Understanding the Wireless Technology and Mobile …...mobile computing device to the site’s information system through a docking cradle wired to the LAN. However, since the end

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COPYRIGHT © 2002 BY THE HEALTHCARE INFORMATION AND MANAGEMENT SYSTEMS SOCIETY. 1

2002 ANNUAL HIMSS CONFERENCE & EXHIBITION

Understanding the Wireless Technology and Mobile Computing in Healthcare

Session 153Session 153

Fran TuriscoDirector, Emerging PracticesFirst Consulting GroupLexington, MA

Paul SteinichenVice President,Enterprise Technology ServicesFirst Consulting GroupAtlanta, GA

AUTHORS/PRESENTERS

BACKGROUND

Over the past several years, the trade and popular press has been full of cover stories touting mobilecomputing and wireless technology as the linkage solution for personal and professional communica-tion, as well as a tool for conducting business for the mobile professional. In healthcare, that trans-lates into hope that we can finally connect our mobile caregivers with the tools that give them accessto clinical and administrative data anywhere, anytime.

Data quality, patient safety, efficiency and cost reduction are some of the pressing factors that makemobile computing an attractive and practical solution. Physicians, now working longer hours and see-ing more patients, need a more efficient means to do their work. They cannot and will not spend moretime locating a desktop computer, logging in and then entering data when it is much quicker to hand-write a note while standing in the hallway between exam rooms. On the nursing side, there is a dra-matic shortage of nurses in the US. For both of these highly mobile professionals, there are newregulatory pressures for clinical documentation and point of care access to information technology(IT) solutions. The net result is a dire need for applications that incorporate data and function porta-bility with ease of use at reasonable prices.

The vendor market is trying to respond, but technology and applications are still maturing.Applications are focused on specific clinical and administrative tasks rather than an entire careprocesses. The technology has connectivity and integration issues that musts be resolved before widespread adoption is possible. Therefore, decision makers must understand the costs, risks and realisticbenefits before moving forward with wireless.

This report is designed to provide an introduction to mobile computing and wireless technology con-cepts for non -technical managers and caregivers. It is a snapshot of the current market place with aview towards future developments and is intended as a basic information reference for those consid-ering mobile computing. Publication references for additional reading, a representative applicationvendor list, and a table of related wireless reference web sites are included in the appendix to provideaccess to more in depth information on specific aspects of wireless and mobile computing.

MOBILE COMPUTING DEFINED

Mobile computing is not one technology. It is a range of solutions that enable end-user mobility byproviding access to data any time, from any location. Because the term is used so broadly, there arebound to be misconceptions about what wireless is and does. Here are just a few of the many pub-lished wireless statistics that actually refer to different technologies.

• The number of wireless Internet users will reach 83 million by the end of 2003, or 39 percent oftotal Internet users.1 (Subject: Wireless Internet).

• By the end of 2004 there will be 95 million browser-enabled cell phones and over 13 million web-enabled Personal Digital Assistants (PDAs).2 (Subject: Internet ready devices)

• The wireless LAN market, expected to reach $1 billion in 2001. That figure will double by 2004.3

(Subject: Wireless LAN)

For healthcare executives and caregivers, a clear understanding of wireless technology options is fun-damental to sound decision-making on whether and in what ways to use wireless.

2002 HIMSS Proceedings: Educational Sessions Session 153 / Page 2

Mobile Computing ComponentsMobile computing is a combination of three components as shown in Figure 1:

1. Handheld computing device

2. Connecting technology that allows information to pass between the healthcare organization’sinformation system and the handheld device and back

3. Information system

Here is an example of how the three components work together:

• The end-user enters data using the application on the mobile computing device. Data could bevital signs, charge information, clinical notes or medication orders.

• At this point the data on the handheld is sent to the healthcare organization’s information systemto be stored in the patient’s electronic record or stored in a central data repository using one ofseveral “wireless transfer” methods.

• Now both systems (the handheld and the site’s computer) have the same information and are “insync.”

