As physicians continue to switch EHR systems or select a first vendor, a new survey by research firm Black Book Rankings has identified  a “meteoric trend” in favor of mobile EHR applications, especially a marked leaning for iPad apps.

Black Book conducted the user poll as a  follow-up to the 2013 electronic health record study, foretelling the “Year of the Big EHR Switch.” Nearly one in five physician users indicated the high likelihood of shifting systems after disappointing first vendor results. Several new EHR integrated mobile apps have been added to the list of physician must-haves in the replacement market demand.

[See also: EHR users unhappy, many switching.]

Today, 8 percent of office-based physicians use either a mobile device for electronic prescribing, accessing records, ordering tests or viewing results, according to the survery. However, 83 percent indicated they would immediately utilize mobile EHR functionalities to update patient charts, check labs and order medications immediately if available to them via their EHR.

The mobile application market is expected to grow 500 percent by the end of 2014 primarily because of the government's meaningful use incentive program, but the marketplace remains quite crowded, according to Black Book, and overall physician usability and approval are the main factors that will keep vendors competitive.

“A mandate has been issued and progressive vendors are reacting,” Doug Brown, managing partner of Black Book Research, said in a news release. “A full 100 percent of practices participating in the poll expect EHR systems that allow access to patient data wherever physicians are providing or reviewing care."

Black Book received 122 vendor responses, indicating vendors planned to introduce fully functional mobile access and/or iPad native versions of their EHR products by the end of 2013. Another 135 EHR product vendors claim to have mobile applications on their near strategic horizons.

Desire for mobile apps and their actual use remain two separate matters, as more programs are introduced, according to Black Book. Although 89 percent of primary care and internal medicine doctors use smart phones to primarily communicate with staff, and 51 percent of clinicians use tablets to perform independent medical reference and Internet research, less than 1 percent estimate they are maximizing use of their mobile clinical and business applications.

In a separate Black Book poll of hospital CIOs with network physician practices conducted last month, mobile applications ranked above cloud computing and clinical analytics as well as business intelligence in upcoming technology urgencies. “The business priorities of operational results and reducing costs, combined with the digital management requirements for records, access, identity and risk, have healthcare information executives seeking broader EHR solutions with useful mobile applications,” Brown said.

[See also: Physician mobile use grows 45 percent .]

Criticism for some mobile apps

Although authorities debate the advantages of virtualized versus native iPad implementations, current users of both mobile EHR application types note past flaws that require the most technological attention. Of the mobile app issues most criticized, 95 percent of physicians indicated the small screen of iPhone/Smart Phone/Android Screen Size as their biggest problem; 88 percent indicate difficulties in the ease of movement within the chart; 83 percent do not want an EHR system replicated on their mobile device preferring simplified versions, and 71 percent do not appreciate non-optimized touch screens.

“The vast majority of all survey respondents favored mobile applications that focus on the patient data and core parts of medical practice most needed when the physician is away from the office setting,” noted Brown.

Ultimately, practice leaders and clinicians seek to enhance healthcare delivery and reduce medical liability through documentation of out-of-office practices including lost reimbursement. The highest ranked EHR mobile applications determined from client experience polling had 10 common characteristics: the ability to remotely review charts, update charts, assign tasks, view schedules and appointments, send messages to practice staff, lab orders and result review, permit electronic prescribing, patient encounter documentation, input vital signs and access EHR data after office hours.

The highest rated vendors in physician user satisfaction were awarded to those few mobile EHR applications which adeptly link to patient portals, assure enhanced security access, billing, speech-to-text technology, real time features such as eligibility checks, and customizable templates for specialists. Vendor system certification for meaningful use was the unanimous prerequisite.

Primary care and internal medicine physicians indicated a strong preference for electronic health record usability on their mobile devices. Of physician specialties, Black Book recorded the highest anticipated use of mobile applications reported from:

• 100 percent: hospitalists
• 98 percent: primary care/ general and family practice
• 97 percent: Internal Medicine
• 92 percent: office-based physicians
• 88 percent: rheumatology
• 87 percent: nephrology

Surgeons, particularly the specialties of orthopedics, ophthalmology, and ENT indicated  the lowest interest in mobile and iPad devices, currently at less than 14 percent on average.

The most popular mobile devices currently used by physicians and practices that Black Book surveyed:

• 68 percent: iPhones
• 59 percent: iPads and tablets
• 31 percent: smart/android phones/other

Black Book’s report on native and virtualized iPad applications also shines light on the performance disparity between vendors seeking to capture both new EHR and replacement physician practices and hospitals. The May 2013 report focuses on measuring user perceptions on the performance and functionality in several key areas and meaningful use readiness.

Mountain View, Calif.-based drchrono, achieved the highest customer satisfaction scores for iPad EHR applications as determined by the responses of more 1,400 practices nationwide.

Other top scoring vendors in the recent 2013 Black Book iPad and mobile device application survey in addition to drchrono include: MediTouch Health Fusion, Care 360 by Quest, MacPractice, Greenway Prime Mobile, NextGen Mobile, Practice Fusion, Cerner Physician Express, Nimble Clear Practices, Mitochon Systems, Point Click Care Mobile, GE Centricity, IClickDocs, Allscripts, IMedDoc EMR, Mediforms, Acumen EHR Mobile, One Touch EMR and eClinicalTouch.