For all the incentivizing, prompting and pleading to get physicians to adopt health IT, perhaps no one could have predicted 20 years ago that the cell phone would have the biggest impact on adoption rates.

Evidence comes in a recent report, "Taking the Pulse v9.0," issued by Manhattan Research. It found that 64% of doctors, more than double the number eight years ago, are using smartphones -- iPhones, BlackBerrys, Treos and other hand-held devices with phone, wireless Internet access and robust applications that bring formerly desktop solutions to the palm.

"You have to make it very easy for the average doctor," said Denis Harris, MD, a solo orthopedic surgeon from Washington, D.C., who runs most of his practice from his iPhone. Dr. Harris, 63, said that by having the technology mobile, many physicians who avoided IT adoption because they thought it would be obtrusive are now taking a second look.

According to Manhattan's research, some of the most widely used mobile applications by physicians are drug and clinical references, as well as clinical tools such as dosage calculators. But many believe this is just the launching pad for a technology-driven health care system that will revolve around the smartphone.

Monique Levy, senior director of research for Manhattan Research, said she is starting to see the line between the tasks done by physicians on desktop computers and on mobile devices "start to blur."

64% of doctors use smartphones.

"You prefer to do things where you need bigger visuals on your PC, but if it's useful to you because you are on the train or between patients, whatever it is, it seems to be good enough to do it on your mobile phone, which mirrors the consumer world," Levy said.

Alex Kasten, a consulting analyst for The Diffusion Group who conducted a study two years ago on physician use of smartphone technology, said mobile devices and applications will never replace desktop systems entirely. They will, however, help physicians become more efficient by bringing those applications to the point of care, which may persuade more doctors to adopt health IT.

"Primarily, the work flow you are going to enter into as a provider at the point of care, in front of the patient, will be done on a device like an iPhone. [A] desktop, laptop, keyboard is pretty much not going to work if you want to do things quickly and do things at the point of care," said Tom Giannulli, MD, an internist from Westlake Village, Calif., who developed the first stand-alone EMR for the iPhone. It was launched in September 2008.

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