The difference between this method and the one used to connect a desktop PC to an organization’sapplications is simply that the end device is NOT physically connected to the organization’s network.

Data Transfer OptionsThe three most commonly used wireless data transfer methods are:

1. Wireless Local Area Network (Wireless LAN)

2. Wireless Internet or Wireless Web

3. Data syncing or “hot syncing”

Wireless LAN Wireless LAN is a flexible data and communications system used in addition to, or instead of, a wiredLAN. Using radio frequency (RF) technology, wireless LANs transmit and receive data over the air,minimizing the need for wired connections and enabling user mobility. The wireless network oper-ates as an extension of the facility’s traditional wired network. Radio frequency access point devices


Figure 1: Mobile Computing Components

installed throughout the coverage area serve as the connection between the wireless device and thewired network.

In a wireless LAN, for example, the caregiver enters data into a handheld device that has a specialwireless LAN card. This card has an antenna that transmits the data in real time using radio frequencytechnology to an access terminal, usually connected to a ceiling or wall. The access terminal, con-nected to the local area network, sends the data received or requests for data from the handheld to thepatient care information system. Conversely, data from the organization’s information system can besent to the handheld using the same technology.

Unlike some technologies such as infrared, wireless LAN is not a “line-of-sight” technology. As aresult, the handheld device can operate anywhere within the coverage area even when the access ter-minal is not in view.

Wireless LANs work best when the area of mobility is confined to a building or campus and when theneed for up-to-date information is immediate. Ambulatory and inpatient medical record applicationswork very well in a wireless LAN environment with larger user devices such as laptops. For example,Ohio State University Medical Center has a wireless LAN that spans six buildings and supports anumber of mobile clinical and administrative functions, including order entry, patient registrationsand outpatient prescription writing.4

Wireless InternetWireless Internet, also known as the Wireless Web, provides mobile computing access to data usingthe Internet and specially equipped handheld devices.

Using a web phone or a PDA phone with a micro Web browser (a scaled-down Web browser that dis-plays mostly text), the end user can display data accessible from the Internet. Technically speaking,the mobile device connected to the cellular system sends the request to a computer link server. Thisserver acts as a gateway that translates signals from the wireless device into language the Web canunderstand, using an access and communication protocol. One of the leading protocols is called WAP(Wireless Access Protocol). The server also forwards the request over the Internet to a Web site, suchas Yahoo, AOL, or the organization’s site and information systems.

The Web site responds to the request and forwards the information back through the link server.Again the response is translated into a wireless mark-up language (WML) so it can be viewable onthe small cell phone screen. This translated response is then sent to the cellular system and finally tothe Web-enabled mobile computing device.

Examples of the current uses of Wireless Internet include accessing short emails, quick look-up capa-bilities, and access to the organization’s intranet and subsequently its applications.

Data Synchronization (“data syncing”)With data synchronization, information is periodically downloaded from the organization’s informa-tion system to the handheld device and then uploaded from the device to the information system. Themajor drawback of data synchronization is that it does not provide real- time access to data on theinformation system.

Data synchronization is not a “wireless” data transfer method since data is transferred from themobile computing device to the site’s information system through a docking cradle wired to the LAN.However, since the end user device is only physically attached to the LAN during the batch datatransfers, it is commonly grouped under the general term “wireless.”

To illustrate data synchronization, let’s look at the respiratory therapy charge capture process done atBanner Health System in Phoenix:

• Each respiratory therapist starts the shift by downloading the current inpatient census into thePDA device. By placing the PDA device in the network connected docking cradle and pressing a“sync” button on the cradle, the therapist downloads census information from the hospitalAdmission Discharge and Transfer system to the PDA.

• During each patient visit, the therapist selects the correct patient from the list on the PDA displayand then identifies the appropriate charge and visit code information from menu lists.

• At the end of the shift, the charge information is uploaded to the Billing system, again using datasynchronization.

In addition to eliminating data keying errors and lost charges, using the PDA charge capture systemhas reduced the time to get charge information to the billing system from ten days to one day, elimi-nated incorrect charging, and improved workflow.5


Data synchronization solutions have been used widely in healthcare and are typically the first use of wire-less because of the low cost to implement and the wide range of applications that deliver immediate valueto the organization.

