Data collection using handheld computers.
Explore the source record for details and available documents.
SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Providers are finding great success at improving patient care and operations with hand-held computers that cut documentation time, reduce errors, and streamline operations. Here's how a Colorado medical center revamped its homecare operation and integrated wireless technology on the inpatient side, too.
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.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The payoff is a dramatic decline in the drudgery of paperwork. Here's an example from home health nursing.
Explore the source record for details and available documents.
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.
Explore the source record for details and available documents.
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.
BACKGROUND: Daily documentation and maintenance of medical record quality is a crucial issue in orthopaedic surgery. The purpose of the present study was to determine whether the introduction of a handheld computer could improve both the quantitative and qualitative aspects of medical records. METHODS: A series of consecutive patients who were admitted for the first time to a thirty-six-bed orthopaedic ward of an academic teaching hospital for a planned operation or any other treatment of an acute injury or chronic condition were randomized to daily documentation of their clinical charts on a handheld computer or on conventional paper forms. The electronic documentation consisted of a specially designed software package on a handheld computer for bedside use with structured decision trees for examination, obtaining a history, and coding. In the control arm, chart notes were compiled on standard paper forms and were subsequently entered into the hospital's information system. The number of documented ICD (International Classification of Diseases) diagnoses was the primary end point for sample size calculations. All patient charts were reread by an expert panel consisting of two surgeons and the surgical quality assurance manager. These experts assigned quality ratings to the different documentation systems by scrutinizing the extent and accuracy of the patient histories and the physical findings as assessed by daily chart notes. RESULTS: Eighty patients were randomized to one of the two documentation arms, and seventy-eight (forty-seven men and thirty-one women) of them were eligible for final analysis. Documentation with the handheld computer increased the median number of diagnoses per patients from four to nine (p < 0.0001), but it produced some overcoding for false or redundant items. Documentation quality ratings improved significantly with the introduction of the handheld device (p < 0.01) with respect to the correct assessment of a patient's progress and translation into ICD diagnoses. Various learning curve effects were observed with different operators. Study physicians assigned slightly better practicability ratings to the handheld device. CONCLUSIONS: The preliminary data from this study suggest that handheld computers may improve the quality of hospital charts in orthopaedic surgery. LEVEL OF EVIDENCE: Therapeutic study, Level I-1a (randomized controlled trial [significant difference]). See Instructions to Authors for a complete description of levels of evidence.
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.
We propose a set of requirements for designing handheld computer systems for electronic collection of patient diary and questionnaire data in clinical trials: (1) the system should be suitable for use by all types of patient to be included in the clinical trial programme; (2) patients must be capable of using the system and be comfortable with it after a short period of training; (3) responses should always result from an action by the user--defaults should not be taken as data; (4) all information necessary to a given question should be simultaneously available on the screen. This applies to both the questions and the response options. We present guidelines as to how these requirements may be met in practice, so that bias may be avoided both in patient selection and in the responses made; so that electronic data collection may be as effective as possible, and so that study procedures are convenient and unobtrusive for the patients.
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.
The PDA or handheld computer, is not just a toy of the Cusper generation or for your pre-teens to use for games. It is a serious tool that has found a niche in medicine. Everyone of our residents carries a PDA and uses it several times a day. Web-based programs such as ePocrates provide them with instantaneous information on correct drug dosage and interactions. The literature already contains reports of the ability of this type of PDA-based software to reduce prescription errors. Our residents also use shareware versions of patient management software to keep track of patients on service and of individual surgeon's preferences. If your residents use ResSOLution to enter surgery case data, they will find that the new, PDA-based version shown at the recent Surgical Education Week will make data entry and transmission to the program director's files a piece of cake. The software has a long-awaited, full alpha-search capability for current CPT codes. I download my calendar and telephone files to my PDA every day so that I have everything on my office computer in the "palm" of my hand where and when I need it. Try remembering the office number of a referring physician in the middle of the night or suffering through the Muzak-ridden delays of waiting for a hospital operator to give you a specific extension and you will carry your PDA too!
Personal digital assistants (PDAs; also known as "handheld computers," "pocket personal computers," and Palm Pilots) provide immediate access to vital and clinically relevant infectious diseases information at the point of care. Several infectious diseases applications are available that provide information on pathogens, diagnosis, medication, and treatment. In this article, 4 infectious diseases PDA applications are reviewed: ePocrates ID (part of ePocrates Rx Pro), the Johns Hopkins Division of Infectious Diseases Antibiotic Guide, the 2002 Sanford Guide to Antimicrobial Therapy, and Infectious Diseases and Antimicrobials Notes. Drug information, including clinical pharmacology, dosing in patients with renal insufficiency, adverse reactions, and drug interactions, is evaluated for completeness and accuracy by comparison of each application with the package insert. Treatment recommendations for 6 diseases are compared with current practice guidelines. Each PDA infectious diseases application reviewed has unique advantages and disadvantages. This critical review will help health care professionals select the infectious diseases PDA application best tailored to meet their individual information needs.
RATIONALE: Information retrieval technology tends to become nothing less than crucial in physician daily practice, notably in family medicine. Nevertheless, few studies examine impacts of this technology and their results appear controversial. AIMS AND OBJECTIVES: Our article aims to explore these impacts using the medical literature, an organizational case study and the literature on organizations. METHODS: The case study was embedded in an evaluation of the implementation of medical and pharmaceutical databases on handheld computers in a Canadian family medicine centre. Six physicians were interviewed on specific events relative to the use of these databases and on their general perception of impacts of this use on clinical decision making and the doctor-patient relationship. A thematic data analysis was performed concomitantly by both authors. RESULTS AND CONCLUSION: Findings indicate six types of impact: practice improvement, reassurance, learning, confirmation, recall and frustration. These findings are interpreted in accordance with both a medical and organizational perspective. The fit with the literature on inter-organizational memory supports the transferability of the findings. In turn, this fit suggests how information retrieval technology may change physician routine. This study suggests a new basis for evaluating the impact of information retrieval technology in daily clinical practice. In conclusion, our paper encourages policy-makers to develop, and physicians to use, this technology.