Sess08 My Back Up Brain


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The use of a PDA or handheld computer as support in the clinical setting

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Sess08 My Back Up Brain

  1. 1. SESS April 2008 Presented by: Edward A Stern, RN NothingBetter, Healthcare Team
  2. 2.  Need for HIT in the ED  Growth of PDA Use  Why a Handheld Device  Clinical PDA Uses  Use beyond the clinical to get things done  The right PDA for you  Enterprise PDA  Live Product Demonstration Visit for a copy this presentation
  3. 3.  Edward Stern, RN  Founder of NothingBetter Healthcare Strategies  Clinical ED Nurse  Consulting with ED’s on the effective utilization and integration of clinical technologies  EMR needs assessment and RFP development  Workflow analysis  Implementation support  Training delivery and development  Web-based training development and delivery models
  4. 4.  Adoption of health information technology (HIT) can improve quality and patient safety.  Rapid growth of EMR/EHR solutions in the ED, increase safety and reduce LOS  Only about a quarter of primary care doctors in the U.S. (28%) and Canada (23%) use EMRs  Compared with a large majority of primary care doctors in the Netherlands, (98%), New Zealand (92%), the U.K. (89%) and Australia (79%). [Health Affairs 25 (2006): w555-w571 (published online 2 November 2006; 10.1377/hlthaff.25.w555)]
  5. 5.  PCP’s Ability to offer care to patients other than during working hours, which can prevent unnecessary emergency room visits.  Just 40% of U.S. primary care doctors report they are able to offer such access; in the Netherlands the rate is 95%, and in the U.K. it is 87%.  Access to resources for managing complex chronic conditions at a time when more and more patients are suffering from these conditions.  Use of multi-disciplinary teams varied widely, from a high of 81% in the U.K to lows of 29% to 32% in the U.S., Canada, Australia and New Zealand. [Health Affairs 25 (2006): w555-w571 (published online 2 November 2006; 10.1377/hlthaff.25.w555)]
  6. 6.  Health Information Technology (HIT) involves more than just the EMR solution. Handheld PDA devices are a remarkable bedside partner to the complete EMR solution.
  7. 7.  Since the “Apple Newton” came to market in 1993. the market continues to grow with “Smart Phones” and “Integrated PDA/Phones.  Common growth of use for PDA style devices is 25% increase each fiscal quarter in 2008  Growth markets where once personal data management however modern devices can access external data and voice networks as well as the Internet through a wireless connection dramatically changing the market segment and healthcare potential.
  8. 8.  Minimize risk and error in patient care  Faster and safer dose management  Patient/medication confirmation (5 rights etc)  Brigham and Women's Hospital, reports: 50% of physicians using a PDA drug reference guide avoided one or more serious adverse drug events per week.1  A survey of nurses indicated that immediate access to drug references was the most important use of a PDA in nursing.2 Photo compliments of Cerner Corporation 1. 2003 study and report as reported by PDA Cortex 2. 2003 study conducted by PDA Cortex on the “PDA Nurses listsev hosted by PDA Cortext
  9. 9.  Administration errors account for 38% of medication errors. (1)  Only 2% of drug administration errors are intercepted. (1)  Medication errors occur in nearly 1 of every 5 doses given to patients in the typical hospital. (2) Images compliments of Care Fusion® (1) Leape LL, Bates DW, Cullen DJ et al. Systems analysis of adverse drug events. JAMA 1995; 274:35-43. (2) Medical malpractice verdicts, settlement and statistical analysis, Jury Verdict Research. Referenced by: Albert, T. Liability insurance crisis: Bigger awards just one factor. April 15, 2002. Available at:
  10. 10.  The median compensation award for medication errors was $668,000 per award in 2000. (1)  Through integrated Positive Patient ID (PPID) and PDA “style” reference tools we can immediately reduce patient care error. 1. Barker KN, Flynn EA, Pepper GA, PhD, Bates DW, Mikeal RL. Medication errors observed in 36 health care facilities. Arch Intern Med 2002;162:1897-1903.
  11. 11.  The “Early Palm” Device
  12. 12.  The “Modern Palm Device”
  13. 13. • Most common Clinical Uses • Vast array of patient care references and other “nurses tools” • Immediate access to hospital process and, procedure manuals
  14. 14.  Patient education resource  Providing references to prepare the nurse  Providing anatomic visual aids  Bedside real time education  Interpretation opportunities  Through phone features  Through dictionaries that can speak for you
  15. 15. • Requirement in some nursing schools • Some medical facilities are offering payback and/or support programs
  16. 16.  CEU/CME  Stand alone applications  Web applications  Clinical Tips and Primers  Clinical charting solutions  Internal Communications  Phones integrated into the PDA  Text message alert for entire hospital networks (replacing paging)
  17. 17.  Immediate patient care data retrieval, and charting  While still a relatively immature market segment, PDAs can (and should) be part of the documentation process.  Significant cost savings and manpower hours could result from technologies that expedite the documentation process Images compliments of Cerner Mobile
  18. 18.  PDAsare known for scheduling but what else?  Schedule  Tasks  Contacts  The“GTD” (Getting Things Done) movement as brought all sorts of “back up brain” additions. For example:  Bug Me  EverNote (PC & PDA)  SugarSync (PC and PDA Web)
  19. 19.  Whatto take into consideration for personal and professional use  Needs – What are you going to do with it  Operating System  Size and Weight  Price and Budget  Systems integration use  (more detailed)
  20. 20.  Consider needs and growth  Always get a unit with expandable memory  Consider your technology comfort and support  Consider integration concerns  Do you want phone and email with it or just a simple reference tool?
  21. 21.  Palm operating system (not device)  Simple easy set-up and interface  Loosing market share rapidly  Still lots of software on the market  Products price point starts around $100  Price plans for phone models vary  Some are stand-alone some integrated with phone  Email integration is limited with “office” email solutions  Check out: or your cell provider
  22. 22.  Windows (and Smart phone)  “Hey it’s Windows”  Large and growing market share  Products start at around $300  Price plans for phone models vary – Phone units are cheaper due to cellular plans  Typically integrated with phones  Email integration is seamless with office email solutions (hey it’s Microsoft)  Be sure you focus on the “type” of device and versions  Check out,, or your cell provider
  23. 23.  Blackberry  a.k.a “Crackberry”  Always integrated as a phone/email device  Rapid growth marketing but still limited medical product line  “Sleek” product integrations… more the corporate tool  Email is sweet!  Prices vary depending on cell provider
  24. 24.  iPhone  Very new tool on the market  Very limited application choices for clinical use  Recent change in Apple business to “open” the technology may dramatically change availability of applications  Cost varies around $400 or more
  25. 25.  Consider “Broad User” site licensing options for merged Intranet and PDA access  Micromedex  Offers Intranet and limited PDA Integration  Pepid  Offers comprehensive Intranet, PDA and even Wireless secure network options  Offers clinical specialty content areas
  26. 26. • Full Integration with an EMR/HER • Care Fusion (now a Cardinal Company) for patient and care identification • Cerner Mobile • Reality is the “interface” for the device might be the only limiting factor
  27. 27.  Hybrid Device – The “Mr Coffee of PDAs”?  Integrated Reference, Charting device, Patient safety tool and in hospital voice phone (e.g. SpectraLink®, Vocera®) + + + = ?
  28. 28. Visit for this presentation