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Point-of-Care Point-of-Care Computing: PDAs, Computing: PDAs, Health Care and Health Care and

the HIMthe HIM

Ralph La Tella B.App.Sc.(Hons). AFACHSERalph La Tella B.App.Sc.(Hons). AFACHSE

Health Information Management Association of AustraliaHealth Information Management Association of Australia

What are PDAs?What are PDAs?

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Handheld or palmtop computers Originally designed as PIMs (Personal Information Managers) All PDAs come with built-in software Information may be entered using handwritten gestures, using virtual (on-screen) keyboard or by mini- keyboard

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Do PDAs make sense?Do PDAs make sense?

Desktop ComputerDesktop Computer

Size +++++Size +++++ Cost ++++Cost ++++ Simplicity ++Simplicity ++ Versatility +++++Versatility +++++ Security +++++Security +++++ TCO +++++TCO +++++

Handheld ComputerHandheld Computer

Size +Size + Cost ++Cost ++ Simplicity +++++Simplicity +++++ Versatility +++++Versatility +++++ Security +Security + TCO ++TCO ++

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Personal vs. FunctionalPersonal vs. Functional

FeatureFeature PDAPDA PC/LaptopPC/Laptop

Start-upStart-up InstantInstant SlowSlow

Functional Functional PhilosophyPhilosophy

User-centricUser-centric Application-Application-centriccentric

Overhead Overhead (OS gets in the (OS gets in the way)way)

Single tier, Single tier, transparenttransparent

Multiple tiers, very Multiple tiers, very visiblevisible

PDAs – Truly personal, portable computing power

The PDA Market: OS The PDA Market: OS WarsWars

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Palm OSPalm OS Pocket PCPocket PCLow average price.Low average price. Average price higher than Average price higher than

most Palm OS.most Palm OS.

More software available More software available (including health care related (including health care related titles). titles).

80,000 80,000 (Source: DAD (Source: DAD Enterprises)Enterprises)

Better integration with other Better integration with other Microsoft products. Microsoft products.

Fast, transparent operating Fast, transparent operating system.system.

Formal operating system Formal operating system structure. Trying to look too structure. Trying to look too much like desktop PC OS.much like desktop PC OS.

Palm or Pocket PC ?Palm or Pocket PC ?

Only the two most popular (Palm & Pocket Only the two most popular (Palm & Pocket PC) have a large developer focus and thus PC) have a large developer focus and thus hold the majority of market sharehold the majority of market share

Avoid immediate redundancy (built-in)Avoid immediate redundancy (built-in) Caveat EmptorCaveat Emptor

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The Palm OS logo and the Pocket PC logo are theRegistered Trademarks of Palm, Inc. and Microsoft, Increspectively and are used in this presentation purely forillustrative purposes.

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Medical Relevance: Medical Relevance: Why PDAs in Healthcare? Why PDAs in Healthcare?

Clinical working Clinical working environmentenvironment is highly is highly mobile with decisions made at the bedside.mobile with decisions made at the bedside.

The The size, shapesize, shape and and performanceperformance of of computing devices that can be used in computing devices that can be used in such an environment are constrained by such an environment are constrained by the environment (Arshad et al 2002).the environment (Arshad et al 2002).

Handheld computers (PDAs) mobilise Handheld computers (PDAs) mobilise caregivers from the constraints of caregivers from the constraints of accessing data at accessing data at fixed terminalsfixed terminals..

PDAs in Use: Who, what PDAs in Use: Who, what and when?and when?

Who uses a PDA & why?Who uses a PDA & why? More than More than 50%50% of doctors in the USA of doctors in the USA

(Skyscape survey, Dec 2003).(Skyscape survey, Dec 2003). 85%85% of physician agreed that by using a of physician agreed that by using a

PDA they had decreased the number of PDA they had decreased the number of potential medical (prescription) errors. potential medical (prescription) errors.

Almost Almost 90%90% of the doctors surveyed of the doctors surveyed concluded that PDAs help them provide concluded that PDAs help them provide better care.better care.

Almost Almost 20%20% of respondents concluded of respondents concluded that PDA use enabled them to treat at that PDA use enabled them to treat at least 3 more patients per day.least 3 more patients per day.

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Skyscape SurveySkyscape Survey Does PDA use improve the overall Does PDA use improve the overall

quality of patient care?quality of patient care?

How?How?

