a patient goes from one stage of care to the next. Mobile health is closing some of those gaps. I recently visited a patient with bedsores, for instance. In the past, I would have written a paragraph describing the wound. With the iPad, I can take a picture of the wound, send it to my team and tell them what I did to treat it and how I want them to follow up. They don’t have to interpret my words; they can see the wound for themselves. 
  5. Mobile technologies speed workflow. The system I use from Greenway Health enables me to complete and manage most tasks on the iPad. Dictating notes through Siri saves me hours of manual documentation. I still need to use the office computer to integrate unstructured data into the patient’s record, but each release provides more mobile functionality. I fully expect that someday I will be able to do everything from a single portable device.
  6. Mobile physicians are poised for interoperability. My practice in Brooklyn is a completely integrated electronic practice. Within my office, we maintain a complete record of every patient, no matter where that patient was seen. We attested to Stage 1 meaningful use in 2011 and - thanks to all of our work to integrate knowledge across our practice - I’m confident we’re ready for the subsequent stages of meaningful use. Most importantly, our records are more complete, we have access to important details about our patients, and that helps us deliver better care.

Mobile health and the future of HIT

What I’m looking forward to is the ability to manage the many tasks involved in patient care: ordering lab tests, sending directions to the care team and writing prescriptions from wherever we are. “Doctor” isn’t merely my profession - it’s my life. Because of the ongoing advances in mobile technology, I’m able to experience positive improvements in day-to-day work-life balance because I’m no longer restricted to one building, one office or one appointment.

My patients and my medicine are just a click away, and that’s a truly remarkable improvement.

Donald E. Moore, MD, MPH, founded his Brooklyn, N.Y. practice, Dr. Moore & Associates, in 1988. He is the current co-chairman of the Health Information Technology Committee of the Medical Society of the State of New York.

Related articles: 

Hospital targets patient education and satisfaction by issuing them tablets

Reaching into Medicaid populations with mHealth tools

Top 10 mHealth stories of 2014 (so far)

5 steps to get payers and providers to tap mHealth apps 


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