Overview of Mobile Computing Devices Although there are many products on the market, handheld devices fall into several categories, eachwith specific capabilities and options. Because the handheld device is the link between the end userand the data, it is important to understand its functionality, limitations, and enhancements to setexpectations and plan for effective use.

The following table provides a high-level summary of these characteristics. For more information ondevices and operating systems, please refer to Appendix A for reference web sites.


Table 1: Mobile Computing Devices

Current Technology IssuesEven though wireless technology is maturing at a rapid rate, there are still real technical issues thatstand in the way of widespread adoption. Good decisions about current technology need to be basedon realistic understanding about its performance and how limitations can be addressed.


Future Direction for Mobile ComputingIn the next year expect to see continued growth in wireless technology, device capabilities, and appli-cation development that takes advantage of both. Emerging device functionality such as video con-ferencing, voice recognition, cameras, language translators and printer attachments will becomemainstream. Wireless and mobile computing is just starting to enter the realm of medical diagnosticsand delivery of care, with solutions ranging from an artificial pancreas, diagnostic wristwatches forcystic fibrosis, and “swallowable” cameras.6

On the infrastructure side, the issues of speed, interference, and standards are aggressively beingaddressed with a focus of bringing access to both data and voice communication through the sametechnology.

MOBILE COMPUTING APPLICATIONS

Overview There is currently both excitement and confusion in the mobile computing application market forhealthcare. Successes have taken mobile computing beyond the fad stage for both inpatient and out-patient settings, however they point to automating specific tasks within a process, not the entireprocess.

Scarce capital funding has been real barrier for mobile computing. Both health care delivery organi-zation and physician practices are scrutinizing all spending to make sure there are measurable andachievable benefits, leaving little funding for leading edge information technology projects. The endresult in today’s marketplace is few vendors have achieved profitability or gained a critical mass ofusers.

The initial mobile computing applications for healthcare were reference tools that allowed clinicianseasy access to information such as guidelines, medical literature, or drug information databases. Thencame transaction-based systems, which automate specific clinical and business tasks such as chargecapture and prescription writing. The other avenue for mobile computing is as an extension of a totalHospital Information Systems (HIS) or practice management system. The mobile computing devicein this case can provide both HIS access and specific mobile computing functionality. The next stepin the evolution of mobile computing products is to provide multiple integrated applications on a sin-gle device, which is underway now.

Niche Mobile Computing ApplicationsThe major categories of niche mobile computing applications on the market include the followingsystems:

Prescription Writing is one of the most popular mobile computing applications in ambulatorycare. Using a PDA or pocket PC instead of a prescription pad, physicians can generate prescrip-tions simply by clicking on the patient, medication, and dose. Many e-prescribing tools can alsocheck the prescriptions for interactions and allergic reactions and transmit the prescriptiondirectly to the pharmacy. Advancements for e-prescribing tools are likely to develop rapidly asmore products provide better integration with patient data and resolve data transmission issues.

Another of the most successful mobile computing applications today is Charge Capture andCoding. These tools can be used for both inpatient and outpatient care. With the benefit of mobil-ity, physicians and other care providers can record necessary information at the point of careinstead of after-the-fact. The manual index card systems for recording charges is replaced with anautomated mobile charge capture and coding tool that also helps physicians comply with complexpayer rules, especially in the ambulatory setting. These applications can have a positive financialimpact by capturing more accurate and complete information about diagnoses, procedures, andother care-related services.

Lab Order Entry/ Results Reporting applications allow users to order lab tests and view results atthe point of care. These applications are most often found in the inpatient setting. Lab order entryoffers physicians the benefit of streamlining the ordering process; results reporting allows them toaccess this often-critical patient information anytime, anywhere. Because Lab OrderEntry/Results Reporting requires real-time interfacing with existing ordering and resulting sys-tems, successes have been limited to a few vendors who have either partnered with well-knowntraditional vendors or added integrating tools to their products.

