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  1. 1. Exploring Digital / Wireless Application In Healthcare Presentation of Research Mohammad Al-Ubaydli, M.D. December 3, 2007
  2. 2. © 2007 The Advisory Board Company Roadmap for Discussion I. Introductions and Definitions II. Scholarship Sponsored by Epocrates III. VCU Hospital: Admissions and Billing IV. Refining the Medication Reconciliation Process
  3. 3. Introductions and Definitions I
  4. 4. Introductions <ul><li>The Advisory Board Company </li></ul><ul><li>IT Insights team </li></ul><ul><li>Mohammad Al-Ubaydli </li></ul><ul><ul><li>Doctor, University of Cambridge </li></ul></ul><ul><ul><li>Programmer, National Center for Biotechnology Information </li></ul></ul><ul><ul><li>Management Consultant, The Advisory Board Company </li></ul></ul>© 2007 The Advisory Board Company
  5. 5. Definitions © 2007 The Advisory Board Company Addition, not Replacement <ul><li>Handheld computer: a computer small enough to hold in your hand </li></ul><ul><li>Personal Digital Assistant (PDA): a handheld computer </li></ul><ul><li>Smartphone: a handheld computer that can make telephone calls </li></ul><ul><li>Mobility: small form factor and long battery life </li></ul><ul><li>Connectivity: cellular, WiFi, infra-red </li></ul><ul><li>Ubiquity: every clinician already knows how to use their phone </li></ul>Doctor’s Dream Device
  6. 6. Scholarships Sponsored by Epocrates II
  7. 7. Avoiding the Mistakes of Others <ul><li>The challenge </li></ul><ul><li>At the start of 2006 there were over 600 papers in PubMed™ that dealt with handheld computers. Many lessons have accumulated in the clinical literature but we need to understand and assimilate these lessons. </li></ul><ul><li>The challenge is to provide these lessons as peer-reviewed and unbiased summaries based on scientific fact, not marketing hype. </li></ul><ul><li>The Scholarships </li></ul><ul><li>Five exceptional students from around the world will be selected each year to review selected literature and make summary reports that will be published in the Mobile Medical Computing Reviews journal. The Scholarship winners will be mentored and trained by Dr. Mohammad Al-Ubaydli, author of four books, including “Handheld Computers for Doctors”. </li></ul><ul><li>The results </li></ul><ul><li>Once complete, the reviews will be published and freely available through the website of the new journal Mobile Medical Computing Reviews . Each student will be able to quote their own reviews in their list of publications. </li></ul><ul><li>www.handheldsfordoctors.com/research </li></ul>© 2007 The Advisory Board Company
  8. 8. © 2007 The Advisory Board Company Teaching Tomorrow’s Teachers Dr. Yunan Chen , China Dr. Adesina Iluyemi , Nigeria PhD candidate at Drexel University PhD candidate at University of Portsmouth Dr. Emily MacDonald , UK Joshua McAllister , USA Dr. Devashish Saini , India Medical Student at University of Cambridge Medical Student at University of Texas Medical Branch Resuscitation Sciences Fellow at University of Alabama at Birmingham
  9. 9. © 2007 The Advisory Board Company
  10. 10. © 2007 The Advisory Board Company Teaching Tomorrow’s Teachers Dr. Mina Hafzalah, Iraq Dr. Craig Huang , USA Completing a fellowship in Pediatric Critical Care at the University of Chicago Professor, Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, Texas Dr. Mizna Murza , Pakistan Dr. Alfonso Rodriguez-Morales , Venezuela Dr. Iman Tavassoly , Iran Completing a Public Health Informatics Fellowship at the Centers for Disease Control and Prevention, Atlanta, GA PhD candidate at the Tropical Medicine Institute, Central University of Venezuela Resident at the Mehran Health Network, Ilam University of Medical Sciences, Ilam, Iran
  11. 11. Matching the Wireless Device to Clinical Needs III
  12. 12. Success on the Move © 2007 The Advisory Board Company <ul><li>VCU Health System </li></ul><ul><li>779-bed academic medical center </li></ul><ul><li>Located in Richmond, VA </li></ul><ul><li>Physicians perform electronic charge capture and review clinical results with PocketPC (Treo) Smartphones </li></ul><ul><li>Successful only after failed attempts with PocketPC PDAs and Palm OS Smartphones </li></ul><ul><li>$800,000 annualized revenue for 1 department from: missing charge rate 15.7% --> 0.07% and charges within 10 days 25% --> 90% </li></ul><ul><li>Will deploy to 600 physicians after the success of the pilot with 40 physicians </li></ul>Case in Brief <ul><li>Software on smartphone includes: </li></ul><ul><li>Patientkeeper integrating with Cerner EMR </li></ul><ul><li>UpToDate medical reference </li></ul><ul><li>SPB Software and integrating with corporate contacts </li></ul><ul><li>Google Maps, local weather </li></ul><ul><li>Show missed pages </li></ul><ul><li>Infrastructure </li></ul><ul><li>Secure VPN tunnel through Sprint PCS </li></ul><ul><li>Remote PocketPC monitoring through MobiControl </li></ul><ul><li>Lotus Notes to PocketPC via iAnywhere </li></ul>
  13. 13. Pocket PC PDA Confusing to Clinicians © 2007 The Advisory Board Company Pocket PCs connect to Wi-Fi WiFi network available throughout hospital. <ul><li>Reconnecting to different wireless stations around the hospital too complicated </li></ul><ul><li>Battery life too low because of Wi-Fi usage and failure to recharge would lead to cumbersome reinstallation of software </li></ul><ul><li>Physicians refused to use devices </li></ul>Project Almost Abandoned
  14. 14. Palm OS Smartphone Lacked Multitasking © 2007 The Advisory Board Company <ul><li>Palm operating system does not have multi-tasking </li></ul><ul><li>Physician must log into electronic medical record and e-mail software </li></ul><ul><li>Switching to application expires authentication of previous application </li></ul><ul><li>Clinical work relies on constant switching between tasks </li></ul>Switching Too Cumbersome Treo Smartphones with Palm Operating System Promising Friendly user interface and constant connectivity through cellular network Log into EMR Log into EMR Log into e-mail
  15. 15. Refining the Medication Reconciliation Process IV
  16. 16. Nurses’ Perceptions Slowing Adoption of Bar Coding © 2007 The Advisory Board Company
  17. 17. Striking a balance © 2007 The Advisory Board Company
  18. 18. Combining the Best of Both Worlds © 2007 The Advisory Board Company
  19. 19. Raising Awareness, Reducing Errors © 2007 The Advisory Board Company
  20. 20. Avoiding the Mistakes of Others <ul><li>www.handheldsfordoctors.com/research </li></ul><ul><li>Mohammad Al-Ubaydli, MD </li></ul><ul><li>[email_address] </li></ul><ul><li>202-266-5425 </li></ul>© 2007 The Advisory Board Company