Using Mobile Technologies to Transform Nursing Practice by Renee McLeod PhD, APRN, CPNP Presented at the mHealth Initiative Spring Seminar, March 31, 2009 Boston MA www.mhealthinitiative.org

1. USING MOBILE
TECHNOLOGY TO
TRANSFORM NURSING
PRACTICE
Renée P. McLeod PhD, APRN, CPNP

2. To Communicate
Effectively In Today’s
World We Need To
Deprogram Ourselves, And
Look For New Ways to
Connect To Our Patients
and Families

3. Why?
Your patients and families are mobile
 (2008)
Worldwide

1.1 billion use the internet

1.4 billion carry credit cards

1.5 billion have TVs

4 billion cell phone subscribers

62% of all Americans participates in digital activities

away from work, home, or school.
84% penetration of cell phones in the US population

In June 2006 (1 month) 75 million text messages

were sent; in June 2008 7.2 billion text messages
were sent.
RC Lefebvre, GWU
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4. Why?
“American families in 2008 continue to

function as units. Although they often go
their separate ways during the day, they
are connected by the internet, and even
more so, by cell phones. They
communicate socially and coordinate
activities. Few household members feel
the internet separates them.”
Pew Internet & American Life Project, 2008

5. Who Uses Mobile Technology The
Most?
73% Hispanic (84% of English speaking

Hispanics have cell phones and on a
typical day, more than half do something
the might involve sending or receiving
data)
68% Black

53% White


6. Who Uses Technology The Most?
95% of married couples living with children

89% own multiple cell phones (1/2 with 3 or more and

57% of children 7 – 17 have their own cell phone)
58% own 2 or more desktop or laptop computers.

Both spouses use the internet as do 84% of their

children age 7 – 17.
Single parents of children under the age of 18

multi-adult families not living as married who are

with or without children under the age of 18
42% of parents contact their child/children daily

using a cell phone

7. “Despite all of this technology, the majority

of adults say technology allows their family
to be as close or closer than their families
were when they grew up!”
Pew Internet & American Life Project, 2008

8. Why?
Despite fears that many Americans are isolated from

family members because of immersive personal internet
and cell phone use, most families are together at night.
Their heavy home internet use suggests that many
households are hubs of personal communication
networks, as they log on to e-mail, IM, post on social
networking sites, chat, and text.
Families of today are neither isolated individuals or your

traditional family. Rather their households are active
sites of individual activity and family togetherness.
Pew Internet & American Life Project, 2008

9. Why?
Nurses use mobile technology

67% of nurses carry two or more mobile

communication devices Spyglass Consulting, 2008
88% of nurses had three phone numbers Ascendant Systems, 2008

Nurses are mobile*

Walk an average of 3 miles (up to 5) per shift

regardless of racetrack, corridor, or radial design facility
Spend 31% of shift in the patient room

Spend 38% of shift at the nurses station

Spend 24% on the unit and 7% off the unit

* Hendrich, A, Chow, M, Skierczynski, BA & Zhenqiang. L. A 36-hospital time and motion
study: How do medical-surgical nurses spend their time? The Permanente Journal,
12(3):25-34.
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10. Why?
Nurses need access in real time; they

spend 35% of shift in documentation*
 3% in the patient’s room
 81% at nurses station
 15% on the unit
 1% off the unit
* Hendrich, A, Chow, M, Skierczynski, BA & Zhenqiang. L. A 36-hospital time and motion
study: How do medical-surgical nurses spend their time? The Permanente Journal,
12(3):25-34.
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11. Information for everyone
No dummies


12. Why practice must change
Information is changing

Access to information is changing

Technology is changing

Access to technology is changing

Human interaction is changing

 Patient is changing

13. Why iPhone and iTouch?
It’s the only new PDA on the market

 In 2008 Apple sold 14 million iPhones
 AppStore has 15,000+ applications
as of 1/21/09

ATT has reported that in the first 12 days

of the release of the 3G iPhone, they sold
twice as many iPhone 3Gs as the total
number of 1st generation iPhones sold.

14. You can combine address books, and

content from different sources and
computers
 iPhones can be wiped remotely in case of
loss
 The iPhone can display Microsoft Office
applications and Adobe PDF files but the
ability to edit must come from a 3rd party
developer
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15. Encrypted Programs Address Security

issues
You can pay to get the camera removed if

you work in a secure facility where this
feature is not allowed.
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16. Web-linked Applications For the
Clinician
MobileMe

 E-mail
 Calendar
 Contacts
 Photo Features
 iDisk online file storage
 Updatable on the go in real time and Syncs
with Microsoft Outlook or the Mac
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17. WEB Based Applications
Drugs.com

 Airstrip OB
 Will be out for the iPhone
Ultralingua Mobile: Bilingual Dicitonaries

 MyNetDiary- Track what you eat and
compare calories

18. APPLICATIONS FOR
CLINICIANS
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20. Skyscape References

21. Lexi‐Comp References

22. Unbound Medicine, Inc.

23. Drug Programs

24. EMR on the iPhone

25. Search PubMed
(Pub Search is a free application)

26. Medical Calculators like ABG

27. Medical Calculators

28. Clinical Tools Based On Current
Guidelines

29. Health Education Tools

30. Radiology Cases

31. Pharmacology Flash Cards

32. Specialty Applications

33. Speech Recognition Tools For
Immediate Dictation Capability

34. Patient Programs

35. Practice Tools

36. Preventive Care Guidelines

39. Productivity Applications
Noter

 Jott Voice Service sends text to yourself or
others
 reQall – voice to text converter
 People- Search U. S. phone numbers
 MobileMe

40. Text Messaging
• In general, fewer than 5% of adults are currently
able to communicate with their providers
electronically
• When asked 62% of adults stated that electronic
communication would influence their choice
• 75% stated they wanted to schedule
appointments electronically
• Harris Ineractive: Feb. 8, 2007
• 50% of 12 to 24 year olds send or receive text
messages
• Ipsos: 2007

41. Text Messaging
Appointments
•
Medication Reminders
•
Health Promotion
•
Patient‐Initiated Communication
•
– Need to reschedule appointment
– Need for prescription refill

42. Teensource.org
Interactive Website that allows students to

text message for information

43. Digital Books

44. E‐Readers
• The Kindle

45. The Kindle 2
• Instant access to
Newspapers
–
Internet
–
Blogs
–
Books
–
Journals
–

46. Netbooks

47. Future Applications
How about applications that locate your

patient or staff in the hospital by using the
Assisted GPS
 How about applications that use the
Accelerometer to measure patient activity
and send it to the healthcare provider (for
use in monitoring and research)
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48. Consider digitizing all your healthcare

videos and offering them to patients in the
waiting room or handing out a list of
healthcare games for use in the office or at
home for your patients.
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49. QUESTIONS?
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