Litigation, accreditation, payment requirements, and regulatory compliance are increasing theneed for Clinical Documentation applications in care delivery settings. Clinical documentationtools include a wide range of functionality from basic notes templates on a PDA to the entire clin-ical document displayed on a laptop, but they all help clinicians organize and track patient infor-mation from one encounter to the next. Most mobile computing products in the group for inpatient


care are focused on nursing documentation. Applications for physicians in the ambulatory settingare currently supported by only a few mobile computing vendors.

Alert messaging and communication tools are gaining ground in inpatient care delivery. Thesetools go beyond the pagers long used by on-call physicians, often allowing them to receive testresults and send messages as well. The challenge for these products today is the ability to deliverysecure, non-interrupted messages.

Clinical Decision Support (CDS) capabilities assist the clinician in determining and deliveringthe correct therapy or intervention for a given patient based upon a combination of patient-specificinformation and knowledge bases. Common clinical decision support offerings are stand-alonereference tools, such as medical computations or drug databases, which have gained popularity onmobile devices. Integrating patient specific data such as medications and lab results with the CDStools will provide more significant alerts and reminders for the mobile caregiver.

Mobile computing to support patient medication processes can be found in both the inpatient andoutpatient settings. Although inpatient physician ordering via mobile computing is still uncom-mon, mobile Medication Administration systems for nurses offer both advantages to documenta-tion and potential error reduction when combined with bar-coding technology.

For more information, Appendix B includes a table of representative vendors, their mobile computingproducts, and Web site and contact information. Additionally, Appendix C has references to relatedmobile computing application articles.

As the mobile computing applications listed above illustrate, they can be used in both the inpatientand outpatient settings, though most applications are designed initially for one and then modified tobe useful in the other.

Current Marketplace for Inpatient Care ApplicationsIn hospitals today, mobile computing is used in one of two ways:

1. Multi-function wireless LAN solutions implemented throughout the hospital, typically using oneof the larger mobile computing devices (e.g. laptop or tablet)

2. Caregivers and administrative staff using small handheld devices (e.g. PDA) to automate a singlefunction or several related functions

In the first case, these solutions support complex processing, a high level of integration, and real-timeaccess to data from multiple sources. They are mobile extensions of the traditional HospitalInformation System (HIS). Some of the most popular inpatient applications are bedside charting,Emergency Room documentation, and remote access to data for physicians.7

For many hospitals, the risk, complexity and costs are too high to jump into a high-end wireless solu-tion right now. Inpatient applications that support single functionality (such as charge entry or refer-ence data access that have little integration with the HIS) are an attractive way to experiment withwireless. While these applications solve a specific need for data and usually only require a PDA andperiodic synchronization, the biggest drawbacks are the proliferation of devices supporting uniquefunctions and the lack of data sharing. Examples of this second category include visit code and chargecapture, clinical documentation, and results display.

Future Trends and Directions for Inpatient Care Applications:Mobile solutions for inpatient clinical computing are likely to be offered by traditional HIS vendorswho will partner with wireless technology providers and mobile computing vendors. Wireless LANswill become increasingly common as the cost of deploying them decreases and integration acrossapplications improves. Increased documentation requirements, concern over patient safety, and theproliferation of wireless LAN technology in general will drive adoption. Applications that started outperforming only one function are now adding more capabilities to build market share and adoption.

Current Marketplace for Outpatient Care Applications Mobile computing in the outpatient setting is focused primarily on physician use. Handheld devicesand mobile computing seem ideally suited to the physician practice since physicians often spend theirwhole day moving from exam rooms to offices and back and need ubiquitous access to clinical data.Mobile computing also avoids the cost of hardwiring many physician offices and exam rooms

In the physician office, “off-line” mobile devices that use batch synchronization of data are most com-mon. As mobile computing catches on, physicians—particularly those in large practices—are begin-ning to invest in wireless LANs. A snapshot of the current market shows the following characteristics:

• Applications that automate specific point-of-care processes such as prescription writing andcharge capture.


