1. Exploring Digital / Wireless Application In Healthcare Presentation of Research Mohammad Al-Ubaydli, M.D. December 3, 2007

2. 2007 The Advisory Board Company Roadmap for Discussion I. Introductions and Definitions II. Scholarship Sponsored by Epocrates III. VCU Hospital: Admissions and Billing IV. Refining the Medication Reconciliation Process 3. Introductions and Definitions I 4. Introductions

The Advisory Board Company

IT Insights team

Mohammad Al-Ubaydli

• Doctor, University of Cambridge

• Programmer, National Center for Biotechnology Information

• Management Consultant, The Advisory Board Company

2007 The Advisory Board Company 5. Definitions 2007 The Advisory Board Company Addition, not Replacement

Handheld computer: a computer small enough to hold in your hand

Personal Digital Assistant (PDA): a handheld computer

Smartphone: a handheld computer that can make telephone calls

Mobility: small form factor and long battery life

Connectivity: cellular, WiFi, infra-red

Ubiquity: every clinician already knows how to use their phone

Doctors Dream Device 6. Scholarships Sponsored by Epocrates II 7. Avoiding the Mistakes of Others

The challenge

At the start of 2006 there were over 600 papers in PubMed that dealt with handheld computers. Many lessons have accumulated in the clinical literature but we need to understand and assimilate these lessons.

The challenge is to provide these lessons as peer-reviewed and unbiased summaries based on scientific fact, not marketing hype.

The Scholarships

Five exceptional students from around the world will be selected each year to review selected literature and make summary reports that will be published in theMobile Medical Computing Reviewsjournal. The Scholarship winners will be mentored and trained by Dr. Mohammad Al-Ubaydli, author of four books, including Handheld Computers for Doctors.

The results

Once complete, the reviews will be published and freely available through the website of the new journalMobile Medical Computing Reviews . Each student will be able to quote their own reviews in their list of publications.

www.handheldsfordoctors.com/research

2007 The Advisory Board Company 8. 2007 The Advisory Board Company Teaching Tomorrows Teachers Dr.Yunan Chen , China Dr.Adesina Iluyemi , Nigeria PhD candidate at Drexel University PhD candidate at University of Portsmouth Dr.Emily MacDonald , UK Joshua McAllister , USA Dr.Devashish Saini , India Medical Student at University of Cambridge Medical Student at University of Texas Medical Branch Resuscitation Sciences Fellow at University of Alabama at Birmingham 9. 2007 The Advisory Board Company 10. 2007 The Advisory Board Company Teaching Tomorrows Teachers Dr.Mina Hafzalah,IraqDr.Craig Huang , USA Completing a fellowship in Pediatric Critical Care at the University of Chicago Professor, Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, Texas Dr.Mizna Murza , Pakistan Dr.Alfonso Rodriguez-Morales , Venezuela Dr.Iman Tavassoly , Iran Completing a Public Health Informatics Fellowship at the Centers for Disease Control and Prevention, Atlanta, GA PhD candidate at the Tropical Medicine Institute, Central University of Venezuela Resident at the Mehran Health Network, Ilam University of Medical Sciences, Ilam, Iran 11. Matching the Wireless Device to Clinical Needs III 12. Success on the Move 2007 The Advisory Board Company

VCU Health System

779-bed academic medical center

Located in Richmond, VA

Physicians perform electronic charge capture and review clinical results with PocketPC (Treo) Smartphones

Successful only after failed attempts with PocketPC PDAs and Palm OS Smartphones

$800,000 annualized revenue for 1 department from: missing charge rate 15.7% --> 0.07% and charges within 10 days 25% --> 90%

Will deploy to 600 physicians after the success of the pilot with 40 physicians

Case in Brief

Software on smartphone includes:

Patientkeeper integrating with Cerner EMR

UpToDate medical reference

SPB Software and integrating with corporate contacts

Google Maps, local weather

Show missed pages

Infrastructure

Secure VPN tunnel through Sprint PCS

Remote PocketPC monitoring through MobiControl

Lotus Notes to PocketPC via iAnywhere

13. Pocket PC PDA Confusing to Clinicians 2007 The Advisory Board Company Pocket PCs connect to Wi-Fi WiFi network available throughout hospital.

Reconnecting to different wireless stations around the hospital too complicated

Battery life too low because of Wi-Fi usage and failure to recharge would lead to cumbersome reinstallation of software

Physicians refused to use devices

Project Almost Abandoned 14. Palm OS Smartphone Lacked Multitasking 2007 The Advisory Board Company

Palm operating system does not have multi-tasking

Physician must log into electronic medical record and e-mail software

Switching to application expires authentication of previous application

Clinical work relies on constant switching between tasks

Switching Too Cumbersome Treo Smartphones with Palm Operating System Promising Friendly user interface and constant connectivity through cellular network Log into EMR Log into EMR Log into e-mail 15. Refining the Medication Reconciliation Process IV 16. Nurses Perceptions Slowing Adoption of Bar Coding 2007 The Advisory Board Company 17. Striking a balance 2007 The Advisory Board Company 18. Combining the Best of Both Worlds 2007 The Advisory Board Company 19. Raising Awareness, Reducing Errors 2007 The Advisory Board Company 20. Avoiding the Mistakes of Others

www.handheldsfordoctors.com/research

Mohammad Al-Ubaydli, MD

[email_address]

202-266-5425

2007 The Advisory Board Company