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mHealth nuances: Mobile security and training

Author Name Kyle Murphy, PhD   |   Date October 18, 2012   |   Tagged , , , ,

Originally posted by Patrick Ouellette via EHRintelligence.com 

Training is often brought up as the element that sets apart a smooth and, well, not-so-smooth EHR implementations. Variables such as who does the training and for how long can be magnified if and when there are early adoption problems. Much like learning the EHR software, doctors need to start taking proper training for external EHR software or add ons such as mHealth apps or speech recognition software seriously.

It’s no secret that data breaches have been at the forefront of health IT news this summer. Though the majority of thefts have involved a laptop or USB memory stick, it reasonable to wonder how much (if at all) these incidents will affect the use of mobile devices. Most doctors are using them these days, sometimes with important data that could be susceptible to theft or hacking. Brian Levine, MD, at Western Presbyterian in New York City has a great deal of mobile experience. Levine said that if you’re dependent upon the cloud for mobile data storage, you have many access points to your patient information, which opens you up to a lot of vulnerability.

“I’m a doctor who works in New York City, I live 40 blocks away and need to have some sort of connection,” Levine said. “Which is why having a local installation on my computer of a VPN client is appropriate. And I think that’s the safest way for doctors in general to allow for VPN networks to be set up for their hospitals.”

Doctors also need to understand that if a breach does happen with their mobile device, they have to be able to “kill” the devices and shut them down remotely from data access.

“For my hospital, we use encrypted VPN software and my laptop, iPhone and iPad are all VPN,” said. “That is a secure connection but I’m not unrealistic. I actually have the ability to kill all my devices if they get lost.”

Physicians with more than 10 pieces of unique patient information, and their phone isn’t secure, their hospital is at risk of suffering serious federal penalties if they lose that device. In Levine’s mind, common sense applies, even when it comes to mobile data security.

“For internet security, you need to train your doctors how to be safe and secure. Your login should not be your name and birthday,” he said.

Speech recognition training

Another EHR add-on that customers are trying to grapple with is speech recognition software. Levine uses Nuance’s Dragon Medical product and realizes that there are plenty of physicians who have been discouraged with the product. Again, he believes that you have to be sure you have adequate training for EHR and dictation software. And part of the equation is making the dictation software learn your voice and also teaching it the commands that you need.

“I say to [into the mobile microphone] ‘OB/GYN admission order sets’ and all of a sudden my computer knows to go to order sets, order entry, enter, input order for OB/GYN order set and here come the order sets for my patients,” Levine said. “Part of that is fine-tuning your EHR environment and making it appropriate with the preferences you need, and teaching people how to implement those preferences.”

Hospitals don’t do enough to teach dictation software skills and force the physicians to take the time to grasp the product’s ins and outs and how to apply it to their practice.

“The hospital rolls it out and they don’t take the time to train their doctors. They buy them a new toy and say learn it on your own,” Levine said. “These physicians just don’t want to read directions. I can tell you that if you take 15 minutes to train it, and select the appropriate vocabulary, pick accent, and pick specialty, it will make a big difference.”

Saying that you’re going to train your employees on new technology is great, but you actually need to go through with it and show them how secure their mobile devices or use expensive new speech recognition software. PowerPoint slides, which plenty of healthcare providers like to use, will not cut it. As Levine said, this knowledge gap in security and dictation software can be resolved by taking the time to ensure physicians and nurses are comfortable with the technology.

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