You know something has caught on in health IT when healthcare CIOs start talking about it. And when vendors are willing to shell out big bucks to hear hospital-based IT administrators share their opinions on it. By that measure, mobile access to hospital networks is very much a mainstream idea now.

I come to this conclusion after sitting in on a Compuware focus group with a baker's dozen of CIOs at last week's College of Healthcare Information Management Executives (CHIME) Fall CIO Forum.

Compuware executives convened the panel to help them make R&D investment decisions in healthcare, based on three areas of discussion: how CIOs are addressing the mobile user experience; what poor user experience costs health systems in terms of lost productivity and low adoption rates; and what CIOs consider important elements of user "dashboards" on both fixed and mobile devices.

This was just the second year CHIME allowed media to observe the previously off-limits focus groups, and not all vendors consented. Journalists like myself were bound by strict rules. We could report on the general concepts discussed, but specifics about technology and the CIOs' opinions were strictly off the record. Nor were we allowed to identify or directly quote individual participants unless they were willing to talk one-on-one after the session.

The idea is that vendors spend a lot of money for 90-minute blocks of time with health IT leaders so they can have frank discussions about strategic concepts, many of which are still be considered confidential. Having reporters around kind of defeats that purpose, unless we're given a gag order in advance. (If you want something to be off the record, tell me up front. Otherwise, it's fair game.)

So, what did I find? CIOs are having a lot of growing pains with mobility. No surprise there. Unlike pretty much every other form of technology in a hospital, lots of mobile devices network administrators are being asked to support actually belong to the users. Employees and medical staff are bringing in their own smartphones and tablets, then demanding on-the-go access to institutional systems.

As the Compuware discussion noted, clinicians expect a "Google experience" out of EHRs, meaning a fast response. But network capacity, particularly of the wireless variety, is being stretched, lessening the user experience. This leads to reduced clinician productivity, lower satisfaction and, ultimately, resistance to EHR adoption and lower "meaningful use" bonus payments.

"We're hearing that there's a gap in service because [smartphones and tablets] are personal devices," Michael Wilson, senior IT director for clinical services at Compuware, told me at the end of the session. And Detroit-based Compuware is sharpening its healthcare focus around application performance, or what the company calls "end-user experience management."

The general consensus in the focus group was that mobile devices don't quite deliver the optimal user experience. For example, physicians are often inconvenienced by the iTunes App store. Last month, millions of iPhone and iPad owners had to reinstall all of their apps after downloading the new Apple iOS version 5. In healthcare settings, guess who all the docs turned to for tech support?

(The desire among CIOs to get a better handle on app management has been driving the nascent trend of private healthcare app stores.)

Some CIOs also complained that health IT vendors might be working a bit too hard to produce software in native mobile format that they neglect security. With tighter HIPAA restrictions and increased penalties for breaches since the HITECH Act in 2009, this could be a fatal flaw. But it's vital information for companies to have as they walk the delicate line between security and usability. Those who strike the right balance will be richly rewarded.

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