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Handhelds in healthcare: benefits of content at the point of care Jackie Cahoon NHS Partnership

Handhelds in healthcare: benefits of content at the point of care Jackie Cahoon NHS Partnership Development Manager. 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

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Handhelds in healthcare: benefits of content at the point of care Jackie Cahoon NHS Partnership

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  1. Handhelds in healthcare: benefits of content at the point of care Jackie Cahoon NHS Partnership Development Manager

  2. 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

  3. Presentation outline Introduction to mobile technologies in healthcare Applications currently available Content applications Case study: Ovid@ Hand The future

  4. Why mobile? • 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

  5. 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

  6. 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

  7. 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

  8. The advantages of handhelds in healthcare • Price • Size • Time • Real point-of-care utility • Potential for revolution with EPR

  9. Presentation outline Introduction to mobile technologies in healthcare Applications currently available Content applications Case study: Ovid@ Hand The future

  10. Popular applications in healthcare • Medical calculators • Patient management tools • E.g. patient tracking, booking • Most EPR vendors have PDA initiatives • Electronic prescription management - messaging to pharmacy

  11. Popular applications in healthcare • 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!)

  12. 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 )

  13. 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

  14. 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

  15. Presentation outline Introduction to mobile technologies in healthcare Applications currently available Content applications Case study: Ovid@ Hand The future

  16. 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

  17. Handheldmed.com’s top sellers

  18. 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

  19. 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

  20. 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!

  21. 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

  22. Ovid@Hand

  23. Ovid@Hand

  24. Journals tables of contents and abstracts New content indicated clearly (*) Submit questions and conduct searches

  25. Article ordering Browse through records Easily and automatically upload articles

  26. Searches are automatically uploaded to “MyLibrary” when you hotsync View abstracts, citations and full text, or link to related articles Click “Search Ovid” to execute your stored search

  27. Question-capture Select a database Attach references or notes Enter ‘smart search’

  28. 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

  29. Presentation outline Introduction to mobile technologies in healthcare Applications currently available Content applications Case study: Ovid@ Hand The future

  30. 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

  31. 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

  32. More information: www.pdamd.com www.handheldmed.com www.med.virginia.edu/hs-library/pda/home.html www.mclibrary.duke.edu/respub/pdaformat/ www.ovid.com/products/hand www.med-mobile.org jcahoon@ovid.com

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