By: Stephanie Riesenman for Medtech1.comThe first year of residency can be a scary and somewhat overwhelming experience. For 26-year-old Ben Heyworth, an orthopaedic surgery intern at Hospital for Special Surgery, it is the first time he is directly responsible for patient care. That means having to recall all he was taught in medical school as well as having to sometimes diagnose and treat patients with ailments that he has not encountered before. For many first-years, this anxious period is less daunting thanks to a small device that fits in the palm of their hands—a personal digital assistant, or PDA.
“You used to have to carry this big handbook around, now you just click on a button and all the information is right there at your fingertips,” said Heyworth.
Dr. Heyworth mostly uses the device as an address book and calendar, and he uses it to access information about medications. He can also look up clinical resources that have been downloaded to his PDA without having to use what little free time he has to run to the library.
“As an intern, the first six months I had to open the PDA for almost every [prescription] order I would write,” said Heyworth.
Health care professionals say the PDA’s, when used to their full potential, can help clinicians reduce medication errors and increase efficiency. That is why many hospitals have begun providing their residents and faculty with their own handheld devices. For example, the University of Mississippi Medical Center reports that the handheld computers “assist in the medical decision making process by providing the latest evidence-based information on clinical guidelines, drug reference, coding and medical calculations at the point of care.”
A few years ago the New York State Department of Health awarded Hospital for Special Surgery the “Patient Safety Award.” It was a grant to purchase every resident in the orthopaedic surgery residency program their own Palm PDA. The goal of the grant was to promote patient safety and reduce medication errors. Each Palm was loaded with software that is updated regularly as medications come on and off the market or gain broader or restricted indications. The device also contained a medical calculator, clinical reference guide and a calendar and address book, just to name a few items.
Use of the PDA’s is not restricted to residency programs. In fact 40 percent of practicing physicians owned a PDA in 2004, according to Manhattan Research LLC, a market research company in New York. That number is up from 19 percent in 2001, and is four times greater than the overall use by general consumers.
Helping to fuel the popularity is new technology and a federal push towards making health care information and medical records electronic. At this time, most PDA owners use them for personal rather than professional use. One deterrent is that the systems collecting information entered by a physician into a PDA are not yet up and running. It has been suggested that physicians will be able to enter prescription orders on their handheld devices for patients, but most pharmacies are not able to accept electronic prescriptions. And there are still some legal obstacles to overcome before patient medical records will be available in an electronic form for access via a PDA, though some institutions are currently serving as test sites for the technology.
There are also the inherent drawbacks of the portable technology, which are a small screen and short battery life. In some cases, physicians are just not adequately trained on the proper use of software or the full potential of their handheld device. It can also be intimidating to stay abreast of the latest technology, since it is advancing so quickly.
With all that said, many technology and health care professionals believe that as the pressure increases for greater efficiency and safety, and as the federal government and insurers offer financial incentives to entice physicians to implement the use of PDA’s and other clinical information technology, adoption of handheld devices will continue to grow among health care professionals. And it just might be that the initiative towards electronic healthcare will give the younger generation of physicians, such as Dr. Heyworth, the opportunity to teach their elders a thing or two about the cutting edge of patient care.
