Guest post by Bradford Perez, MD, Duke School of Medicine
(The picture below shows Dr. Perez wearing a custom tailored white coat with an iPad pocket.)
Hi everyone, thanks for taking the time to learn a little bit about the work that we are doing over in the Department of Medicine to better understand how we can integrate technology to improve the way we provide clinical care to patients. I’d like to mention right off the bat that this study could not have happened without the help of Duke Medical Center Library librarians Megan von Isenburg and Brandi Tuttle. I’m also very grateful for the mentorship of Dr. Martha Adams, which has been exceptional from the start of this project. We were fortunate enough to receive a CIT Jump Start Grant award to explore use of the iPad for medical residents in Duke Hospital.
The goal of our project was to improve the quality of medical education and clinical care by harnessing new technologies we thought would help with information gathering and clinical decision-making. We distributed iPads to members of two teams in internal medicine and asked them to complete weekly surveys about the experience for eight weeks. We also included two teams in a control arm of our study, but this group did not receive any iPad and only received computer training for accessing medical resources. We wanted to see if the iPad was a key ingredient to improving learning.
The study has just ended, and we are beginning our quantitative and qualitative analyses of the survey data. While the final interpretations are still pending, we already know the iPad is useful for accessing native medical apps that are available through the Apple App Store as well as web-based resources. The internet is loaded with information to help in clinical decision making. Two companies, Modality and Skyscape , gave us apps to pre-load on the iPads. A favorite Skyscape app was the MGH Internal Medicine handbook. A few individuals really liked an echocardiography atlas from Modality which helped with learning how to interpret both normal and abnormal cardiac echocardiography image sets. Interestingly, we found that people used websites to access information as often as stand-alone apps, especially when they were easy to navigate through a touch interface. 
Accessing patient information on the iPad in such a portable way was compelling, although many users felt the Citrix Receiver app was a little clunky. The good news is that both the hospital IT, Duke Health Technology Solutions (DHTS) folks and Citrix have improved the interface dramatically since we started our study 3 months ago. The addition of multitasking in the November iOS update offered a significant improvement in functionality and usability as well. This study has generated a significant amount of interest regarding how to improve the way we access patient info on a tablet device.
All in all, we think there is definitely going to be a growing population of tablet users in medicine in the months and years to come. The iPad has reignited interest in a class of devices that to date have not been widely adopted. It’s very exciting to be part of a group that is at the forefront of identifying what potential new uses exist for tablets and how to best implement them to improve the way we care for patients.