Doctors Trade Clipboards For PDAsDoctors Trade Clipboards For PDAs

Doctors have long relied on clipboards and bedside charts to track hospital patients' health. But that's changing.

Mobile and wireless system providers are targeting the medical field as a natural fit for wireless communications, PDAs, and handheld devices. The promise: to provide doctors--often on the move from one hospital room to another--with easy access to a patient's records, treatment therapies, and other data. With handheld devices, physicians can order tests, check results, and prescribe treatments.

Moses Cone Hospital in Greensboro, N.C., has just finished testing a mobile infrared system that lets doctors, pharmacists, and physicians' assistants at its four affiliated hospital locations access patient records directly from PDAs. The system, which goes live this month and will initially be used by about half of Moses Cone's medical staff, combines MercuryMD Inc.'s Staging Database and client software with Extended Systems Inc.'s XTNDConnect Server.

The system lets doctors use handheld devices equipped with infrared ports to access patient records and download treatment plans at several dozen infrared beaming stations around the building. Doctors can regularly update their PDAs by synchronizing them with the hospital systems throughout their shifts.

The system provides "the location of the patient, the room number, and all the lab, radiology, and other information that's available for that patient," says John Jenkins, VP and CIO at Moses Cone.

Jenkins says the system cost approximately $250,000 to install. But the hospital expects to reap benefits because the system eliminates the need for doctors to sit down at workstations to check patient records or print out and fill out necessary forms. "The doctors on average save anywhere from a half-hour to an hour and a half a day by using this in their rounds," Jenkins says. "The time saved gets pretty staggering when you talk about how many people we have per hospital."

The hospital opted to use infrared hubs rather than a wireless-only system because of the price: A wireless implementation could cost up to $500,000 for each of the hospital's locations, compared with $50,000 to $60,000 per location using the infrared hubs, Jenkins says.

Moses Cone is considering adding wireless technology so doctors can access information anywhere, at any time. One Moses Cone physician, Dr. David Simonds, who admits he was previously a "technoskeptic," says he's looking forward to wireless access.

"The busier you are, the more time it saves you," says Simonds, a pulmonologist and critical-care specialist. "This gives me more time to spend with the patient. Per week, I think I save about five hours."

Simonds bought his own Palm IIIc device to access the system. "In the near future, the hospitals will have the constant transmission of the data," he says. "That's going to be phenomenal. That future is going to be exciting."

Moses Cone's physicians aren't the only hospital personnel to save time by using the new system. The pharmacy has also been given access to the MercuryMD system to access patient records and prescriptions via handhelds. Previously, pharmacists had to write down or print out information about each patient at the start of each day. Using the new system, each pharmacist saves an hour or more a day simply by having less paperwork. With 15 to 20 people working a day, at $30 to $50 per hour, the cost savings add up, says Jan Stafford, a systems analyst in management systems for Moses Cone who coordinates the pharmacy computer systems. "It's a time savings for the pharmacists, as well as having the data readily retrievable, since it's not on several pieces of paper or printouts," Stafford says. "And in following the patients and the consultations for the medication, it's important to have that data." The hospital's pharmacy uses the same system the doctors use, but Stafford's goal is to add specialized medication-profile modules that will be more specific to the pharmacy.

Other companies are approaching doctors to use handhelds in less-traditional ways, such as recording notes and instructions that can then be downloaded, transcribed, and processed on laboratory and patient-care systems.

This week, MDoffices.com Inc. is signing on with IBM for a service that will let doctors record patient notes on a Pocket PC device using spoken commands. Those commands are collected as standard audio .wav files that are then transcribed using IBM ViaVoice speech-recognition technology on IBM eServer p660 and p640 Unix servers. The notes are then verified by a medical transcription service and sent as E-mails or faxes to patients' pharmacies or labs. Billing systems can also be updated.

The service is priced at $2.50 per transcription. "We charge the physician whenever he produces a billable patient," says Dr. Kevin Smith, CEO of MDoffices. "It actually saves them money. The average price for transcription alone is $3 per page."

The MDoffices service is expected to be available in October.