Mr HIStalk unveiled the HISSIES yesterday - this is his tongue in cheek send up of the HIT market subtitled, the Brutally Honest Healthcare Information System Awards, Nominated and Voted On by the Readers of HIStalk. In among the nose tweaking and insider jokes, this item caught my eye - in the category of Most Overrated Technology, PDAs won big. When looking at workflow automation at the point of care, I must agree.

What's wrong with PDAs? Well, they're expensive, most you can't drop because they're not ruggedized, and most you can't wipe with disinfectant because they're not moisture resistant. The PDAs that are ruggedized and moisture resistant are about the size of a brick - or at least that's what it feels like after a 12 hour shift. The typical PDA would last less than a week on a nursing unit.

Battery life is also a problem - few PDA batteries can support an 8 hour shift, let alone go the full distance of 12 hours. That means you've got to have battery chargers and extra batteries for all your PDAs.

Screen real estate is also a big limitation. Given that tiny screen combined with the eyesight of the average nurse (who was 45.2 years old in 2001) there's not much you can do with a PDA. Forget data entry applications, or accessing patient records - you get either too much tiny text or too many screen flips.

An often overlooked weakness of PDAs is their poor suitability as a general purpose computing platform. The operating systems on PDAs are tweaked to a much greater extent than laptops, tablets or desk top PCs. This means that application code must be written for specific PDAs - that's the specific model made by a specific vendor. The processing horsepower in a PDA is also more limited than larger computers. Running an app while connecting to a device via Bluetooth while connected to an 802.11 WLAN will bring many PDAs to their knees. In practical use this means that PDAs are single use devices - you can have one for meds administration, and one for nursing worklists and results reporting, and another one to go with your "smart" pump. Caregivers will have so many holsters they'll look like scrub-clad commandos.

At HIMSS I'll be checking out all the caregiver carried computing devices and reporting back on the lay of the land.