What's In Your Pocket?


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Smartphones and their applications in medicine. Presenation briefly discusses the evolution from the PDA to the smartphone and looks at medical applications available to professionals.

What's In Your Pocket?

  1. 1. What’s in Your Pocket? Mobile Medical Applications Michelle Kraft, MLS, AHIP November 5, 2008
  2. 2. Brief History <ul><li>Mobile medical applications not new </li></ul><ul><li>1993 Apple introduced first PDA ( Newton Message Pad )‏ </li></ul><ul><li>In 2001 Ovid created Ovid@Hand </li></ul><ul><li>Computers, Handheld introduced as MeSH Term 2003 </li></ul><ul><li>Original PDAs required direct sync </li></ul><ul><li>Wireless PDAs evolved </li></ul>
  3. 3. PDA to Smartphone <ul><li>Huge trend shift from PDA to Smartphone </li></ul><ul><ul><li>Traditional PDAs saw 43% drop in sales from 2006-2007. 1 </li></ul></ul><ul><ul><li>Most PDA owners (69%) say their PDAs double as cell phones. This trend is also rapidly increasing; in 2006 only 26% used their PDAs as cell phones. 2 </li></ul></ul>1.PDA Market Continues Steep Decline. Palm InfoCenter. August 8, 2007. http://www.palminfocenter.com/news/8767/pda-market-continues-steep-decline/ 2.Networked Workers. Pew Internet & American Life Project. September 24, 2008. http://www.pewinternet.org/pdfs/PIP_Networked_Workers_FINAL.pdf
  4. 4. Palm Handheld & Smartphone Growth Figure 1: Palm Analyst Day –Revenue Smartphone/PDA's over the last few financial years. April 10, 2007. http://palmaddict.typepad.com/
  5. 5. PDA vs Smartphone <ul><li>PDAs had no phone capabilities </li></ul><ul><ul><li>PDAs do not require carrier contracts </li></ul></ul><ul><li>Smartphones now have PDA style programs and functionality </li></ul><ul><ul><li>Smartphone subsidized by carriers </li></ul></ul>
  6. 6. Growth and Evolution <ul><li>Wide acceptance </li></ul><ul><ul><li>“ Swiss Army Knife” of devices </li></ul></ul><ul><ul><li>iPhone adoption grew by 48% among those earning $25,000 - $50,000 per year 3 </li></ul></ul><ul><li>Perceptions have changed </li></ul><ul><ul><li>People no longer “unplug” </li></ul></ul><ul><ul><ul><li>63% men have smart phone </li></ul></ul></ul><ul><ul><ul><li>69% can’t live without Internet vs. 31% who can’t live without TV 4 </li></ul></ul></ul><ul><li>More functions available </li></ul><ul><ul><li>Internet always available </li></ul></ul><ul><ul><li>No longer need multiple communication devices </li></ul></ul><ul><li>Easy and Fun </li></ul>3. iPhone Appeals to All Buyers. TheStreet.com Oct. 31, 2008 4. Break Media Research Paints Portrait of Men 18-34. Oct.7, 2008
  7. 7. Evolution and Growth in Applications <ul><li>Previously two primary systems now has grown to seven different systems </li></ul><ul><li>Thick vs. thin client, move towards thin client applications </li></ul><ul><li>Syncing updates and Real time downloads </li></ul>
  8. 8. US Smartphone Market Looks Like BlackBerry Pie. Just Another Mobile Monday (JAMM). May 31, 2008. http://justanothermobilemonday.com/Wordpress/2008/05/
  9. 9. Smartphone Platforms <ul><li>Windows Mobile 6.0 </li></ul><ul><ul><li>Not PocketPC </li></ul></ul><ul><ul><li>Relies heavily on Internet connectivity </li></ul></ul><ul><ul><li>Internet surfing not as seamless as other devices </li></ul></ul><ul><ul><li>Limited availability of medical software </li></ul></ul><ul><li>Blackberry </li></ul><ul><ul><li>Relies heavily on Internet connectivity </li></ul></ul><ul><ul><li>Often used standard device for institution/business email </li></ul></ul><ul><ul><li>Lags in medical software availability but improving </li></ul></ul><ul><li>Palm </li></ul><ul><ul><li>Multiple types of phones available </li></ul></ul><ul><ul><li>Very similar to Palm PDA systems </li></ul></ul><ul><ul><li>Many models are NOT wifi capable </li></ul></ul><ul><ul><li>Has the most medical software available </li></ul></ul>
