Personal Digital Assistants: Which One is Right for Me?
Personal digital assistants (PDAs) are quickly becoming an important working tool for the practicing physician. The value of these devices is in their ability to furnish physicians with the right knowledge at the point of care. They can provide instant access to information such as patient data, lab results, medical reference resources, drug guides, billing and coding systems and diagnostic tools. What device to purchase or software applications to acquire is dependent upon how a physician intends to use a personal digital assistant in his/her practice.
Early PDAs were primarily used like day planners or organizers. They all possessed basic features such as calendars for scheduling, address books and memo pads. Much has changed in the last few years. The PDAs of today offer an increasing range of functionality such as email and multimedia capability, word processing, spreadsheet and database software, Internet access, and infrared transfer. The first step in deciding which PDA to purchase is defining how you plan to use the PDA in your education and practice. One way to do this is to look at the large number of software applications available for physicians. Reviewing this information will give you an idea of how PDAs can support a physician's day-to-day work processes. There are several types of medical software applications available, which can be categorized as follows:
Patient Tracking: Depending on the type of software, a physician can keep simple patient demographic information or track more detailed information such as lab data, medical history and prescriptions.
Specialized Calculators: Software packages exist to calculate medication dosages, IV rates, etc.
Reference Materials: Reference materials, such as medical textbooks and drug references, can be downloaded to the PDA and be a handy source of information at the moment it is needed.
Internet Access: Many PDAs have the ability to access the Internet using either wired or wireless connections.
Billing: PDAs can track procedures to ensure proper billing. The electronic data from the PDA can be transferred to a physician's office billing system to minimize transcription errors and ensure all charges are captured.
Drug Prescription: PDAs can bring drug information to the point of care. They also have the ability to send prescriptions to pharmacies via wireless transmission.
Patient Education: Many of the medical software applications can be used to educate patients during a visit. For example drug references can help the physician educate the patient about side effects and drug-drug interactions. Health risk assessment tools and calculators can be used to demonstrate the impact that modifying a risk factor could have on altering a patient's health status. Image viewers could be used for visually educating patients about anatomic structures and disease processes.
Once a physician decides on how to utilize the PDA in his/her practice, the doctor can determine what device will support the desired software applications and functionality. The factors to consider when comparing devices include:
Operating System: An Operating System (OS) provides a software standard or platform on top of which other software programs or applications can run. The application programs, such as word processing or database software, are written to run on a specific operating system. Your choice of operating system, therefore, determines to a great extent the applications you can run. There are three main categories of operating systems for PDAs: Palm, Windows CE (PocketPC) and Epoc. The Palm OS is the most common platform and currently has the largest user base. This operating system is used by the Palm series and has been licensed by companies such as TRG, IBM and Handspring. The Windows CE or PocketPC OS is rapidly gaining favor amongst PDA users, due in part to its ease of use and greater functionality. If you use Windows 95/98/2000 on your personal computer you will have no problems with this operating system. Companies using the Pocket PC operating system include Compaq, Hewlett Packard and Casio. Epoc is an operating system created by the London-based software developer Symbian. Symbian is a joint venture between several companies (Psion, Nokia, Ericsson and Motorola) and is the most popular PDA operating system in Europe. It is a powerful operating system and like PocketPC comes with several applications such as word processing, spreadsheet, database, Internet browser and email applications.
Software Availability: Knowing which software applications you wish to run on your PDA is important as not all software is written for each type of operating system. In general, the Palm operating system has the largest number of applications available for PDAs. However, the PocketPC operating system's popularity is growing and many of the top software developers are writing applications for both operating systems.
Memory: The amount of memory a PDA requires is dependent on the type and/or number of applications used. If you wish to store several sources of reference material, for example, your memory needs may increase significantly. Some devices offer the ability to add extra memory to allow for increased user needs. It is important to identify those software programs you will be loading on the PDA to determine your device's memory needs.
Display: Color displays are available on PocketPC devices and some Palm devices. Color displays enhance the use of multimedia applications (i.e. ability to view diagnostic images). It is important to consider resolution and screen size when deciding whether or not to purchase a PDA with a color display.
Size: The size and weight of a PDA is dependent on manufacturer and model type. In general, Palm devices are lighter and thinner. PocketPC devices are larger but have the built-in advantage of color displays and expansion capabilities.
Options: Several options are available to increase the usability of PDAs. Options vary by manufacturer and model but include such features as portable keyboards, Global Positioning Systems (GPS), cameras, barcode readers, cell phones and modems. Organizations are exploring the potential of new wireless technologies that allow physicians to access patient information from hospital or practice management systems. If your healthcare facility is looking at mobile and wireless devices it would be important to determine if the PDA your purchase can support that capability.
Battery Life: Battery life is an important factor to consider when purchasing a PDA. Battery replacement can be expensive and inconvenient, therefore you should consider replacement costs and/or charge times for your PDA. For example, PocketPC devices offer color displays and lots of functionality at the expense of a very short battery life.
Security: How sensitive is the data you are keeping on your PDA? If it involves patient information you need to be concerned with security and privacy issues. To protect against unauthorized individuals viewing sensitive data you need to use the security measures built into the PDAs. In general, PocketPC devices have superior security to Palm devices. However, additional security applications are available for Palm Operating Systems, which can enhance the existing security measures.
Cost: How much to spend on a PDA must be balanced with what features the user needs and how long you plan to own the device. An increase in the amount of memory or the need for a color display will increase the cost of the PDA.
The popularity of PDAs in medical practice has been growing due to the large amount of information needed by medical professionals during patient care and the increasing demand for that information to be available at the point-of-care. The following Web sites can be used to begin the process of identifying the device and applications that can best support your practice of medicine.
Purchasing Information
www.activebuyersguide.com - This site allows the user to interact with a virtual sales assistant to give the best product recommendations based on user preferences.
General Information on Devices and Products
www.palm.com
www.pocketpc.com
www.palmgear.com
www.handango.com
www.pdastreet.com
Information on Medical Software Products
www.acponline.org/pda
www.allscripts.com
www.franklin.com
www.pdamd.com
www.medicalpocketpc.com
www.healthypalmpilot.com
www.epocrates.com
www.skyscape.com
Arshad Rahim
CSM Representative, Southeastern Region
University of North Carolina School of Medicine,
2002
Fran Spivak Medical Informatics Analyst, ACP
References
Bailey, M. & Allen, H. Prospective Users - What is a PDA? Retrieved April 30, 2002, from http://www.pdamd.com/vertical/tutorials/whatispda.xml
Lewis, M. Patient Education with a PDA. Retrieved April 30, 2002, from http://www.pdamd.com/vertical/features/PatMat.xml
How-To Guides - Palm Security. Retrieved April 30, 2002, from http://www.pdamd.com/vertical/tutorials/palmsecure.xml
HIMSS (Healthcare Information and Managment Systems Society) Handheld Healthcare Guide http://www.himss.org/webguides/handheld/index.asp
How-To Guides - PDA Buyers Guide, Part 2: How Do I Choose a PDA? Retrieved April 30, 2002, from http://www.pdamd.com/vertical/tutorials/buyersguide2.xml
Prospective Users - Why Buy a PDA. Retrieved April 30, 2002, from http://www.pdamd.com/vertical/tutorials/whybuy.xml.
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