Hospitals Warn Smartphones Could Distract Doctors

Apple's iPads and rival devices are finding a happy home in hospitals and medical practices. But as with driving, distractions are threatening safety — in this case, patient safety.

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DAVID GREENE, HOST:

This is MORNING EDITION from NPR News. I'm David Greene. Good morning to you.

INTERVIEWER: Today in Your Health, what your Facebook posts say about your self-esteem. But first, smartphones and tablets in the hospital. Like most of us, doctors love to try the latest and greatest new gadgets and many have eagerly embraced digital devices as useful tools for their trade. But critics worry that their widespread use could end up distracting doctors from patient care. Jenny Gold of our partner Kaiser Health News recently went to Beth Israel Deaconess Medical Center in Boston, where mobile devices are just about everywhere.

JENNY GOLD, BYLINE: Dr. Henry Feldman is a mobile technology evangelist. He struts boldly around Beth Israel, armed with an iPhone and iPad. Some people even refer to him as the i-doctor. That's the letter I, not a vision specialist. Feldman says mobile technology has made him a better physician.

DR. HENRY FELDMAN: The advantage of the iPad is it lets me do everything I could do if I was sitting at my desktop at the patient's bedside. And actually some things I couldn't easily do at the office setting. But I find in general, it speeds me up a lot.

GOLD: He gives free lectures for doctors at the Apple store in Boston, where he touts the iPad as a revolution in patient care. It allows him to show patients anatomy drawings, surgical videos and medical records right at their bedside. Recently, Feldman used his iPad with patient John Garret and his wife Cheri shortly after a surgery, showing them actual photos taken during the procedure.

FELDMAN: So if we look, this is them going in. And then they're cutting it right here.

JOHN GARRET: I love the pictures.

CHERI GARRET: Yeah, I do too.

GARRET: It's fantastic, because I wasn't exactly there, you know.

FELDMAN: Right. Right. You were asleep.

GARRET: Yes, that's right. Those are great.

GOLD: Beth Israel is almost entirely electronic, but chief operating officer John Halamka says paper will always have its place.

DR. JOHN HALAMKA: The paperless hospital is as likely as the paperless bathroom. It is possible but not necessarily easily achievable. So we don't have complete absence of paper, I just would say we have eliminated as much paper as possible.

GOLD: Halamka is also co-chair of the federal government's committee on health information technology. But recently he's been issuing a warning: All of this mobile technology has a downside - distracted doctors.

HALAMKA: I think all of us who use mobile devices have what I will call continuous partial attention. And that is, we're engaged in our work, but at the same time we're checking that email or we're glancing at that instant message.

GOLD: Most of 1,000 iPads and 1,600 iPhones at Beth Israel are owned by the doctors themselves. That makes it hard for the hospital to dictate which apps they can have on their devices. In a recent survey, 55 percent of medical technicians nationwide said they used their cell phones during procedures and nearly half admitted texting. Dr. Halamka says he's experienced the problem of distraction himself as a specialist on cases where patients ingest poisonous mushrooms.

HALAMKA: So what will happen is, I will typically get a telemedicine email of a photo of a mushroom and then a question: What should we do? Well, the problem is, is I'm looking at that on a mobile device, so at same time I'm trying to make a treatment decision, I'm getting a phone call, I'm getting a text, I'm getting some information pushed to me from some application.

GOLD: In December, Halamka wrote up a case study of an incident at a different hospital. A team of doctors there was making rounds and decided to stop giving one patient a blood thinner he was on. But as one of the residents was entering the new order into her smartphone, she got a text about a party. She was so busy RSVP-ing that she never completed the drug order. It wasn't a small mistake. The patient almost died.

HALAMKA: So gee, if you forgot to pick something up at the grocery store, it's an inconvenience. If you forgot to stop a blood thinner, it can result in significant harm.

GOLD: Halamka is trying to implement new policies at Beth Israel to prevent such a problem from happening there. The hospital now has written guidance for doctors on how to avoid distraction on their mobile devices. And they're experimenting with ways to block social networking apps in the facility. But Henry Feldman, the i-doctor, says of all the distractions he faces at the hospital, mobile technology is the least concerning.

FELDMAN: Unlike my mobile technology, which I can shut off and not pay attention to, I can't not pay attention to the nurses directly in front of me. Shutting off the nurses is a quick career-ending move around here.

GOLD: He says doctors have always had to deal with the mayhem of a hospital. Compared to the quiet buzz of a mobile device, he insists, that human noise is much more distracting.

For NPR News, I'm Jenny Gold.

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