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Text entry on handheld computers by older users.

Small pocket computers offer great potential in workplaces where mobility is needed to collect data or access reference information while carrying out tasks such as maintenance or customer support. This paper reports on three studies examining the hypothesis that data entry by older workers is easier when the pocket computer has a physical keyboard, albeit a small one, rather than a touch-screen keyboard. Using a counter-balanced, within-subjects design the accuracy and speed with which adults over 55 years of age could make or modify short text entries was measured for both kinds of pocket computer. The keyboard computer was the Hewlett Packard 360LX (HP), but the touch-screen computers varied across studies (experiment 1: Apple Newton and PalmPilot; experiment 2: Philips Nino; experiment 3: Casio E10). All studies showed significant decrements in accuracy and speed when entering text via the touch-screen. Across studies, most participants preferred using the HP's small physical keyboard. Even after additional practice with the touch screen (experiments 2 and 3) many entries still contained errors. Experiment 3 showed that younger people were faster but not more accurate than older people at using the touch-screen keyboard. It is concluded that satisfactory text entry on palm-size computers awaits improvements to the touch-screen keyboard or alternative input methods such as handwriting or voice. Interface developments that assist older people typically benefit younger users too.

Aged↗

Development of a handheld computer documentation system to enhance an integrated primary care clerkship.

Documentation systems are used by medical schools and residency programs to record the clinical experiences of their learners. The authors developed a system for their school's (Dartmouth's) multidisciplinary primary care clerkship (family medicine, internal medicine, pediatrics) that documents students' clinical and educational experiences and provides feedback designed to enhance clinical training utilizing a timely data-reporting system. The five critical components of the system are (1) a valid, reliable and feasible data-collection instrument; (2) orientation of and ongoing support for student and faculty users; (3) generation and distribution of timely feedback reports to students, preceptors, and clerkship directors; (4) adequate financial and technical support; and (5) a database design that allows for overall evaluation of educational outcomes. The system, whose development began in 1997, generated and distributed approximately 150 peer-comparison reports of clinical teaching experiences to students, preceptors, and course directors during 2001, in formats that are easy to interpret and use to individualize learning. The authors present report formats and annual cost estimate comparisons of paper- and computer-based system development and maintenance, which range from $35,935 to $53,780 for the paper-based system and from $46,820 to $109,308 for the computer-based system. They mention ongoing challenges in components of the system. They conclude that a comprehensive documentation and feedback system provides an essential infrastructure for the evaluation and enhancement of community-based teaching and learning in primary care ambulatory clerkships, whether separate or integrated.

Clinical Clerkship↗

The usefulness of handheld computers in a surgical group practice.

We designed a system using hand-held computers allowing physicians in the hospital setting to access their surgical schedules, to track patients in multiple hospitals, and to quickly enter billing information. The physicians would then update their schedules and pass billing information electronically when they returned to the office. The system was successfully implemented, it was well accepted by clinicians and staff users, and it showed an increased capture of charges. Whether an economically important effect on the number of days to post hospital charges will be evident after follow-up data has been collected.

Appointments and Schedules↗

The handheld computer in critical care medicine.

The wealth of information that can be generated from programmable pocket calculators is not widely appreciated. These inexpensive devices have evolved into "user-friendly" microcomputers with impressive memory capacity and mathematic sophistication. A series of critical care programs is presented to illustrate the degree of computer support that is available from the newest generation of programmable pocket calculators. These programs constitute the most comprehensive microcomputer software package reported in the literature. They demonstrate that high-level mathematic capability is available not only in large medical centers, but in virtually any small community hospital as well.

Aminoglycosides↗

The anesthesiologist's guide to Palm Computing.

Handheld personal computers (HPCs) are permeating the clinical and personal lives of anesthesia care providers. Common characteristics include low cost, portability, easy PC data sharing, and applications such as a calendar, phone directory, memo pad, and a task list. Additional software includes databases for case logs, medication lists, task organizers, and document readers. This article discusses the Palm brand HPC (Palm Computing, A 3Com Company, Santa Clara, CA) including purchasing tips, common uses, backing up information, security concerns, and information resources on the Internet including websites providing free trial software.

Anesthesiology↗

Providing context-sensitive decision-support based on WHO guidelines.

A decision support system was developed implementing the WHO guideline for diarrhea management. The decision-support system is integrated into a medical records application on a handheld computer. The system will be used by primary health care workers in rural India. The guideline was encoded as a set of chained rules in CLIPS format. To enhance adherence to guidelines, we use a model based on a context-adapted guideline to provide decision support at the point of care in a particular setting. The purpose of the system is to tailor the recommendations based on the patient's condition and the local factors such as resource availability in order to create feasible uniformity in a practice across different providers of care.

Computers, Handheld↗

Using a personal digital assistant enhances gathering of patient data on an acute pain management service: a pilot study.

PURPOSE: Handheld computer technology provides a unique opportunity for health care professionals to access real time or near real time patient information and evidence-based resources at the point-of-care. The purpose of this study was to assess one physician's experience using acute pain assessment software on a personal digital assistant (PDA) to assess patients on an acute pain management service (APMS). METHODS: Using a historical control and a "time and motion" study design, comparisons were made on acute pain assessment time and comprehensiveness when patient assessments are documented on a PDA vs the current paper-based method. RESULTS: The study physician (a PDA-user) reported feeling comfortable with the assessment software after five patient assessments. PDA assessments were more likely to contain documentation regarding pain and side effects (e.g., nausea, pruritus, hypotension) than the paper assessments. The median time of the "assessment only" component of the patient encounter was 53 sec longer using the PDA compared to paper (P < 0.00), however, the median "total encounter" (chart review, assessment, documentation) time was 74 sec shorter using the PDA vs paper (P < 0.00). DISCUSSION: The findings of this preliminary study suggest that the PDA is a reliable tool that meets the data management requirements within an APMS setting. This study found that patient assessments documented using acute pain software developed for use on a PDA were as efficient and content-rich as paper assessments. The PDA may even enhance the efficiency of the patient assessment process through the provision of more comprehensive digital data for research, clinical, and administrative needs.

Computers, Handheld↗