Wednesday, June 6, 2012

Health Care Quality Assurance Issues: Is Your Smartphone Secure -- from Infection?

Recent health care technology surveys indicate that the use of hand-held devices is increasing dramatically among physicians and other health care providers. According to a recent industry study, 38 percent of physicians use health-related mobile apps daily on smart phones or tablets, and they expect that number to increase above 50 percent within the next year.  A study from Manhattan Research found that 71 percent of physicians they surveyed already consider a smartphone essential to their practice.

Most hospitals, even those mid-size and smaller, have begun implementing technology to facilitate conversion to electronic medical records (EMR), with providers increasingly imputing information on laptops and, more recently, hand-held devices. The federal government, as part of the HITECH Act, offers financial incentives approaching $44,000 for clinicians who adopt and can demonstrate “meaningful use” of an electronic medical records (EMR) system.

Some concern has been raised about the ability of physicians to adapt readily to new EMR technology and about the security of widespread use of hand-held devices to handle sensitive medical information in the age of HIPAA.  However, there is another concern related to the proliferation of hand-held devices in hospitals and other clinical settings that has only recently been considered:   Do devices like smartphones provide a new vector for bacterial and viral infection?

Two recent studies have raised concerns:  In 2009, Turkish doctors published a study examining the contamination rate of healthcare workers’ mobile phones and hands in the operating room and ICU. Ulger, Fatma, et al. (2009). “Are we aware how contaminated our mobile phones are with nosocomial pathogens?”.  Annals of Clinical Microbiology and Antimicrobials 8(7).  The study found that 94.5% of phones demonstrated evidence of bacterial contamination with different types of bacteria, including a sizable percentage of resistant organisms.  The study reasonably concluded that “mobile phones used by [healthcare workers] in daily practice may be a source of nosocomial infections in hospitals.”

Another study examined the threat of infection from mobile phones of patients, companions and visitors.  Sait Tekereoglu, Mehmet, et al. (2011).  “Do mobile phones of patients, companions and visitors carry multidrug-resistant hospital pathogens?” AJIC: American Journal of Infection Control 39(5), 379-381. That study concluded that mobile phones of non-hospital staff represented an even higher risk for nosocomial pathogen colonization than those of health care workers.

With the proliferation of mobile devices in today’s society, generally, and within hospitals and medical offices, in particular, those responsible for infection control should address the problem of potential contamination from mobile more effectively than they have to date.  As the 2011 study points out, “successful decontamination will not be easily accomplished with classic methods,” primarily because mobile devices are sensitive to liquid contact and high temperatures, making frequent disinfection impossible.

Until other disinfection methods are available, or devices are made to withstand current techniques, the best solutions are likely the old standbys:  staff education, frequent hand-washing and the use of technology-appropriate disinfectant wipes.  In higher-risk areas, mobile devices may need to be restricted, especially for the public.  Further possible solutions include ultraviolet irradiation and the use of easily cleanable silicon device covers.

Rath, Young and Pignatelli, P.C.


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