Download - Handhelds in healthcare: benefits of content at the point of care Jackie Cahoon NHS Partnership
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Handhelds in healthcare: benefits of content at the point of care
Jackie CahoonNHS Partnership Development Manager
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Who am I? What am I doing here?
New position
Somewhere between business development and market research
Ovid resources now available to all NHS staff in UK
Increasing need for integration with NHS KM/information initiatives
Responsible for communications with all NHS stakeholders:– Librarians
– IM&T staff
– Clinical managers
– Clinical effectiveness
– Education
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Presentation outline
Introduction to mobile technologies in healthcare
Applications currently available
Content applications
Case study: Ovid@ Hand
The future
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Why mobile?
1. Healthcare professions highly mobile -
Clinician sees one patient every 7-9 mins, with 2 mins travel between*
For every 10 patients seen, 1-5 questions arise requiring information*
Ely, Osheroff Analysis of questions asked by family doctors regarding patient care BMJ 1999 319: 358-361
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Why mobile?
2. Medicine and healthcare are information intensive -
Patient notes and test results
Personal notes and records
Evidence and guidance to support treatment and management decisions
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PDA popularity in the US
Doctors using PDAs doubled 99-01
ACP American Soc. Of Internal Medicine survey 2001:
47% of members using PDAs
67% (expected) by end of 2002
ePocarates qRx been used by 200,000 physicians since 1999
ePocrates second product (qID) took 9 weeks to achieve same user levels as qRx which took 9 months
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Operating systems
US – 79% PALM OS
– 12% Pocket PC
Europe– 43% PALM OS
– 28% PocketPC
PocketPC richer colour, more memory, more powerful
PALM OS used by innovative Sony, Handspring
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The advantages of handhelds in healthcare
Price
Size
Time
Real point-of-care utility
Potential for revolution with EPR
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Presentation outline
Introduction to mobile technologies in healthcare
Applications currently available
Content applications
Case study: Ovid@ Hand
The future
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Popular applications in healthcare
1. Medical calculators
2. Patient management tools
– E.g. patient tracking, booking
– Most EPR vendors have PDA initiatives
3. Electronic prescription management
- messaging to pharmacy
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Popular applications in healthcare
4. Content reference
Majority of tools content related
Point-of-care availability
Quicker than print look-up
Review content especially PDA friendly
ePocrates most popular single resource (still free!)
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Calculators – an example
Palm MedCalc - more than 64 formulas e.g.
Alveolo-arterial O2 gradient
Anion gap
Bayes theorem
Body mass index
Corrected calcium ( albumine et proteins )
Corrected QT Corrected sodium ( glucose, proteins and lipids )
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Patient management
e.g. Patient Keeper Personal
admission diagnoses
patient histories
daily progress notes, and lab results
set alarms for reminders
use pop-up lists, check-boxes, and multiple-choice for data entry
beam patient information to others using a Palm OS-based device with an infrared port
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Some trial sites in the UK
Cambridge University – student access to course materials, clinical ‘nuglets’
Surrey Ambulance Trust– Realtime patient tracking and advice system
Salford Royal Hospitals– PDA diaries
Chelsea & Westminster– trialing tablets
Queen’s hospital, Burton on Trent– PDAs is use as part of Electronic Prescribing pilot
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Presentation outline
Introduction to mobile technologies in healthcare
Applications currently available
Content applications
Case study: Ovid@ Hand
The future
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Content applications
Healthcare content marketplace big
Old and new players, and lots of amateurs
PDA ideal for quick reference information
e.g. drug handbooks, treatment guidelines
Content providers struggling with current limitations
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Handheldmed.com’s top sellers
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The value of content at the point of care
Sackett’s evidence cart experiment– 16 questions answered in time it took to visit library
– Availability of evidence sources affected their use
IOM’s report To Err is Human 2000– Medical errors one of the US’s biggest causes of death
– Preventable healthcare errors cost the economy $17-$29 billion p.a.
BMJ editorial March, 2001
– Medical errors lead to 3 million extra bed days per year in England and Wales, costing £1bn 2
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Content considerations for handheld delivery
Memory limitations
Screen size
PDA and desktop combo?
- appropriate info. chunks pushed to PDA
- bulk content storage on internet servers
- query and review at point-of-care
- management and digest via desktop
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Case study – Ovid@ Hand
Why handhelds for Ovid?
web content now available when required/appropriate
integration with clinical workflow
opportunity to work with development partner (Unbound Medicine)
40% of US physicians using PDAs!
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Case study – Ovid@ Hand
Features of Ovid@ Hand:
Journal TOCs and abstracts – user sets preferences
A-Z Drug Facts - downloaded to device
Medline question-capture ‘on the go’ (smartsearch technology)
PALM OS now, Windows CE later in 2002
Web-based ‘personal library’ for doc. management and link-up with Ovid Online
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Ovid@Hand
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Ovid@Hand
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Journals tables of contents and abstracts
New content indicated clearly (*)
Submit questions
and conduct searches
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Article ordering
Easily and automatically
upload articles
Browse through records
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Searches are automatically uploaded to
“MyLibrary” when you hotsync
Click “Search Ovid” to execute your stored search
View abstracts, citations and full
text, or link to related
articles
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Question-capture
Select a database
Enter ‘smart search’
Attach references or
notes
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How to get Ovid@ Hand
User must be affiliated with institution subscribing to Ovid journals
User registers for Ovid@ Hand
Selects journal titles for PDA access
Downloads software
Follows installation process
Syncs and goes
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Presentation outline
Introduction to mobile technologies in healthcare
Applications currently available
Content applications
Case study: Ovid@ Hand
The future
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Some bets for the near future
Clinical PDA use in UK will explode in 2 years
Why? -– WLAN
– UK EHR programme
– Broadband LANs
Phone/PDAs likely to dominate European market (but tablets may take over in hospital setting)
Security issues will not hold back this development
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Some bets for the near future
Student doctors will be issued with handheld devices as standard
Handwriting and voice recognition will become standard
Publishers and info. providers will customise for mobile world
New content types and intermediary services will appear
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More information:
www.pdamd.comwww.handheldmed.com
www.med.virginia.edu/hs-library/pda/home.html
www.mclibrary.duke.edu/respub/pdaformat/
www.ovid.com/products/handwww.med-mobile.org