• Limited functionality and very limited integration with other systems.

• Partnerships and acquisitions among wireless and traditional vendors.

• New business relationships among software vendors, pharmaceutical firms, health plans and otherhealthcare organizations to sponsor mobile or handheld computing for physicians.

• Low but increasing adoption rates of mobile computing applications among clinicians

The primary benefit that these products bring is computer application mobility; whatever the particu-lar capability, physicians can access the application and do their work, anytime, anywhere. Otherpotential advantages of using mobile computing applications include decreased paperwork, increasedrevenue and collections, decreased rework, easier communications, and access to administrative andmedical information (e.g. formularies, schedules).

Trends and Future Direction for Outpatient Care ApplicationsDespite the barriers, the number of clinician users of mobile computing is increasing and expected tocontinue growing. Vendors will continue to address integration issues and increase functionality throughinternal development and by building business alignments with strong partners from among more tradi-tional ambulatory medical record (AMR) and billing system vendors who have established clients. Thuswireless technology will provide the mobile extension to the electronic records, providing physicianswith documentation and access to patient data at the point of care. The other area that shows great poten-tial for outpatient mobile computing is home health services, where visiting nurses need to recordpatient charges, document clinical findings, and have access to medical reference information.

IMPLEMENTING MOBILE COMPUTING

Under what circumstances does mobile computing provide the best computer application option forphysicians and healthcare organizations? Should it involve a wireless LAN or the Internet? What arethe unique technical issues, regulatory requirements, risks and implementations approaches formobile computing?

To answer these questions requires a clear understanding of the opportunities and challenges ofmobile computing in general, and most importantly how the mobile technology solution solves a par-ticular business problem and fits into the workplace. Addressing the “how” determines the people,process and technology changes that will make the introduction of mobile computing successful. Thefollowing section provides a brief overview of the “how.” For more specific information, a good placeto start is to visit mobile computing vendor Web sites. Many offer white papers and case studies thatdescribe how specific products were installed and the benefits achieved.

Understand the Unique Capabilities of Mobile Computing during Selection“What can mobile computing do that traditional applications cannot do to solve a business problem?”The answer should indicate that the problem could only be addressed by putting technology into thehands of users who must have mobility. The only advantage of mobile computing over traditionalsystems at this point is “portability, ” i.e., access to data and functions anywhere.

In addition to financial benefits, recent mobile computing implementations have identified quantita-tive and qualitative benefits in the areas of improved workflow, decreased manual tasks, decreasedpatient and clinician wait times, and improved clinical documentation. Specific cases can be found inliterature and on product Web sites. For example, one electronic prescribing vendor showed savingsof as much as $3.20 per prescription when comparing paper and electronic prescriptions.8 In anotherinstance, an orthopedic practice showed a 577% return on investment by using a mobile computingcharge capture application.9

By following this business value approach, organizations will have a good understanding of the pri-mary benefits they expect to achieve with a particular mobile computing application. Once a businesscase for mobile computing has been made, then specific technology, regulatory and risk considera-tions must be addressed and integrated into the implementation plan.

Addressing the Electromagnetic Interference (EMI) IssueIn hospital settings, many patient monitoring devices use radio frequency (RF) technology to transmitinformation from the portable monitor to the central display station, allowing the patient more freedomof movement. Now that more clinicians, other staff, and visitors to the hospital are using wireless mobilecomputing and handheld devices, there is concern that the signals from these devices may interfere withthe signals of telemetry equipment, causing malfunctions and potentially harm to the patient.

Different radio frequency devices used in the same area can cause interference and malfunction.However, the likelihood of interference is based on the closeness of the two frequency ranges and the


physical distance between the devices. For example, many wireless LAN-supported devices (e.g.wireless laptops supporting an EMR) operate in the 2.4GHz frequency range. Cellular and smartphones operate in the 800 MHz and 1800-1900 MHz frequency ranges. Finally, telemetry and moni-toring devices operate anywhere in the range set aside for medical equipment, but most operate in thelower end. Therefore, the most likely problem with EMI is between cellular phones and medicalequipment, however there is always a potential for interference between monitors and wireless LANaccess points that are in very close proximity.

