This document provides an overview of handheld medical applications and how to ensure compliance with HIPAA regulations when using such applications. It discusses the major operating systems for handheld devices and applications available for each. Examples of applications include e-book readers, medical calculators, drug references and clinical resources. The document also outlines steps to take to secure patient information on handheld devices in accordance with HIPAA and identifies several free and commercial applications and resources available through the library.

1. Handheld Medical Applications Rudy R. Barreras Reference Librarian Pumerantz Library Reference Department

2. Objectives Differentiate handheld operating systems (OS) Know what OS is actively developing applications Comply with HIPAA regulations Locate Pumerantz Library handheld resources Locate freeware and commercial applications

3. Operating Systems Symbian Nokia, Motorola, Samsung, etc. PocketPC Dell, HP, etc. Windows Mobile Devices Shadow, Dash, etc. Palm Treo, Centro, Pre, Tungsten Blackberry Android iPhone/iTouch Actively producing new applications

4. HIPAA Definition HIPAA Title II: Health Insurance Portability and Accountability Act of 1996 (HIPAA, Title II) required the Department of Health and Human Services (HHS) to establish national standards for electronic health care transactions and national identifiers for providers, health plans, and employers. It also addressed the security and privacy of health data. (Centers for Medicare and Medicaid services, 2008) Simplified Any personally identifiable patient information you have, MUST be secured. HIPAA allows for stiff penalties for non-compliance YOU are responsible for patient information and HIPAA compliance

5. HIPAA Compliance What is personally identifiable information? Any personal patient information Test results Insurance information Record notes How to secure information Handhelds & laptops Locking programs for files or the entire handheld Best practice method Don’t take patient information with you

6. Office Applications Pocket PC and Windows Mobile devices Mobile versions of Office applications included Palm & BlackBerry devices Must download converter programs Documents to go – Palm BeamView – BlackBerry iPhone In development

7. Applications for school and in the clinic Asynchronous Calendars Contacts Organizers Office documents E-book readers Medical calculators & dictionaries Pharmacopeias Security Synchronous “ Push” e-mail Database searching E-journals Websites

8. E-book/Document readers All e-book readers are asynchronous For most handheld devices Adobe Acrobat Reader Isilo - Document Reader Mobipocket - Document/e-book Blackberry Beamberry – commercial application iPhone Stanza –download from Apps Store

9. Handheld Research Guide

10. Library Resources AccessMedicine MDConsult DynaMed Micromedex – Thompson Clinical Xpert Discounted Resources Epocrates Contact library for code Lexi-Comp Follow hyperlink from Lexi-Comp webpage

11. Library Resources

12. Library Resources - AccessMedicine MyAccessMedicine Handheld access is open to registered users, registration is free Handheld Features Save chapter & sections of e-books using an e-book reader applications Upload copyrighted pictures Diagnosaurus – Asynchronous DDX application

13. Library Resources - MD Consult A personal account is needed to download the PocketConsult application Features Uses MobiPocket daily summaries of current medical news weekly drug alerts the latest abstracts from hundreds of journals record, store, and initiate searches on MD Consult from your handheld

14. Library Resources - Micromedex Thompson Clinical Xpert is a FREE asynchronous application for Palm or PocketPC Thomson Clinical Xpert information covers... Drugs Interactions Diseases Lab Alternative medicines Toxicology News and alerts Convenient calculators Updated at each sync

15. Library Resources - DynaMed DynaMed - asynchronous point of care application For Palm OS, Windows Mobile, Blackberry and iPhone/iTouch Contact the library at [email_address] to obtain an access code for your handheld device Please specify your device type; i.e. iPhone, Palm, etc.

16. Pharmacopeias & Calculators Asynchronous Epocrates Lexi-Comp Micromedex MedCalc/MedMath Diagnosaurus QXMD Mediquations Synchronous Mobile PDR Orange Book Diagnosis Pro Epocrates Website Clinical Evidence

17. NLM Mobile Free resources sponsored by the National Library of Medicine Palm & Pocket PC compatible Accessible From the Library at http://www.westernu.edu/xp/edu/library/pda_directory.xml#library From NLM at http://www.nlm.nih.gov/mobile/

18. NLM Mobile Products Synchronous resource PubMed for handhelds Asynchronous applications AIDSInfo WISER NCBI Bookshelf

19. NLM Mobile Homepage

20. Where to Find More Apps Freeware Download.com AvantGo Tucows National Guidelines Clearninghouse Commercial iTunes Apps store Undbound medicine pdaMD Skyscape Modality HandheldMed

22. Personal Recommendations DynaMed – Library Serial # Epocrates – Free Products Lexi-Comp – Free products DDX Generator Mobipocket

23. Suggested Reading Jotkowitz, A., Oh, J., Tu, C., Elkin, D., Pollack, L. A., & Kerpen, H. (2006). The use of personal digital assistants among medical residents. Med Teach, 28(4), 382-384. Kho, A., Henderson, L. E., Dressler, D. D., & Kripalani, S. (2006). Use of handheld computers in medical education. A systematic review. J Gen Intern Med, 21(5), 531-537. Knox, C., & Smith, A. (2007). Handhelds and HIPAA. Nurs Manage, 38(6), 38-40. Pancoast, P. E., Patrick, T. B., & Mitchell, J. A. (2003). Physician PDA use and the HIPAA Privacy Rule. J Am Med Inform Assoc, 10(6), 611-612. Rothschild, J. M., Fang, E., Liu, V., Litvak, I., Yoon, C., & Bates, D. W. (2006). Use and perceived benefits of handheld computer-based clinical references. J Am Med Inform Assoc, 13(6), 619-626.

24. Reference Centers for Medicare and Medicaid Services. (12-14-05). HIPAA General Information – Overview . Retrieved April 10, 2008, from http://www.cms.hhs.gov/hipaageninfo/ .

25. Contact Pumerantz Library Reference Department In-person Phone 909-469-5323 ask for Reference Ask a Librarian http://www.westernu.edu/xp/edu/library/library-ask.xml Chat http://www.westernu.edu/xp/edu/library/library-chat-reference.xml