By the middle of 2014, most doctors stepping foot in a Tuality Healthcare hospital will pass through a virtual fence that surrounds the building. Once they do, their tablet or smartphone — the operative word being their — will enable a clinical documentation app that links directly to the electronic health record. At the same time, many personal apps, including the camera, will be disabled. Leave the building and the EHR app shuts down and the camera is ready to snap images again. All clinical data are stored in the cloud, so if the doc loses his phone, patient data won't be compromised.

"My goal is to get out of the business of managing mobile devices," says Sonney Sapra, CIO of the health system, situated just west of Portland, Ore.

Tuality is piloting the geofencing solution, developed by AirWatch, first in the ambulatory environment, but will expand to the inpatient setting in a couple of months. Not only does the solution get Sapra out of the business of managing mobile devices, but it frees doctors from being tethered to multiple devices. And, importantly, it allows the health system to explore the possibility of adding new apps.

The EHR app, developed by Cerner, is a prime example of the gap that seems to be widening in the developer world, between consumer-oriented apps and ones built by and designed for the health care industry.

In a report released today, IMS Institute for Healthcare Informatics found that roughly one-third of 43,000-plus health-related apps on iTunes are "directly related to patient health and treatment." Most of the apps have limited functionality, Murray Aitken, the institute's executive director, said on a press call Monday. Just 20 percent of the apps capture user-entered data, he added, and few focus on prevention, provide alerts to patients to take their medication or can check symptoms.

"We are at the beginning stage," says David Collins, senior director, mHIMSS. "There are developers who may not understand the nuances of the health care market, like reimbursement or reminders if you have a chronic disease."

But, says Collins, there are some "wow" apps that have been developed by health care professionals for health care professionals. For instance, VigiVu, developed at Vanderbilt University Medical Center, lets anesthesiologists and other clinicians monitor patients before, after and during surgery on their iPhones.

"To me, those are the coolest things because those developers get it," Collins said. "They've struggled with a situation and have come up with a solution. Those are the apps that get me excited."

The IMS report lays out a set of recommendations for making the majority of health apps — not just those designed by the industry — more practical. Among those is ensuring that apps don't stand on their own, that they can be integrated with electronic health records.

Aitken, though, acknowledges that it will take several years for the app market to mature. Until that occurs, we are likely to see health systems follow Tuality's route and focus on provider-based apps.

"We want to get the core functions for our providers first," says Sapra.