Another View: Fifteen

This article first appeared on 11.12.12 on digitalhealth.net.

We have all heard the phrase, but what actually constitutes a game changing event?

When the iPhone – or perhaps when iOS – came out many thought: “It’s just another smartphone. But somehow a combination of a simple to use interface, an easy to use SDK, the app store, and the desirability factor created a success that changed the world.

It happened again with the iPad. I had one from day one and it just clicked that it was different to a laptop. The fact that I could stop carrying the charger with me – that I could rely on it to work for a whole day – was amazing.

The apps which really took advantage of the touch interface were groundbreaking and a pleasure to use. Yes, it has limitations and I still find some of these a pain; but it was a game changer.

Of course, there have been others – the Wii, the Xbox connect, Arguably VoIP in gaming. Some are small, some are big, some you only realise changed things after they have changed them.

Emis goes mobile

I haven’t seen a game changer in the GP IT world for ages. I guess online test ordering was the last big thing.

Yes, we led for a while with things like disease registers, audit data on performance, electronic prescribing (though I wonder if people would be on fewer drugs if we still had to do it by hand!)

But I hadn’t seen anything that had amazed me for a while. Yesterday, however, I was treated to a demo of Emis mobile.

I’m fairly blown away by it, and I suspect it might be our next game changer. I’m glad to say Emis has pretty much done what I suggested in this column some time ago.

The app works on multiple devices – not just Apple – and looks great on all of them. My particular favorite is the iPad mini (though that might be because of my desire for one!)

I saw v1 of the system, which requires the practice to be on EMIS Web. I understand it talks to a national server rather than your local networks.

It has the usual summary screen, information screens, prescribing screens and data entry pages. One of my partners thinks it is pricey for one or two home visits a day.

That’s true, but it obviously shines for things like visits to nursing homes and bail hostels (where I go every Monday…) and other such clinics.

I do a clinic at our local hostel, and if I’m lucky if find time to type up my notes the same day or the same week. Even if I managed to do that, the notes I produce are usually short and inadequate.

Since the Emis mobile app allows you to create templates for data entry, I can these notes at the time. I can also see a standard new resident template and a depression assessment, which would speed the process up.

Tweaks needed, bug huge potential

For me, though, the benefits are not just being able to record contemporaneous notes or see last year’s cholesterol readings. The device has more tools which might start to get used in quite new ways.

A built in camera could take photos or video of someone moving or talking, which could then be attached to the record or attached to a referral.

The device would act as a better communications device than a traditional desktop. It would also make a better communications hub – VoIP phone anyone? – and could be used for video conferencing.

NHSmail already works well on a smartphone and with built in Bluetooth I can see this kind of device talking to other devices, such as scales and blood pressure machines.

The app is not perfect. After all, it’s only at v1 and it needs some tweaks. It particularly needs some attention when it comes to Docman attachments. However, it’s already pretty good and its potential is huge.

Some 1,000 homes are being built close to my wife’s practice. I’ve cheekily suggested they open a branch surgery; but that is expensive particularly in terms of IT infrastructure. What if they could just turn up and hold a surgery with iPads? How much cheaper that would that be?

The PC is dead? Long live the mobile device…

Microsoft’s long-serving operating system, Windows XP is coming to the end of its shelf life. We haven’t seen Windows 7 or 8 become a natural successor; not least because they both require new kit, which is expensive.

I’ve talked in these columns about the possibility of using RDP or some form of virtualisation server to deliver the desktop of the future. But now I wonder if all it needs is a laptop/tablet device that you carry with you.

Get away from the room as the limitation. If the lift breaks, I just pick up my screen and walk downstairs. I take it with me on visits or to a clinic. If I’m working at the clinical commissioning group I can catch up if I need to.

For me, this will take off if the interface is right and it will interact with other apps. The lesson from the iPhone was the apps added the features that it didn’t have already. The same would be the case here.