Handheld Computers Boost Medical Apps

FRAMINGHAM (04/13/2000) - Handheld computers are beginning to be used effectively in health care to reduce errors and increase efficiency, according to project managers.

Early deployments and trials of handheld computers show that doctors, nurses and technicians are using the devices to speed billing and admittance and to help safeguard the administering of drugs and the taking of blood samples.

The relatively new technology has been slow to catch on in medical settings, according to industry observers. Although most doctors carry cellular phones and pagers, hospitals are "not big on information technology," according to Jack Gold, an analyst at Meta Group Inc. in Westboro, Massachusetts. One reason is that it's difficult for professionals to comfortably combine exacting procedures, such as drawing blood, with the use of new devices, Gold said.

As a result, putting handhelds in health care settings requires more development time than in many other industries, if only to ensure user acceptance, according to project managers.

"We spent most of our time in rolling out our handheld applications because our integrator [a division of medical supply vendor Beckton, Dickinson and Co.] had the technology but didn't have the clinical experience that we had and didn't know where to make the handheld technology force a user to do things to avoid mistakes," said Michael Mutter, pharmacy manager at The Valley Hospital, a 420-bed facility in Ridgewood, New Jersey.

Valley is starting a 10-week beta test in which nurses administer medications to patients, using SPT 1700 bar-code-scanning handhelds from Symbol Technologies Inc. in Ridgefield, New York, that run the Palm operating system from Palm Inc. in Santa Clara, California.

For the past year, Valley has been gathering blood samples from up to 30% of its patients, using handhelds and software from Franklin Lakes, New Jersey-based Beckton, Dickinson to guide technicians and see that blood is taken from the right patient and properly labeled.

The hospital took pains to make sure the functioning of the technology would match as closely as possible the process used by its professionals, Mutter said. Nurses and health care professionals "have a lot of ownership" in their procedures for administering drugs and drawing blood, he said.

Using a handheld at Valley, a technician must scan bar codes on his identity badge, the patient's wrist and the patient's record before the computer will grant permission for the technician to draw blood. After the blood is drawn, another bar code is printed from a small Symbol printer attached by a cable to the handheld computer and is affixed to the specimen.

Mutter said the process is reducing specimen collection errors to zero, compared with four to six per month under the typical procedure.

"[The] biggest obstacle in introducing handhelds is making sure that people understand the shift in the thought process that goes with data collection in different forms," said Eric Gee, a project manager at American Medical Response in Aurora, Colo. Gee is working to give up to 250 paramedics in 17 towns in San Mateo County, Calif., handhelds from Palm. When the project kicks off next month, paramedics will log information on emergency cases and capture a signature from a hospital official on the handheld when a patient is admitted to the hospital.

The American Red Cross in Arlington, Virginia, is moving toward making a major change to its paper-based blood donation process in a year. Project manager Christopher Patton said the process will eventually provide donors entering one of 450 daily blood drives nationwide with either a Windows CE or Palm OS handheld.

The donors will answer 40 questions on the handhelds instead of on a paper form as they do now, ensuring that they answer all the questions and reducing the time needed to input the information.

"Knowing it would be faster may encourage people to come out and donate," said Karla Heller of Bellevue, Wisconsin, who has donated many times.

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