  10. 10. Smartphone Platforms <ul><li>PocketPC </li></ul><ul><ul><li>Not Window Mobile 6.0 </li></ul></ul><ul><ul><li>Multiple types of phones available </li></ul></ul><ul><ul><li>Has the most medical software available </li></ul></ul><ul><ul><li>Does not play well with MACs and is designed primarily to sync with Outlook </li></ul></ul><ul><li>iPhone </li></ul><ul><ul><li>Two versions 1G and 3G and relies heavily on Internet connectivity </li></ul></ul><ul><ul><li>Very seamless transition with phone, contacts, maps, email, SMS and Internet </li></ul></ul><ul><ul><li>Lots of memory </li></ul></ul><ul><ul><li>Video and audio ready </li></ul></ul><ul><ul><li>Some medical software available, primarily via Internet </li></ul></ul>
  11. 11. Smartphone Platforms <ul><li>Google G1 Android </li></ul><ul><ul><li>Relies heavily on Internet connectivity </li></ul></ul><ul><ul><li>Open operating system </li></ul></ul><ul><ul><li>Applications limited </li></ul></ul><ul><li>Symbian </li></ul><ul><ul><li>Open source </li></ul></ul><ul><ul><li>Requires unique network capabilities </li></ul></ul><ul><ul><li>Least amount medical software </li></ul></ul>
  12. 12. Smartphone Comparison Figure 3: Surfing the web: practicing medicine in a technological age: using smartphones in clinical practice. Clin Infect Dis. 2008 Jul 1;47(1):117-22.
  13. 14. Medical Applications <ul><li>Administrative Tasks </li></ul><ul><ul><li>Most popular </li></ul></ul><ul><ul><ul><li>Billing & coding, calendar & scheduling, email, patient charting </li></ul></ul></ul><ul><ul><li>Other applications </li></ul></ul><ul><ul><ul><li>Word processing, calculator, charge capture, procedure documentation, outpatient tracking, resident hours, dictation, password management </li></ul></ul></ul>
  14. 15. Medical Applications <ul><li>Patient Care </li></ul><ul><ul><li>Most Popular </li></ul></ul><ul><ul><ul><li>Prescribing, patient record, medical calculator, lab value reference </li></ul></ul></ul><ul><ul><li>Other applications </li></ul></ul><ul><ul><ul><li>Medical References (texts, articles), patient tracking, patient reminders, clinical decision pathways, managed care, diagnostic imaging & radiology </li></ul></ul></ul>
  15. 16. Where to Look? <ul><li>Fee based services </li></ul><ul><ul><li>UnBound Medicine http://www.unboundmedicine.com/ </li></ul></ul><ul><ul><li>Skyscape http://www.skyscape.com/ </li></ul></ul><ul><ul><li>PDAMD http://www.pdamd.com/ </li></ul></ul>
  16. 17. Where to Look? <ul><li>Free Resources </li></ul><ul><ul><li>Epocrates Rx http://www.epocrates.com/ </li></ul></ul><ul><ul><li>Diagnosaurus http://books.mcgraw-hill.com/medical/diagnosaurus/index.html </li></ul></ul><ul><ul><li>MedCalc http://med-ia.ch/medcalc/ </li></ul></ul><ul><ul><li>NLM Mobile http://www.nlm.nih.gov/mobile/ </li></ul></ul><ul><ul><ul><li>PubMed for handhelds, WISER, NCBI bookshelf </li></ul></ul></ul><ul><ul><li>Shots 2008 http://www.immunizationed.org/ </li></ul></ul>
  17. 18. Platform Specific Software Surfing the web: practicing medicine in a technological age: using smartphones in clinical practice. Clin Infect Dis. 2008 Jul 1;47(1):117-22.
