One Enterprise's Two-Year Apple Mobile Makeover

Apple gadgets aren't fit for the enterprise? RehabCare begs to differ: This healthcare provider embraces iPhones, iPads and iPod Touches and relies on custom-built iOS apps to improve patient care and beat up the competition.

RehabCare CIO Dick Escue's journey to become a mobile enterprise Apple shop started two years ago, and now he's developing critical iOS apps for some 8,000 iPod Touches, 700 iPhones and 120 iPads. All tallied, three iOS apps will touch every facet of RehabCare's business, from improving patient care to winning new business.

Publicly traded RehabCare employs 19,000 workers, operates 35 acute care hospitals and rehab facilities, and outsources therapists around the country. It must comply with both the stringent Sarbanes-Oxley Act and Health Insurance Portability and Accountability Act.

But is Apple really enterprise ready? "There's this myth IT people perpetuate that these Apple devices can't work in the enterprise," Escue says, adding, "We get so many benefits from doing it in the cloud and leveraging consumer technology."


Why CIOs Should Take a Bite of the Apple

Some enterprise IT groups have lamented the coming of Apple's consumer products and even thrown up walls to slow the march, only to be thwarted. But RehabCare is proof that some companies (even highly regulated ones) can rely on new-fangled consumer devices and apps.

For the first time, Escue says, his IT department is showing a kind of flexibility and teamwork with the business side that doesn't cause extreme tension. His team builds mobile apps quickly and lets workers use Apple devices for personal use.

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Therapists use apps on their iPod Touches that make their job easier, while business folks with iPhones and iPads act on referral opportunities ahead of the competition. Executives fire up a Citrix app on their iPhones or iPads to access corporate servers.

No longer does Escue force technology on workers, which would often lead to the dreaded "change management" adoption hurdle. Instead, workers actually want the technology. "They love the devices," Escue says. "User acceptance with consumer tech is instant."

By supporting consumer tech, CIOs can transform their IT department's negative image, he says. "We decided early on that we were not going to be this department that keeps saying no to everything," Escue says, "We're going to figure out how to make this work."

iPhone and iPad Apps Bring in Business

Only a couple of years ago, RehabCare employees responsible for visiting hospitals and pre-screening potential patients in order to offer appropriate services took an average of five hours to fill out seven paper forms and fax them to multiple parties. Like rats scurrying in a paper maze, RehabCare and its competitors raced to be the first to match patients with services.

Escue realized that RehabCare's employees carried iPhones, and so perhaps an iPhone app could replace paperwork with electronic data gathering and processing. This would give RehabCare a speed advantage over competitors.

RehabCare's in-house developer built a web app on the development platform from in just four days. The web app reduced response time to referrals to within one hour. "We wrote an app to automate that manual process, and it has really paid off beautifully for us in fewer lost opportunities," Escue says.

When the iPad came out, some of the employees wanted to take advantage of the bigger screen for easier data entry. Since the app was a Web app, RehabCare's iPad users merely had to call up the app over the Safari browser.

The Untouchable iPod Touch

On the service-delivery side of the spectrum, RehabCare has 8,000 therapists in the field armed with an iPod Touch and a new app, called Smart Mobile, that delivers their work schedules and tools to record hours and take notes about patient treatment.

More complex than the referral app, Smart Mobile is a native iOS app created by a third-party developer, Casamba. Because it's a native iOS app that resides locally on the iPod Touch, therapists can enter data without an Internet connection. Once a connection is established, data from the app automatically feeds into RehabCare's billing, payroll and clinical documentation systems.

The native interface is tuned to the iPod Touch and takes advantage of drop-down menus and one-click selections that minimize keying. Unlike a web app, a native app also takes advantage of certain device features. For instance, Smart Mobile leverages the iPod Touch's timer functionality.

Therapists are encouraged to use their iPod Touches for personal use, too. The thinking goes that they'll take better care of the devices and save the company replacement dollars.

Consider the case of the Palm Pilot: In 2000, RehabCare deployed thousands of Palm Pilots to therapists to record their time and patient treatment. No personal uses were allowed. "An average of 200 to 300 Palms were returned broken every week," Escue says. In comparison, he says, "We have had 8,000 iPod Touches in the field since April, and I have received only six broken devices."

Apple Drives Deeper Into the Enterprise

Another iOS app similar to Smart Mobile is currently being developed by RehabCare for a different group of RehabCare's therapists. They have their own documentation and reimbursement regulations. So what about security and compliance concerns with Apple devices and iOS apps?

"We've had internal and external legal and compliance departments review every single thing," Escue says. "They bless everything we do."

Even the patient referral web app is getting a remake similar to RehabCare's version of Smart Mobile—that is, a hybrid web app-native app approach—as well as a new name, One Referral. Specifically, One Referral will appear as an iOS app with a native interface optimized for the iPhone or iPad yet still connects to via APIs.

While Escue maintains that the app can be ported easily to other mobile platforms, such as Android devices, the decision to settle on iOS native interfaces for apps that employees will use every day shows RehabCare's growing dependence on and trust in Apple.

Tom Kaneshige covers Apple and Networking for Follow Tom on Twitter @kaneshige. Follow everything from on Twitter @CIOonline. Email Tom at

Copyright © 2010 IDG Communications, Inc.

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