Potential Benefits of PDAs Potential Benefits of PDAs in Health Care in Health Care

By providing access to data where and By providing access to data where and when it is needed:when it is needed: Through the sequential review and entry of Through the sequential review and entry of

data (via interactive, web-based forms and data (via interactive, web-based forms and databases), and databases), and

The retrieval of data (lab results and other Dx) The retrieval of data (lab results and other Dx) at the patients bedside. (Journal of Surgical at the patients bedside. (Journal of Surgical Endoscopy 16(1):221 – 3 Jan 2003) Endoscopy 16(1):221 – 3 Jan 2003)

How are PDAs used?How are PDAs used? Communication. Communication. Document Management (e-Texts).Document Management (e-Texts). Database Management (DBMS).Database Management (DBMS). Electronic Textbooks.Electronic Textbooks. Medical Calculators.Medical Calculators. Coding (CPT/ICD-9).Coding (CPT/ICD-9).

Point of Care Computing: A Point of Care Computing: A summarysummary

DATA RETRIEVAL

DATA CAPTURE

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“Handhelds will likely become vital tools in the practice of medicine”. Dr Peter J. EmbiCleveland Clinic Journal of Medicine. 2001. Vol. 68, (10).

Here

Opportunities for HIMsOpportunities for HIMs

Development Database Design / Forms Design Diagnostic tools / Clinical Pathways Integration of PDAs & Legacy Systems Security & User Access Protocols / VoIP

Training Provide PDA training to Clinicians Provide Multimedia Materials for students Provide technical support to users

P.O.C Resource Management Create PDA compliant web applications Quality Activities for Mobile Systems Providing Data Analysis Services Clinical Data Warehousing & Distribution

PDAs / POC systems: The New HIM / Medical Informatics Frontier

Where to from Here?Where to from Here? There has never been a better time to add-value There has never been a better time to add-value

to your career:to your career: For those in Health I.T / Health InformaticsFor those in Health I.T / Health Informatics

Extend your knowledge to PDA / Tablet PC applications Extend your knowledge to PDA / Tablet PC applications particularly in the area of Relational Database applications – for particularly in the area of Relational Database applications – for the majority of you the transitional learning curve will be flat.the majority of you the transitional learning curve will be flat.

Champion the cause. Be at the leading edge – clinicians WILL Champion the cause. Be at the leading edge – clinicians WILL turn to you for support & training. turn to you for support & training.

For those in traditional HIM environments:For those in traditional HIM environments: Find out how your knowledge of specific processes could be Find out how your knowledge of specific processes could be

ported over to PDAs to provide niche solutions both within the ported over to PDAs to provide niche solutions both within the MRD and other departments (e.g. record tracking using a bar MRD and other departments (e.g. record tracking using a bar code enabled PDA). There is an amazing lack of standards (in code enabled PDA). There is an amazing lack of standards (in terms of data items required by various clinicians). Your skills terms of data items required by various clinicians). Your skills are invaluable.are invaluable.

Case NotesCase NotesProject: MedLogsProject: MedLogs

Client: PMEFQClient: PMEFQ

Scope: A tool forming the basis of a system of Scope: A tool forming the basis of a system of assessment of 1assessment of 1stst year (junior) doctors year (junior) doctors

Initial Costing: (by non-HIM, IT- only, Initial Costing: (by non-HIM, IT- only, Canadian firm) = AUD$120,000Canadian firm) = AUD$120,000

Final Costing: (HIM) Nowhere near 10% Final Costing: (HIM) Nowhere near 10%

Recommended Software for Recommended Software for DevelopmentDevelopment

HandBaseHandBase Easy to learn and useEasy to learn and use Has desktop PC component so you can build Has desktop PC component so you can build

databases on your PC then download to your PDAdatabases on your PC then download to your PDA Handheld databases may be uni/bidirectionally Handheld databases may be uni/bidirectionally

synchronised with MS Access tablessynchronised with MS Access tables Relatively inexpensiveRelatively inexpensive Pocket PC and Palm PDA versionsPocket PC and Palm PDA versions Able to synchronise to web-based databaseAble to synchronise to web-based database

http://www.handbase.com

Thank youThank you

Thank you for your interest and your attention!Thank you for your interest and your attention!

For further information – please contact me at:editor@MedicalSoftwareForPDAs.com

or

Visit:www.MedicalSoftwareForPDAs.com