Currently, the best way to address the EMI problem is for an organization’s Biomedical EngineeringDepartment to conduct controlled tests with the specific devices and RF medical equipment in a labsetting. The longer-term solution to the EMI problem is to separate the frequency ranges for the dif-ferent devices and have guidelines for electromagnetic compatibility (EMC). The FDA and FCC areworking with vendors to set up such frequency use standards. It will take some time, however, forvendors to migrate their telemetry products to the new frequencies, so organizations should alwaystest for interference in a lab setting.

HIPAA and Other Regulatory ConsiderationsOrganizations adopting mobile computing need to address the security and patient privacy require-ments of the Health Insurance Portability and Accountability Act (commonly referred to as“HIPAA”) in a manner consistent with technology, policy, and procedures for patient-identifiableinformation delivered electronically by any other device. This includes policies and procedures forhardware and software installation and maintenance, security features, and security testing.

The biggest HIPAA related issue for mobile computing is also its biggest advantage: “portability” ofpatient data. Unlike fixed desktop workstations, small mobile computing devices are at much greaterrisk for theft and loss. And along with the device goes potentially confidential patient data. Whilevendors need to be able to address requirements related to code sets, encryption, privacy, and audittrails, organizations need to manage the devices and the data. For mobile access-only devices, whichare typically browser-based solutions, HIPAA user authentication policies apply. Authentication canbe a user ID and password or include more advanced multi-tier methods. Those devices that also storepatient data need to comply with privacy and confidentiality HIPAA standards. Using data encryptionmethods and setting device storage cache settings off are current best practices for managing thesemobile computing devices.

The Wireless LAN that provides data transport can be secured from unauthorized access by using astandard encryption method such as Wired Equivalent Privacy (WEP), and other enhanced safeguardmeasures. These measures include:

• Include encryption by higher level protocols such as the IP Security Protocol (IPSec)

• Set the encryption level on the wireless cards to the highest level—128 bit

• Configure Windows File and Print sharing carefully with passwords or turn them off

• Use a personal firewall

• Make sure anti-virus software is up to date

HIPAA is not the only regulatory requirement to consider. Since HIPAA does not preempt more strin-gent state laws governing medical privacy, organizations must take into account these laws as well.For information on the Administrative Simplification rules of HIPAA, organizations can refer tohttp://aspe.hhs.gov/admnsimp/Index.htm.

Implementation ConsiderationsThe following implementation considerations, based on experiences in recent mobile computingprojects, should help projects move more smoothly.

1. Understand the Risks Risks with newer technologies and first generation applications from new vendors are more sub-stantial that typically seen for traditional healthcare systems. Consider the impact on workflow,the technology staffing needs for implementation and support, and the stability of the vendor inthe marketplace.

2. Understand the integration of workflow, information flow, and technologyUnderstanding the points at which technology is used and the information that will be collected ordisplayed for the end user will lead to a clear map of the necessary changes in the current processand how workflows and roles will be affected by this new applications. In many projects, imple-menting the changes in process can be far more challenging than installing the new technology.


3. Set User ExpectationsWith all the hype, misuse and interchange of the terms wireless and mobile, project leaders musttake the time to understand, document and set expectations regarding what functionality and whattechnology is being implemented.

4. Learn from ExperienceCombing the health industry trade press, networking with contacts in other organizations, andperforming a literature search will provide organizations with valuable insight into how the tech-nology works on the ground. Useful starting points include product, vendor, and organization websites.

5. Pilot the applicationOne big advantage with mobile computing is that piloting is possible. The cost for the handhelddevices, software, and basic data synchronization interfacing is very low, especially if the vendoris willing to partner with the organization to gain experience with implementations and gain ref-erence sites. By starting small, both sponsors and users get a clear understanding of how mobilecomputing impacts the work environment.

