Apple released the first version of the iPad in April 2010 to tremendous hype, promising to revolutionize the way we browse the web, read, watch videos, play games and work.
Later that year, the University of Chicago Medicine gave iPads to all 115 residents in internal medicine, becoming the first hospital in the country to do so on a large scale. Despite early reports that the devices increased efficiency in the hospital, a new survey of these residents shows that even the iPad can’t live up to such lofty expectations.
Prior to deployment, 34 percent of the residents strongly agreed that the iPads would improve patient care, and 41 percent thought they would improve efficiency. But after four months of using them, only 15 percent still strongly agreed they had improved patient care. Just 24 percent strongly agreed they improved efficiency.
Some residents, for example, found typing notes difficult on the iPad’s onscreen keyboard, and toggling between programs cumbersome. Like many new iPad users who hoped the device could be become a laptop replacement, these issues dampened their enthusiasm.
The results of this survey, published recently in the Journal of Medical Internet Research, suggest that the despite the enthusiasm for introducing new technology in hospitals, high expectations can lead to disappointment.
Vineet Arora, MD, MAPP, one of the authors of the study and a member of the committee overseeing the iPad program at the University of Chicago Medicine, said managing those expectations is key to rolling out any new technology.
“It’s always important to understand whether expectations live up to reality and how you can adjust people’s expectations,” she said.
The dip in expectations doesn’t mean that the iPad hasn’t found a place in the hospital. In another survey conducted after the rollout, 90 percent of the residents said they routinely used their iPads for clinical tasks, and analysis of electronic medical records confirmed that they submitted more medical orders with the devices.
Residents who already owned iPhones were more likely to use the iPad than those who weren’t familiar with the Apple iOS. James Town, MD, one of the chief residents of the Internal Medicine Residency Program at the University of Chicago, said that acceptance of the iPads seems to be a matter of personal comfort and established work habits, as residents figure out how to fit them into their daily routines.
“When people got them earlier in their residency, they were much more likely to make the iPads useful for themselves in their day-to-day business, versus those of us who started on a paper and pen system and then got electronic medical records and iPads later,” he said.
The iPads were initially intended to give residents a way to access electronic medical records and review reference materials, but Town said they continue to find more unintended uses for them, such as showing diagrams and images to patients to illustrate treatment options or explain procedures.
“There’s been an explosion of apps that are medically related, and as people become more comfortable with this type of technology they find more and more uses for it,” he said.
He and the members of the iPad committee are studying data from tracking software installed on the devices to understand how people use them, and for what kind of work. For instance, they can analyze when and where the iPads are used to see how often residents are using them at home versus work to assess how the affect work-life balance.
Even if the iPad didn’t live up to its hype, 84 percent of the residents said they thought they were a good investment. Arora said she agrees, and as more people are used to using these devices in their personal lives they’ll continue to be a part of their professional lives too.
“The ability to access information is really key in medicine, and it has improved the ability to access information and make real time decisions,” she said. “The challenge, as in any new technology, is in optimizing its use and teaching people to get the most out of the technology.”