Handheld health care delivery and education to conquer Canadian hospital world

Toronto 07 January 2002Faced with increasingly smaller budgets and a shortage of physicians, Canada's medical community is going digital to deliver better patient care and streamline processes. Health care professionals, medical researchers, doctors and interns regularly turn to Palm handhelds to assist them in day-to-day duties from illness assessment to ongoing patient management. Last year, the Canadian Medical Association (CMA) cited that more than 25 percent of physicians under age 35 have used a PDA in clinical practice.


In hospitals and similar settings, handheld technology is being used as a teaching tool for medical students, paramedics and nurses, and for overall patient education. In addition, handhelds are fast becoming an important element for conducting effective clinical research studies, making the data collection processes more efficient.

"Palm handhelds have experienced strong growth in the Canadian health care industry last year, a trend which appears to be gaining momentum", stated Palm Canada President and General Manager Michael Moskowitz. "Handhelds are being used to educate, train, reduce errors, enhance practice efficiencies, manage supply orders, and store and quickly retrieve large amounts of medical information."

At Mount Sinai Hospital in Toronto, Palm handhelds are being used to provide up-to-date medical information to physicians in the hospital's Critical Care Unit, and to monitor and log the educational experiences of surgical interns and medical trainees. Doctors working in the Critical Care Unit have been using Palm handhelds to collect and share patient information.

Palm handhelds aid in the transfer of information from one doctor to the next when shift changes occur, and with applications such as mobile drug databases now in use, Palm handhelds have become an indispensable tool for the proper and timely administering of drugs. Currently, Mount Sinai's pharmacy is equipped with Palm m500 handhelds and staff are evaluating four handheld databases, including the drug-reference database ePocrates Rx.

In addition, 75 surgical postgraduate trainees are using Palm handhelds to document their educational experience and log procedures they have conducted over a two-year period, downloading these via the Internet to a central database. This allows individual trainees to access their data and enables the programme director to follow the trainees' progress and assess which hospital provides the best learning experience.

"At present, Palm handhelds have significant potential to improve access to information and overcome many of the problems with communications which plague health care delivery", stated Dr. Stephen Lapinsky, associate director of the Intensive Care Unit at Mount Sinai Hospital. "I have a number of medical reference databases on my Palm handheld. Even my office scheduling is linked to my handheld, as well as to my assistant's handheld."

With the increased demand for medical solutions, Canadian developers are actively creating portable databases, reference texts, diagnostic aids and conversion keepers. For example, Metaworks Inc., based in Halifax, Nova Scotia, has developed a series of health care applications which encompass a selection of calculators, analysis engines and reference tools. The company has made demo versions of many of its applications available for free download including the following:

  • Apache II, a prognostic scoring method which measures the severity of an illness in critically ill patients;
  • Respirology, which collects data in order to facilitate the selection of patients for research-study purposes;
  • ABG Decoder, which allows users to interpret blood-gas values;
  • Top Flow, to quickly calculate cardiac outputs for a range of cardiac indexes using patient height and weight; and
  • Mantis Rx, to assist pharmaceutical sales representatives with collecting and managing product-related information and to provide product education to doctors and pharmacists.

"Two of our applications are currently in use at the QEII Health Sciences Centre and the Dartmouth General Hospital in Nova Scotia. One of these applications is being used to collect data in order to facilitate the selection of patients for clinical drug trials in the field of respirology", stated Christopher Hachey, president of Metaworks Inc. "We are also in the process of developing a medical dictionary and a drug-interaction application for a major pharmaceutical company. Applications such as these are more efficient and accurate than traditional paper-based data collection and reference tools, and provide fingertip access to a wealth of information."

The biggest increase in the use of handheld technology in the medical field can be seen in medical schools and internship settings. Whether students are in a rural setting making house calls or a large urban hospital, having information when and where they need it is critical. With Palm's latest models, the Palm m125, m500 and m505 handhelds, which feature Palm's SD Card/MultiMediaCard expansion slot, students can easily move health information resources, such as textbooks or reference manuals, to the point of care. Students often use a multitude of applications.

At the Centre Hospitalier de l'Université de Montréal, each new intern is given a Palm handheld to carry necessary information while they are working. Contained on the handhelds are speciality reference books and drug reference guides, which also are available for purchase. More news on the use of handhelds in Canadian health care is available in this VMW issue's article Canadian rural doctors increasingly converted to Palm handhelds for efficient patient care.

Leslie Versweyveld

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