Everybody uses mobile devices, but no one is still quite sure how to make the most of them. That, to varying degrees of more-or-lessness, is the upshot of the most recent HIMSS Analytics Mobile Technology Survey, which for the past three years has taken the pulse of an industry still coming to terms with the benefits and risks of mobile technology.

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As providers try to get a handle on how best to put wireless technologies to work, HIMSS polled them in 2013 on six areas of focus: new care models; technology; ROI and payment; legal and policy implications; standards and interoperability; and privacy and security.

Broadly speaking, they represent "the six areas to consider as you roll out an mHealth implementation strategy," says David A. Collins, senior director, mHIMSS.

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The results of the survey show just what a multifaceted thing the still-new phenomenon of mobile technology in healthcare represents. Some organizations clearly have a handle on what they want from it and how they plan to get there. Others are still finding their way.

On the policy front, for instance, just more than half of providers – some 59 percent – said they had a mobile plan in place; 29 percent said they were in the process of putting one together. Where they did exist, most policies had to do with data security. When it comes to securing devices, however, there's still a mishmash of strategies, with use of passwords the most common.

But privacy policies are easy, relatively speaking. It's where and how to use mobile devices for care delivery that many providers still seem to be tossing around ideas. Pharmacy management – medication reminders or medication reconciliation – remain popular, but still, just more than one-third of providers thought mHealth tools would "substantially or dramatically" impact care – a decrease from the two-thirds that thought so just a year ago.

Does that represent a steep decline in confidence that these tools can get the job done? Or is it just a recognition that many providers are still unsure just how do it?

Responses to HIMSS' questions about interoperability are illustrative of the different clinical approaches. Most organizations said their clinicians had the ability to access clinical systems via a mobile device, most often over the Web, using virtual private networks.

The numbers are similar for notifications from remote monitoring tool, with more than half of respondents reporting getting alerts in their EMR/clinical system. As for more comprehensive data, just 22 percent said that three-quarters of the data captured by mobile devices was integrated into their EMRs.

Providers were fans of the enhanced access to patient data – especially the ability to view it remotely. But most were still vexed by cost issues, with majorities pointing to funding limitations as the top hurdle to wider mobile adoption at their organizations.

Perhaps that's why more and more organizations are starting to closely track the money spent on these tools: roughly half of respondents formally measure return on investment related to mobile technology, and one-third of respondents evaluate the total cost of ownership as it relates to their mobile strategy, according to HIMSS.

"Not too many people are measuring ROI yet, as well as total cost of ownership," says Collins. "That's a gap – one that kind of aligns itself with the gap of the number of people who don't have a mobile technology policy in place."

Which is no particular surprise, after all.

"It reflects on the fact that mobile is still relatively young. And people are still grappling with it," he says. The challenges are many and varied, and most facilities are still experimenting with what works best for them: BYOD, whether they're going to build apps in-house or outsource them, how to deploy within and outside.

All in all, it points to one big fact: well-thought-out policies are crucial. "It's pretty important to have something like that in place before you try to integrate mobile into the overall system," says Collins.