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Up close and personal

by ArabianBusiness.com = staff=20 writer on Wednesday, 13 February 2008=20

zoom

Once the realm of the business executive, personal digital assistants = now=20 look as at home on the ward as in the boardroom. From point-of-care = support to=20 e-prescribing, argues Khaled El Emam, an associate professor at the = University=20 of Ottawa and the Canada Research Chair in electronic health = information, PDAs=20 are helping physicians practice more efficiently.

El Emam = develops=20 electronic data management systems for clinical research and has watched = a=20 frosty market steadily thaw towards handheld systems. When PDAs first = entered=20 the market it was mainly for administrative tasks - for billing = purposes,=20 contacts list," El Emam observes.

For=20 paper to disappear the whole cycle will have to be automated, which = would take a=20 long time. But that=E2=80=99s the direction we are going = [in].

The next set of applications included what I would call reference = tools, such=20 as drug references, medical encyclopedias - but they are essentially = read-only.=20 More recently, though, there have been applications that will help us = collect=20 information about patients." El Emam argues that modern medicine bases = itself on=20 evidence, and handheld technology is in the best possible position (the=20 physician's pocket) to collect immediate, accurate patient data.

Story=20 continues below =E2=86=93=20

According to market information, PDAs now enjoy = adoption=20 rates of around 60-80% in North America, although El Emam concedes that = the=20 figure is weighted more heavily towards administrative tasks.

If = you look=20 at the other types of use then the adoption rates will be smaller - also = a lot=20 of the data does not differentiate between personal and professional = use."=20 Nevertheless, the use of PDAs in healthcare has never been greater and = industry=20 insiders like El Emam predict the future is digital. "For paper to = disappear the=20 whole cycle will have to be automated, which would take a long time, but = that's=20 the direction we are going."

Handheld=20 healing

Motorola Enterprise Mobility supplies rugged = PDAs to the=20 healthcare market. As well as the traditional handhelds, Motorola has = recently=20 launched the CA50, a voice over internet protocol (VoIP)-enabled = wireless=20 scanner. The product is a pared-down version of PDA technology and can = be used=20 as a portable communication and data tool for hospital staff. When even = hospital=20 orderlies have gone handheld, you know that healthcare is beginning to = embrace=20 mobile technology.

"A hospital is a very mobile environment - not = a lot=20 of people sit at their desks," reasons Tarek Hassaniyeh, channel manager = for the=20 Enterprise Middle East division. He believes that the plethora of = healthcare=20 projects currently under construction represent a golden opportunity for = handhelds to get a grasp on the regional market. "There has been a lot = of=20 investment in healthcare systems here and they are really looking to = mobilise=20 their workforce"

While Motorola's Hassaniyeh agrees with El Emam = that=20 mobile technology is yet to fully establish itself, he believes we are=20 approaching a digital dawn in healthcare. "I don't believe these = technologies=20 have become standard yet, but I think they will in the next two to three = years.

Keeping up with the doses

Doctors = are=20 notoriously slow to embrace technology, and introducing a PDA into the = workflow=20 can be a labour-intensive exercise. The unit cost of the devices = themselves is=20 negligible when compared to most medical equipment, but PDA proficiency = does not=20 happen overnight. If you are determined to use handheld technology for = admin,=20 referencing and data entry, it will inevitably add valuable time to your = procedures in the short term.

"If physicians have to bill = according to=20 the number of patients they see in a day then that becomes a pretty = tricky=20 selling point," says El Elam. The solution is to introduce PDAs from the = start=20 of medical training, and the more progressive medical universities now = consider=20 them an essential tool, claims El Elam.

If they have been using = these=20 tools since they were in med school, then their workflow has already = been=20 adapted and they can learn new things easily - change is always hard and = it can=20 be difficult to move with the times.

While techniques might be = tried and=20 tested, medical knowledge is swelling at a prodigious rate. If senior = physicians=20 wish to retain their authority, it is imperative they stay up to date - = and a=20 PDA provides one of the simplest ways to do so.

Keeping up with = the=20 amount of information that is out there is almost impossible," explains = El Elam.=20 "PDAs can be successfully used for looking up dosage information for = drugs or=20 for best available evidence for a certain sort of symptom, or=20 condition.

Hand me downs

Information at = your=20 fingertips should not be a privilege reserved solely for doctors, argues = Sylvia=20 Suszka, editor of pdacortex.com, a website dedicated to resources for = PDAs in=20 healthcare, with an emphasis on nursing. "We saw that doctors were using = them=20 and we thought - what about nurses?

Nurses regularly have to = consult=20 reference material to and mistakes or outdated information can be = lethal.=20 "Nurses have been using PDAs for the referencing, because staying = updated about=20 the drugs can be very timely," she explains. "The big vendors update = their=20 systems every month or so and that makes a big = difference.

Hospitals will=20 usually have a collection of printed reference texts available for = nursing staff=20 but Suzka complains that they are usually four or five years out of = date.=20 Lengthy printing turnarounds mean that even the newest guides can be as = much as=20 12 months behind their online counterparts. Suzka believes that PDAs = with=20 digital libraries would be the most cost-efficient way to keep nursing = staff at=20 the clinical cutting edge. Unfortunately, her employers do not=20 agree.

Nurses in the US are left having to purchase our own = handsets,"=20 she complains. "Our healthcare organisations are not willing to do that = at the=20 moment - they will for their doctors, but not for staff nurses." =

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