Nurses, Midlevel Clinicians Online More Than Docs

11 Super Mobile Medical Apps

Registered nurses (RNs), advanced practice registered nurses (APRNs), and physician assistants (PAs) spend substantially more time online in their professional duties than do physicians, according to a new Manhattan Research survey.

Specifically, RNs spent an average of 16 hours per week online; APRNs spent 14 hours; PAs spent 14 hours; and physicians spent 11 hours performing work-related tasks.

More nurses and midlevel practitioners than doctors used smartphones in patient consultations, according to the survey: 74% of PAs, 67% of RNs, 60% of APRNs, and 40% of physicians used these devices at the point of care.

Other surveys paint a more positive picture of physicians' use of mobile devices. A CompTIA survey last fall found that more than half of doctors used a smartphone for work purposes, and that 38% used medical apps on a daily basis. A Jackson & Coker report, also published in late 2011, said that 80% of physicians use smartphones, computer tablets, and other mobile devices in their practices.

Christina Anthogalidis, the Manhattan Research consultant who wrote the report, told InformationWeek Healthcare there was no conflict between its results and that of other studies showing heavier physician use of smartphones. The Manhattan Research data, she noted, pertain only to use of mobile phones in patient consultations.

[ There's almost no end to the amount of useful medical information available online. For seven valuable resources, see 7 Health Education Tools For Patients. ]

One possible reason nurses are more likely to use mobile devices at the point of care, Anthogalidis said, is that they "spend more time with each patient and interact with them more. So it makes sense for them to use a mobile device to show their patient something or to use it for some other purpose. Physicians are likely to have a higher number of patient contacts, but [they] spend less time with each patient and have less interaction with them."

Connie White Delaney, dean of the school of nursing at the University of Minnesota, told InformationWeek Healthcare she was not surprised by the study's findings. She mentioned three factors that have contributed to nurses' extensive use of health IT, including EHRs, the Internet, and mobile phone applications:

--The longstanding emphasis of nursing schools on "IT and informatics literacy." Because of the requirements set by the American Association of Colleges of Nursing, she said, "there's a level of IT literacy among all levels of nursing that is higher than for other [healthcare] professionals."

--Nurses' "heightened sensitivity to patient-centered care." As consumers have become more engaged with electronic devices, she said, nurses have had to keep up with the technology.

--Nurses' significant role in the adoption and implementation of health IT, including EHRs and clinical decision support tools.

It isn't clear whether respondents to the Manhattan Research survey interpreted the question about online time in their professional work as referring to the use of EHRs, Anthogalidis said. Because some EHRs are web-based, she said, "part of that could be [related to] EHR."

To the extent that the results do cover the use of EHRs, Delaney said, that might partly explain why the nurses spent more time online than the doctors did. In hospitals that have adopted EHRs, she pointed out, nurses must document their work electronically, but physicians are not always required to do the same. In many cases, she said, "there is significant nursing time involved in doing the documentation that a physician should really be doing. I think that is a factor."

As for the use of smartphones, Delaney pointed out, "Nurses, including APRNs, have no reticence in welcoming all forms of knowledge or decision support. They make it a priority, for instance, in medicine administration, to use the resources available electronically."

Delaney could not say whether nurses are more likely to use personal mobile phones or devices supplied by their hospitals, and the Manhattan Research survey didn't ask about that. But she emphasized that nurses must meet the same security requirements that institutions impose on physicians, regardless of what kind of device they use.

InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital CIO Roundtable issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.)