title: Tablet computers in support of rural and frontier clinical practice.
abstract: OBJECTIVE
  Healthcare organizations are increasingly faced with an environment in which they must implement health information systems to achieve higher standards for efficiency and quality of care while at the same time being asked to provide needed services with fewer resources. This is particularly challenging for rural health systems where access to resources is often more limited. This study investigates the potential value of iPad tablets for enhancing health services delivery by primary care physicians in rural Nevada.
  
  
  METHODS
  Five physicians from rural Nevada were selected to receive iPads and funding for apps that would enhance their medical practices. Following a year of use, data was gathered on each physician's actual use and perceived value of the iPads. A case study approach was taken using both an online survey and semi-structured phone interviews to collect case data.
  
  
  RESULTS
  Use and perceived usefulness of the iPad was mixed but generally positive with some physicians utilizing it much more than others. The iPads were primarily used by the physicians to access medical information through online resources (e.g. Epocrates and UpToDate) for reference and diagnostic purposes, although they were also used for some interaction with patients. All felt that resources available through the iPad were limited and that better applications would improve the usefulness of the iPad, particularly in regard to graphical and video content suitable to sharing with patients.
  
  
  CONCLUSIONS
  Physicians in this study felt that the iPad could fill a need between smartphones and desktops, which were their primary technology tools prior to receiving the iPad, but that useful medical applications and resources are currently limited for the iPad. In particular, better graphical and video content would improve the usefulness of the iPad as a tool for patient interactions. Apps that store content locally would serve to mitigate inconsistent internet access that is still common in rural settings, increasing the usefulness of the iPad in that context. Tablets like the iPad also have potential for use in accessing the electronic medical record systems that are increasingly being implemented in rural hospitals and healthcare facilities.
authors.affiliation: Accounting and Information Systems, University of Nevada, Reno, Reno, NV 89557, United States. Electronic address: chadanderson@unr.edu.
authors.forename: Chad
authors.initials: C
authors.lastname: Anderson
authors.forename: Terry
authors.initials: T
authors.lastname: Henner
authors.forename: Jake
authors.initials: J
authors.lastname: Burkey
mesh_terms: D007256:Information Systems; D008838:Microcomputers; D009505:Nevada; D010818:Practice Patterns, Physicians'; D019035:Rural Health Services / Q000458:organization & administration*; D014584:User-Computer Interface
keywords: Handheld computers; Health services accessibility; Mental health; Mobile health; Rural health; Technology acceptance models; Telemedicine