Mobile Content Goes to the Doctor

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Perhaps no group of workers (along with intelligence and law enforcement) needs quicker access to accurate, current information than medical professionals. So it comes as little surprise that the medical community has been among the early adopters of mobile content. For a number of years, physicians have been carrying Personal Digital Assistants (PDAs) with different types of content including contact information, schedules, medical references such as the Physician's Desk Reference (PDR), and drug interaction information. To some extent, members of the medical community have been doing this independently of the medical organizations where they work, though mobile is becoming part of the fabric of the way the medical business gets things done.

As the medical enterprise begins to embrace the PDA, organizations are deploying mobile applications that tie directly into the medical information infrastructure, allowing personnel to access more specific patient content such as admissions information, lab results, and prescription histories. What's more, medical professionals can use the PDA to enter charge information on the spot, providing a convenient and reliable way to capture chargebacks. This article looks at some of the ways medical professionals are using PDAs on the job.

Advice at your Fingertips
First and foremost, physicians (and other medical professionals) love the convenience of having information at their fingertips in a device that fits in their pockets. Alex Slawsby, research analyst for Mobile Devices at IDC says, "The devices are approachable, relatively inexpensive, and doctors very much enjoy having a lot of data and reference material, and also having an easy way to input information, at their finger tips."

To date, the Palm remains the device of choice, but Dr. John Halamka, who is CIO at both Harvard Medical School and CareGroup Healthcare says that while Palm is the clear favorite, devices running Windows CE are making inroads, and people in his facilities are using a variety of devices. "What's interesting, although it's true we're seeing a tipping point of doctors going more to Windows CE devices, the Palm OS still has mindshare." Halamka attributes this to a couple of factors. First of all, he points out that the Palm form factor is small and fits neatly into the doctor's white-jacket pocket. He says, "The Compaq iPaq is a little big, so it doesn't quite fit." Further, he says that many folks in his organization don't have offices and therefore don't have access to a charging cradle, so they need a device with a long battery life.

IDC's Slawsby says, "I think the battery life of [Palms] tends to be significantly longer than that of Pocket PCs, which enables a doctor to have that device with them and use it for a couple of days at a time without having to find a [charging] cradle. Traditionally with Pocket PCs, you've had to recharge them at least once a day and that makes it very difficult if a doctor needs the device and has to put it in a cradle because it doesn't operate." Slawsby also points out that Palms cost less. He says, "Palms also tend to be cheaper and doctors can find the requisite amount of functionality at a lower price from a Palm than they can with a Pocket PC."

Doctor, Doctor Give Me the News
Michael Buhr, senior director of business and enterprise marketing for Palm Solutions Group (hardware), says that physicians were early Palm users, originally using it for the calendar and address book functionality, but gravitating to reference material as it became available. "Physicians started to use the Palm handheld really early on as a reference tool and in the healthcare space; there are a ton of reference books out there—whether it's nursing guides, the PDR, or whether it's looking up drug information or how drugs react with each other. Really," says Buhr, "what happened was companies out there such as ePocrates started making available very powerful lookup tools that allowed physicians with their Palm handhelds, not only to carry around their important datebook information—to do list, memos, etc.—but also this application allowed them to easily look up drug interaction information."

Halamka has taken ePocrates a step further by using it with CareGroup's own custom prescription formulary to help drastically reduce the rate of prescription drug price growth at CareGroup. "We put ePocrates special formulary edition on the doctors' PDAs, and because we know that pharmacy costs are going up 18 percent a year and we felt we could constrain pharmacy costs by putting in a CareGroup-specific formulary, we were able to significantly reduce our total pharmaceutical cost by doing that." Halamka says that by using what he calls "proactive use of formularies" he was able to cut that 18 percent growth rate down to five percent.

In addition, Halamka says they were able to transfer large amounts of educational materials to the PDAs. He says, "We moved a very large quantity of educational materials for doctors onto PDAs and we used AvantGo and created a Harvard Medical School AvantGo channel, which enabled the doctors to synchronize all of the course content of Harvard Medical School onto their PDAs."

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