  18. 19. Drawbacks and Concerns <ul><li>Primarily point of care tool </li></ul><ul><li>Formatting </li></ul><ul><ul><li>Images, text, layout design </li></ul></ul><ul><ul><li>Internet sites </li></ul></ul><ul><li>Functional but not always efficient </li></ul><ul><ul><li>Word processing, quick emails, quick research </li></ul></ul>
  19. 20. Drawbacks and Concerns <ul><li>Institutional buy in </li></ul><ul><ul><li>Email and Outlook sync </li></ul></ul><ul><ul><ul><li>BlackBerry only? </li></ul></ul></ul><ul><ul><ul><li>Intranet / Internet access </li></ul></ul></ul><ul><li>EMR Access and Integration? </li></ul><ul><ul><li>Institutional platform compatibility </li></ul></ul><ul><ul><ul><li>EpicOnHand runs on Windows Mobile or Pocket PC devices </li></ul></ul></ul><ul><ul><ul><li>Other issues regarding HIPAA </li></ul></ul></ul>
  20. 21. Drawbacks and Concerns <ul><li>Security </li></ul><ul><ul><li>Patient information </li></ul></ul><ul><ul><ul><li>Scheduling and Calendars, tracking software, notes, dictation </li></ul></ul></ul><ul><ul><li>Web security </li></ul></ul><ul><ul><ul><li>Theft of personal information, financial information, scammers </li></ul></ul></ul><ul><ul><ul><li>Encryption varies </li></ul></ul></ul><ul><ul><li>VOIP security </li></ul></ul><ul><ul><ul><li>Spam, Interruptions, Eavesdropping, </li></ul></ul></ul>
  21. 22. Drawbacks and Concerns <ul><li>Patient’s Health </li></ul><ul><ul><li>Smartphones might cause medical device malfunctions </li></ul></ul><ul><ul><li>Newer phones generate less EMI than older ones but Internet devices cause more than phone </li></ul></ul><ul><ul><ul><li>1 meter debate </li></ul></ul></ul><ul><ul><ul><li>FCC looking to expand usage in “white space” </li></ul></ul></ul>
  22. 23. Where Do We Go From Here? <ul><li>Library and IT support </li></ul><ul><li>Buying power and synchronization </li></ul><ul><li>Training </li></ul>
  23. 24. Library and IT Support <ul><li>Be familiar with the technology </li></ul><ul><li>Make library web pages mobile friendly </li></ul><ul><li>Decide amount of library support </li></ul><ul><ul><li>Work with IT to coordinate support </li></ul></ul>
  24. 25. Buying Power <ul><li>Decide upon purchase plans and licensing </li></ul><ul><ul><li>Site licenses </li></ul></ul><ul><ul><ul><li>Can be very costly, count potential users not actual </li></ul></ul></ul><ul><ul><li>Downloads or concurrent users </li></ul></ul><ul><ul><ul><li>Purchase a set number of downloads </li></ul></ul></ul><ul><ul><ul><li>Concurrent user only works if web based </li></ul></ul></ul><ul><ul><li>Add ons </li></ul></ul><ul><ul><ul><li>Value added option but if no specific license agreement for product, access could change </li></ul></ul></ul>
  25. 26. Buying Power <ul><li>Discount purchases </li></ul><ul><ul><li>Users purchase with institutional/library discount </li></ul></ul><ul><li>Electronic loaning </li></ul><ul><ul><li>NetLibrary, Overdrive approach </li></ul></ul>
  26. 27. Synchronization <ul><li>Work with IT </li></ul><ul><li>Get the message out! </li></ul><ul><ul><li>Have product and purchasing information available on website </li></ul></ul><ul><ul><li>Catalog </li></ul></ul><ul><ul><li>Advertise, advertise, advertise </li></ul></ul>
  27. 28. Training <ul><li>Many are uniformed of possibilities </li></ul><ul><ul><li>Young adopters are usually new to profession </li></ul></ul><ul><ul><li>Older potential users unfamiliar with the technology </li></ul></ul><ul><li>Ensures adopters are aware and select appropriate quality resource </li></ul>
  28. 29. Training <ul><li>Demonstrate improved patient care </li></ul><ul><ul><li>Better access to point of care resources </li></ul></ul><ul><ul><li>Answer patient questions real time </li></ul></ul><ul><li>Demonstrate time savings </li></ul><ul><ul><li>Scheduling </li></ul></ul><ul><ul><li>Patient care </li></ul></ul>
  29. 30. Questions? Michelle Kraft http://www.kraftylibrarian.com