Clinician Perspectives on Unmet Needs for Mobile Technology Among Hospitalists: Workflow Analysis Based on Semistructured Interviews

Abstract

Background The hospitalist workday is cognitively demanding and dominated by activities away from patients’ bedsides. Although mobile technologies are offered as solutions, clinicians report lower expectations of mobile technology after actual use. Objective The purpose of this study is to better understand opportunities for integrating mobile technology and apps into hospitalists’ workflows. We aim to identify difficult tasks and contextual factors that introduce inefficiencies and characterize hospitalists’ perspectives on mobile technology and apps. Methods We conducted a workflow analysis based on semistructured interviews. At a Midwestern US medical center, we recruited physicians and nurse practitioners from hospitalist and inpatient teaching teams and internal medicine residents. Interviews focused on tasks perceived as frequent, redundant, and difficult. Additionally, participants were asked to describe opportunities for mobile technology interventions. We analyzed contributing factors, impacted workflows, and mobile app ideas. Results Over 3 months, we interviewed 12 hospitalists. Participants collectively identified chart reviews, orders, and documentation as the most frequent, redundant, and difficult tasks. Based on those tasks, the intake, discharge, and rounding workflows were characterized as difficult and inefficient. The difficulty was associated with a lack of access to electronic health records at the bedside. Contributing factors for inefficiencies were poor usability and inconsistent availability of health information technology combined with organizational policies. Participants thought mobile apps designed to improve team communications would be most beneficial. Based on our analysis, mobile apps focused on data entry and presentation supporting specific tasks should also be prioritized. Conclusions Based on our results, there are prioritized opportunities for mobile technology to decrease difficulty and increase the efficiency of hospitalists’ workflows. Mobile technology and task-specific mobile apps with enhanced usability could decrease overreliance on hospitalists’ memory and fragmentation of clinical tasks across locations. This study informs the design and implementation processes of future health information technologies to improve continuity in hospital-based medicine.

Implementation of a Mobile Application in Acute Stroke Care Documentation

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Nurses' voices

“…The lack of electronic health records readily available at the bedside further hinders an already complex workflow. Research of hospitalists, including advanced practice nurses, indicated that the use of mobile apps could be most beneficial in enhancing team-based communication and care coordination 15. As more healthcare systems move toward team-based care to provide greater efficiency for achieving better patient outcomes and caregiver satisfaction, communication will become even more important for effective coordination and collaboration among healthcare team members 14,16.…”

“…Research of hospitalists, including advanced practice nurses, indicated that the use of mobile apps could be most beneficial in enhancing teambased communication and care coordination. 15 As more healthcare systems move toward teambased care to provide greater efficiency for achieving better patient outcomes and caregiver satisfaction, communication will become even more important for effective coordination and collaboration among healthcare team members. 14,16 Key content areas for consideration in the development of innovative technology include the following:…”

Direct Support Professionals’ Perspectives on Using Technology to Help Support Adults With Autism Spectrum Disorder: Mixed Methods Study

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