1. RSM handheld computer workshop – 2004 January 26. Keynote lecture, page 1 of 3
Thank you for your introduction, and thank you all for coming here today. My name is
Mo and I will be leading one half of today’s workshop while Dr Chris Paton leads the
other half. Our workshop today is about size. We want to explain the advantages and
dangers of small size. Small is… different. By the end of today’s workshop, we want you
to have improved understanding of small devices: when to use them, how to use them,
and when not to use them.
Handheld computers are computers small enough to hold in your hand. Something
important happens when you have access to this much computing power at such a
convenient portable size.
The machines allow information management at a new level. You can improve your
organization; organize your education; and educate your clinical practice. Around the
world, clinicians are using the machines as efficient address books, powerful diaries,
sophisticated notepads and comprehensive task lists. They are also using the machines to
keep track of patients’ progress, personal education, and of course golf handicaps.
If you are new to, or have never before owned a handheld computer, you should attend
Chris’ sessions. He will tell you more about these in a few minutes, but his sessions
include hands on practice in using the machines.
More advanced users should come to my sessions. My focus is on getting the machines to
work right for you and for your team.
I wanted to start by showing you what I mean through this map. It is drawn by a Matthew
Paris, around 1250 AD, and shows Britain. As some of you might notice, Scotland is a

2. RSM handheld computer workshop – 2004 January 26. Keynote lecture, page 2 of 3
little underrepresented. In fact a note on the map, I am reliably told, says that “the whole
island should have been longer if only the page had permitted”. This is what happens
when you don’t think about the size of your display area.
A handheld computer is good for storing and displaying information that is the size of
your hand – a blood form, for example. A handheld computer is not so good for storing
and displaying information that is the size of your arm – a radiogram, for example. With a
little planning, information the size of your arm can be redesigned to for display on
devices the size of your hand – for example an A4 paper textbook. This small disk can
hold several textbooks, and this small computer can display and search through all of
them quickly and efficiently.
The fact that a small display is not good for a large radiogram does not mean that only
large devices are useful. A surgeon in an operation uses large retractors for parts of the
operation, and a small retractor for other parts of the operation. Part of his skills as a
surgeon comes from choosing and using the right retractor at the right time in the right
way.
My sessions will show you how to make such decisions for yourself with handheld
computers.
My sessions will also show you how to make such decisions for your team. Because the
team work aspect is one of the most powerful and underused in handheld computers. Let
me explain why it is so powerful.
First, sharing data is easy because of beaming. To beam, you line up two handheld
computers, press a button, and information is copied from one machine to the other
machine. That’s beaming. If I write the phone number of my hospital’s hematology
department, I can beam it to the SHO on my firm. The SHO can beam a copy to other
doctors, until everyone in the hospital has a copy. If a consultant puts lecture notes on her
machine, she can beam these to the students that attend her lecture. The students can
beam copies to the other students, until every student on the course has a copy. If a GP
copies a useful abstract from the British Medical Journal, he can beam it to the other
partners during the morning tea break. And he can document in his Personal
Development Plan that he did this and contributed to the education of other GPs.
Second, sharing data is flexible because of synchronization. This is the process of making
sure that two computers have the same information, with new information from one
copied to the other, and vice versa. In clinical practice, sometimes we share data by
having everyone in the team sit in the same room, at the same time, and swap
information: the morning trauma meeting in orthopedic departments for example. Other
times we share data by short ad hoc meetings: bumping into your senior while traveling
between wards for example. Unlike PCs, handheld computers make both such meetings
easy. For a morning trauma meeting the machines can synchronize to a central computer,
and pick up information on all the new patients, for all the clinicians. For an ad hoc

3. RSM handheld computer workshop – 2004 January 26. Keynote lecture, page 3 of 3
encounter, the clinicians can synchronize through beaming – the machines connect to
each other when lined up, and swap all the information about new patients encountered;
jobs newly completed; and new jobs to be completed.
Third, and I think most important, this is so cheap. I do not just mean that setting up a
project requires little money. Rather I mean that it requires little effort and little time. We
have all heard of the government’s large and complex NHS IT plan. I am delighted that
the UK government is finally taking IT seriously. But I also know that no matter how
comprehensive the plan tries to be, it will never fill every computing need that individual
clinicians have. And I particularly worry because such a centralized plan takes a long time
to carry out, and carries high risks, just because it is centralized.
Handheld computers make the perfect complement. Any doctor, practice or hospital can
afford to buy a handheld computer. Any doctor can figure out how to use the machine in
their practice or hospital. And a lot of doctors become so enthusiastic about the
possibilities of the technology that they involve other members in their practice or
hospital. If the machines work, you can spend more money, time and effort with more
machines. At each step, the costs are low and returns can be high.
I saw this happen in King’s Lynn during my first year of clinical practice. I helped set up
many such projects. When I wrote about this last year, having completed my house jobs, I
said that “… the achievement I am proudest of is that colleagues have started to think
differently about what they can achieve at work. Rather than often feeling discontented
and impotent about the state of affairs, they see that it is possible to bring about change.
They are not waiting for the Government’s next Plan to fix things – they have asserted
their own power to change.”
I hope that Chris and I can achieve this with you in today’s workshop. Thank you for your
time.
Contact details
Dr Mohammad Al-Ubaydli, me@mo.md