What's In Your Pocket?

What’s in Your Pocket? Mobile Medical Applications Michelle Kraft, MLS, AHIP November 5, 2008

Brief History
Mobile medical applications not new
1993 Apple introduced first PDA ( Newton Message Pad )‏
In 2001 Ovid created Ovid@Hand
Computers, Handheld introduced as MeSH Term 2003
Original PDAs required direct sync
Wireless PDAs evolved

PDA to Smartphone
Huge trend shift from PDA to Smartphone
Traditional PDAs saw 43% drop in sales from 2006-2007. 1
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
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

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/

PDA vs Smartphone
PDAs had no phone capabilities
PDAs do not require carrier contracts
Smartphones now have PDA style programs and functionality
Smartphone subsidized by carriers

Growth and Evolution
Wide acceptance
“ Swiss Army Knife” of devices
iPhone adoption grew by 48% among those earning $25,000 - $50,000 per year 3
Perceptions have changed
People no longer “unplug”
63% men have smart phone
69% can’t live without Internet vs. 31% who can’t live without TV 4
More functions available
Internet always available
No longer need multiple communication devices
Easy and Fun
3. iPhone Appeals to All Buyers. TheStreet.com Oct. 31, 2008 4. Break Media Research Paints Portrait of Men 18-34. Oct.7, 2008

Evolution and Growth in Applications
Previously two primary systems now has grown to seven different systems
Thick vs. thin client, move towards thin client applications
Syncing updates and Real time downloads

US Smartphone Market Looks Like BlackBerry Pie. Just Another Mobile Monday (JAMM). May 31, 2008. http://justanothermobilemonday.com/Wordpress/2008/05/

Smartphone Platforms
Windows Mobile 6.0
Not PocketPC
Relies heavily on Internet connectivity
Internet surfing not as seamless as other devices
Limited availability of medical software
Blackberry
Often used standard device for institution/business email
Lags in medical software availability but improving
Palm
Multiple types of phones available
Very similar to Palm PDA systems
Many models are NOT wifi capable
Has the most medical software available

PocketPC
Not Window Mobile 6.0
Multiple types of phones available
Has the most medical software available
Does not play well with MACs and is designed primarily to sync with Outlook
iPhone
Two versions 1G and 3G and relies heavily on Internet connectivity
Very seamless transition with phone, contacts, maps, email, SMS and Internet
Lots of memory
Video and audio ready
Some medical software available, primarily via Internet

Google G1 Android
Open operating system
Applications limited
Symbian
Open source
Requires unique network capabilities
Least amount medical software

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.

Medical Applications
Administrative Tasks
Most popular
Billing & coding, calendar & scheduling, email, patient charting
Other applications
Word processing, calculator, charge capture, procedure documentation, outpatient tracking, resident hours, dictation, password management

Medical Applications
Patient Care
Most Popular
Prescribing, patient record, medical calculator, lab value reference
Other applications
Medical References (texts, articles), patient tracking, patient reminders, clinical decision pathways, managed care, diagnostic imaging & radiology

Where to Look?
Fee based services
UnBound Medicine http://www.unboundmedicine.com/
Skyscape http://www.skyscape.com/
PDAMD http://www.pdamd.com/

Where to Look?
Free Resources
Epocrates Rx http://www.epocrates.com/
Diagnosaurus http://books.mcgraw-hill.com/medical/diagnosaurus/index.html
MedCalc http://med-ia.ch/medcalc/
NLM Mobile http://www.nlm.nih.gov/mobile/
PubMed for handhelds, WISER, NCBI bookshelf
Shots 2008 http://www.immunizationed.org/

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.

Drawbacks and Concerns
Primarily point of care tool
Formatting
Images, text, layout design
Internet sites
Functional but not always efficient
Word processing, quick emails, quick research

Institutional buy in
Email and Outlook sync
BlackBerry only?
Intranet / Internet access
EMR Access and Integration?
Institutional platform compatibility
EpicOnHand runs on Windows Mobile or Pocket PC devices
Other issues regarding HIPAA

Security
Patient information
Scheduling and Calendars, tracking software, notes, dictation
Web security
Theft of personal information, financial information, scammers
Encryption varies
VOIP security
Spam, Interruptions, Eavesdropping,

Patient’s Health
Smartphones might cause medical device malfunctions
Newer phones generate less EMI than older ones but Internet devices cause more than phone
1 meter debate
FCC looking to expand usage in “white space”

Where Do We Go From Here?
Library and IT support
Buying power and synchronization
Training

Library and IT Support
Be familiar with the technology
Make library web pages mobile friendly
Decide amount of library support
Work with IT to coordinate support

Buying Power
Decide upon purchase plans and licensing
Site licenses
Can be very costly, count potential users not actual
Downloads or concurrent users
Purchase a set number of downloads
Concurrent user only works if web based
Add ons
Value added option but if no specific license agreement for product, access could change

Buying Power
Discount purchases
Users purchase with institutional/library discount
Electronic loaning
NetLibrary, Overdrive approach

Synchronization
Work with IT
Get the message out!
Have product and purchasing information available on website
Catalog
Advertise, advertise, advertise

Training
Many are uniformed of possibilities
Young adopters are usually new to profession
Older potential users unfamiliar with the technology
Ensures adopters are aware and select appropriate quality resource

Training
Demonstrate improved patient care
Better access to point of care resources
Answer patient questions real time
Demonstrate time savings
Scheduling
Patient care

Questions? Michelle Kraft http://www.kraftylibrarian.com

What's In Your Pocket?

by Michelle Kraft on Nov 04, 2008

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What’s In Your Pocket? — Presentation Transcript