Hospitals are starting to get serious about implementing enterprise-level, smartphone-based systems for nurses, according to a study by Spyglass Consulting. In a survey of 100 tech savvy nurses from around the country, half said their hospital was now evaluating such an offering. Only 4 percent had actually implemented them already.

Enterprise mobile systems are applications that include (and go beyond) secure messaging for nurses as a replacement for pagers, nurse call systems, and unsecured texting, which is a violation of HIPAA. Messages sent through an enterprise system can also be stored in the electronic medical record. The systems can also be integrated with biomedical monitoring devices to alert nurses automatically if a patient's vitals drop.

"I think this market is ready to absolutely explode," said Gregg Malkary, Founder and Managing Director of Spyglass Consulting. "The smartphone has been underutilized in healthcare within acute care facilities. We haven't even realized the potential of the smartphone to support nursing workflow, or to support clinical workflow as a whole."

Malkary said a few factors are pushing hospitals toward smartphone systems for nurses. One is the looming move toward outcomes-based medicine necessitated by the Affordable Care Act.

"We have to start working as a team because we're being measured on quality and outcomes," Malkary said. "So we need technology that's going to support that. Not only among members of the nursing team and RNs, but now physicians, pharmacists and ancillary workers are all part of the same team. How do we close the communications loop, so we're all working off the same page and we're not duplicating efforts, inside the hospital and across the continuum?"

Another factor is that nurses are already doing so much unsecured texting, hospitals are looking for ways to eliminate behavior that could cost them millions in HIPAA fines. Despite hospital policies against it, Spyglass found that 67 percent of nurses use their unsecured smartphones in a care setting, and 88 percent of those surveyed were concerned about some kind of HIPAA-related security risk. 

Malkary said that the situation with nurses is very different than with doctors, who tend to have more success shaping policy around their own inclinations -- the rise of "Bring Your Own Device" policies for physicians is one prime example.

"The nurses are looked upon as an expense, and the doctors are looked upon as revenue-generating, so they're more likely to make investments to support physicians, particularly community-based docs, because they're a referral channel for the hospital," Malkary said. "When you talk about BYOD, that frequently doesn't include nursing."

A third of the nurses Spyglass spoke with said their hospitals were already integrating biomedical devices and Voice over Internet Protocol, up from 6 percent when the study was done in 2009. Malkary said this commitment to integrating communication systems and health monitoring made sense, as it reduces the problem of alert and alarm fatigue among nurses.

"I think over the next 12 to 18 months, we're going to start to see penetration of these solutions on the departmental level with more success, and they'll be more widely deployed," he said. "...We're working in silos, we need to work together to improve collaborative care. I think there's going to be a lot of experimentation done and as we see success, we need to add additional capabilities on the smartphone."