iPad brings mobility and portability to Department of Anesthesiology Functions

When Dr. Adam Jenkins, a Department of Anesthesiology resident, is rushing to a code, the first thing he reaches for is his iPad.

“Using my iPad I can access Risk Watch, which lets me look up the patient in distress on my way to the code and gain valuable information about him or her before I even arrive.” Jenkins says.

He and his cohorts are the first group of department residents to use a paperless environment, with all essentials needed for education, patient care, and department functions, available at their fingertips through the iPad.

Dr. Theodore Sanford demonstrates how Department of Anesthesiology residents use the iPad to access reference materials, monitor patients, and perform administrative tasks.

Rethinking the Textbook

The inspiration for this came from Dr. Theodore Sanford, professor and associate chair, Department of Anesthesiology, who noticed that residents were using textbooks less and less.

“We used to provide residents a $3,000 allowance to select and buy textbooks, and discovered that not everyone spent the money,” says Sanford. “Then we moved to a model where we distributed a ‘box of books,’ costing $1,500 each, but some were never opened.”

With more textbooks becoming available electronically, Sanford started thinking about other options. Instead of spending thousands on the usual textbook reorder, “why not use an iPad?” he thought.

Sanford worked with the anesthesiology librarian, Mark MacEachern, and the staff at the A. Alfred Taubman Health Sciences Library to explore alternative ways to access these reference materials. The Library reviewed its U-M license agreements for various eBooks and determined which could be effectively delivered to a mobile platform, recommending textbooks and reference materials that were already available online through the Library´s existing subscriptions.

While reading a textbook online can be cumbersome on a traditional computer, the iPad offers a reading experience that is much like a real book in terms of readability and portability. Beyond the textbook, the iPad technology also enables searches through a much larger collection of reference materials than was previously feasible, as well as access to other devices and capabilities.

Administrative Processes Become Mobile

Sanford worked with a team at the Solutions Center, a unit of Medical School Information Services (MSIS), and Jan Gombert, Department of Anesthesiology webmaster, to repurpose content and administrative functions from the department website for use on the iPad. As a result, department residents now have mobile and portable access to an array of clinical and administrative services, including room and surgical scheduling, Centricity patient information, MedHub, Key Words, and ACGME case logs.

“The mobility aspect is a big plus. With the old system, pre-ops couldn’t be done from home” says Sanford.

Charlotta Jared, desktop support specialist senior at the Solutions Center, worked to create an experience that takes full advantage of the iPad’s capabilities. She used Good Reader to create and distribute PDF versions of department policies and procedures in a format that was optimized for the iPad. She also created special bookmarks on the iPad’s home screen, providing “app-like” access to the library’s online resources, such as Elsevier’s MD Consult.

“Charlotta and the Solutions Center team did a fantastic job,” Sanford says. “Her crew did everything from making the image for the iPads to coordinating production for the protective cover with the U-M logo. The whole process was seamless to us.”

Spending more Time with Patients

Because the iPad also includes a Citrix terminal application, doctors no longer have to compete with other hospital staffers for use of the workstations in a patient’s room. Dr. Adrian Lim, also a resident in the Department of Anesthesiology, explains, “The iPad is instantly on and always at hand. I don’t have to run to a computer terminal and log in first. I can access medical records, enter vital signs, and access online drug databases, making things ultimately safer for the patient.”

Jenkins agrees. “With the availability of the Citrix platform, I can use the iPad for pre-op workups, monitoring the operating rooms, and post-op reporting,” he says.

“Using the iPad means I spend less time hunting for a workstation or looking for information and more time with my patients,” adds Lim.

Making Security a Priority

To access all these resources, users must be on the UMHS-802.1X network, which requires level-2 authentication. In addition, users are required to setup a device password for the iPad. Ten minutes worth of inactivity forces a shut down and requires password re-entry or 10 failed password attempts results in the iPad being erased. The iPads are also equipped with tracking software that provides GPS information, so users can recover lost iPads. Users can also issue a remote command to erase the iPad, should it be lost or stolen.

Discovering New Ways to be Efficient

Sanford was initially nervous about going totally paperless, but is very pleased by how well the residents have taken to the iPads. Jenkins admits, “I was skeptical about transitioning to a primarily electronic platform for learning, but it’s been better than I could have expected. The number of resources I carry with me is amazing.”

Besides being a timesaver, the iPads also enable a smoother workflow and quicker turnaround for reporting or other administrative tasks.

“It’s been fascinating to watch the residents,”

Photo courtesy of U-M Medical School. Copyright 2011 The Regents of the University of Michigan. Licensed under a CC:BY 3.0 license, http://creativecommons.org/licenses/by/3.0/