CareTools

Physicians are the rock stars of health care (sorry John Halamka).
They get most of the press, and have the good fortune to dominate the
cross hairs of many health care IT vendors sales efforts. But
when considering the factors impacting patient safety and outcomes in
hospitals, it seems to me that the focus they receive is blown out of
proportion. A good example is the following press.

Physician adoption of PDAs gets some publicity via iHealthBeat
and The Wall Street Journal. Here's the short version: physician PDA
adoption reached 50% in 2004, with 65% of those using PDAs using them
to look up drugs. That means lots of docs with ePocrates
that occasionally sync their data over the Internet. The balance of the
story then goes on to talk about all the really exciting things doctors
could be doing with PDAs, like:

[...] check patients' medical histories and insurance coverage, find
information about a condition on the Internet and electronically send
prescriptions to pharmacies, the Journal reports. Home
health care nurses can use mobile phone cameras to take pictures of
patients' wounds and e-mail them to hospitals for analysis. Physicians
also can use PDAs as a teaching tool for patients by giving them more
information about diagnoses or conditions.

The obvious limitations are mentioned -- small screen that's inadequate
for EMR applications, and that hospitals need to spend some serious
cash to provide applications that actually work with wireless PDAs. It
seems there was no mention of clinical applications that are actually
suited to PDAs nor potential use of PDAs by hospital caregivers.

Here's another "physician PDA"
story, this time in ADVANCE for Health Information Executives. This
story mentions the convergence of PDAs and cell phones in a class of
devices called smart phones -- the Treo 650 and HP iPAQ H6300 are
mentioned as examples. Neither physicians nor caregivers want to be
burdened with a tool belt of electronic devices. This convergence trend
is melding PDAs and phones into one device. For private practice
physicians (non hospital employees) this means cell phones, for
hospitalists and caregivers VoIP wireless phones (or voice over WLAN,
VoWLAN).

While everyone thinks of EMRs (patient history, electronic MAR, etc.),
PDAs are better suited for simple data transactions like accessing
simple reference data, simple order entry, alerts and messaging of
abnormal diagnostic studies or deteriorating clinical conditions.
Graphics, in addition to text, is a requirement -- especially for
caregivers looking to screen false positive medical device alarms.