ConclusionsMobile computing applications and the use of wireless technologies in healthcare has seen a greatdeal of growth and expansion of capabilities. On the technology side, the acceptance of the Internet,the explosion of wireless devices with promised greater functionality and the decreasing costs allpoint towards continued development of more robust applications. Though these developments willincrease the adoption, careful selection and implementation will improve acceptance and increasevalue to the care providers and the healthcare organization.

REFERENCES1 “Internet User Will Surpass 1 Billion in 20005.” eTForecasts, www.etforecasts.com, (February 6,

2001).

2 “WAP, not Web: 95 Million Browser Handsets in 2004, Marketers Must Resist Imposing WebModels on Mobile Access.” Jupiter Media Metrix, www.jup.com, (August 15, 2000).

3 “Wireless LANs Almost Ready for Widescale Adoption” InformationWeek.com,www.iweek.com, (November 14, 2000).

4 “Wireless LANs Almost Ready for Widescale Adoption. ” InformationWeek.com,www.iweek.com, (November 13, 2000).

5 Personal communication with Kathy Lindale, director of respiratory therapy at Banner Health.

6 “Future Tech Devices: The Information Chain Gets Personal.” Healthcare Informatics,www.healthcare-informatics.com, (September, 2001)

7 HIS Insider Weekly. (February 26, 2001).

8 “TouchScript Solution Drives Managed Care Savings.” Allscripts, www.allscriptsts.com,(October 2000)

9 “Mobile Charge Capture Service Helps One Orthopaedic Practice Reclaim $82,364.”MDeverywhere, www.mdeverywhere.com, (October 12, 2000).


APPENDIX A


Table 1: Reference Web Sites

APPENDIX B


Table 2: Representative Mobile Computing Vendors and Products

APPENDIX C ADDITIONAL READING

1. “A Show of Handhelds.” Healthcare Informatics, www.healthcare-informatics.com, (April 2001)

2. “Colleagues Rate the Leading Software.” Medical Economics, www.memag.com, (October 23,2000)

3. “Continuity of Kids’ Care.” Health Data Management, (April 2001)

4. “High Wireless Act.” CIO Magazine, www.cio.com (July 15, 2000)

5. “Physicians and the Internet: Taking the Pulse.” Hospitals and Health Networks, (February 2001)

6. “Planning a Wireless Future” a series of articles on wireless, Health Management Technology,www.healthmgttech.com, (August 2001)

7. “Put a Computer in your Pocket and Change your Life.” Medical Economics, www.memag.com,(October 23, 2000)

8. “Techniques for Identifying the Applicability of New Information Management Technologies inthe Clinical Setting: An Example Focusing on Handheld Computers.” Proceedings of the 2000AMIA Annual Symposium. Journal of the American Medical Informatics Society SymposiumSupplement.

9. “The Cure is in Hand.” WR Hambrecht & Co. (October 2000)

10. “Your Ticket to Fast, Flawless Prescribing.” Medical Economics, www.memag.com, (October23, 2000)


Table 2: (continued)

AUTHOR BIOGRAPHIES

Fran Turisco, BA—Mathematical Engineering, The Johns Hopkins University, MBA—HealthcareAdministration and Finance, University of Chicago Graduate School of Business. Director, EmergingPractices for First Consulting Group. Responsible for research, publication and consulting on emerg-ing technologies and healthcare applications. Fran has written articles and given presentations onmobile computing, CPOE and Enterprise Architecture and Clinical Integration.

Paul Steinichen, BS—Electrical Engineering, Georgia Institute of Technology, MS—IndustrialElectronics and Computers, U of Miami.Vice President, Enterprise Technology Services for FirstConsulting Group. Provides leadership and technical expertise for the development and implementa-tion of Internet/Intranet architecture services for health delivery and health plans. Has written articlesand technical papers on network technologies and enterprise application integration. Paul is a mem-ber of IEEE, Engineering in Medicine and Biology Society and MS-HUG.


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Understanding the Wireless Technology and Mobile …...mobile computing device to the site’s information system through a docking cradle wired to the LAN. However, since the end