of Palmtop Technology in Medicine Part 1
By: E-Healthcare Connections www.e-healthcare-connections.com
E-Healthcare Connections ("EHC") is an information
intermediary and publisher servicing a broad audience
of high-level healthcare industry executives and physician
leaders. EHC reviews, analyzes and reports on developments
in the healthcare Internet in order to assist its readership
and viewers to better comprehend the practical applications
as well as the strategic implications of the burgeoning
healthcare Internet community.
This article is republished with the kind permission
of John D. Cochrane Editor & Publisher Health System
Executive & E-Healthcare-Connections
John can be reached via email
While health care IT executives ponder the meaning of HIPAA, a
quiet revolution is taking place in the hallways, at the bedsides,
and in the clinics of the nation's hospitals. It's the rapid deployment
of both clinical and adminstrative information to and from the palmtops
of physicians. It's a development that may hold the solution to
the health care integration puzzle.
HIMSS Panelists Predict a Strong Future for PDAs.
Personal digital assistants, or PDAs, will play a
vital role in the future of health care information technology,
according to a panel of vendors speaking at the January 28th Annual
HIMSS Conference and Exhibition in Atlanta.
Wireless PDAs offer three fundamental capabilities
to caregivers and other health care I.T. users, according to Stephen
C. Wilson, research and development manager at Welch Allyn Inc.
They can simplify workflow, optimize productivity, and enable real-time
access to health care data anytime
As it stands, not quite 20% of physicians use PDAs
today. A show of hands at the HIMSS educational session, titled
The Future of Wireless PDAs in Health Care, indicated
that an overwhelming majority of the more than 500 people attending
the session use PDAs today. Of those, about one third have real-time
wireless services, and about 20 use their PDAs for clinical applications.
Physician use of mobile devices and applications -
including electronic prescribing, charge capture, charting and others
- is expected to fuel an industrywide sales leap. Sales should grow
214% from 2001 to 2002, according to Forrester Research Inc., Cambridge,
Mass. Forrester predicts sales of hand-held devices and applications
used by doctors will grow from $19.4 million in 2001 to $60.9 million
in 2002 and $181.35 million in 2003.
At the root of this growth are physicians who began
using PDAs as appointment books to manage daily schedules and store
addresses and phone numbers.
The next phase was physicians tapping PDAs - which
today range in price from approximately $200 to $800to access
reference information on drugs, including interactions and dosages.
According to a study conducted this fall by The Boston
Consulting Group and Harris Interactive, 22 percent of doctors use
electronic medical records to store and track information about
their patients, and that number is expected to double by spring
2003. BCG and Harris interviewed more than 400 U.S. physicians for
the study, titled Doctors Say E-Health Delivers.
For some organizations, the next step will be to install
systems for physicians to write prescriptions on hand-held devices.Prescription
writing via hand-helds is eliminating the legibility problem and
cutting costs by decreasing telephone interplay among provider organization
staff and pharmacists.
In addition to physician group practices and hospitals,
other health care organizations, including managed care and public
health organizations, are implementing hand-held technology. Examples
of new hand-held technology use abound.
Stanford (Calif.) University Medical Center
Physicians at Stanford (Calif.) University Medical
Center access radiological images via PDAs. The medical center is
using a wireless infrared network from Clarinet Systems Inc., Milpitas,
Calif., to extract data from a picture archiving and communication
system from GE Medical Systems, Milwaukee.
Horizon Blue Cross and Blue Shield of New Jersey
Horizon Blue Cross and Blue Shield of New Jersey is
sponsoring a pilot program for physicians to gather and transmit
patient data at the point of care. Physicians use hand-held devices
and software from ePhysician, Mountain View, Calif., to write and
transmit prescriptions, view drug formulary compliance information,
capture billing data, and access clinical data.
BC/BS Rhode Island Launches Prescriptions Online
Blue Cross & Blue Shield of Rhode Island (BCBSRI),
Rhode Island Primary Care Physicians Corp., ePhysician and PharmaCare
have begun an electronic prescription program, with 42 primary care
physicians in Rhode Island, seeking to reduce the number of prescription
errors caused by illegible handwriting. The pilot program, part
of Project BluePrint, has the support of the Rhode Island Department
of Health and Board of Pharmacy. As part of the six-month pilot
program, BCBSRI is providing Palm handheld devices and the first
six months of the monthly ePhysician subscription fee at no cost.
At the end of the trial period, participating physicians
will keep the Palm devices and may continue in the program by assuming
the subscription fee. While the programs main purpose is to
increase the legibility of prescriptions, the ePhysician application
also provides a software program that contains information on drug-drug
interactions and updated formulary information. The software also
allows physicians offices to review a prescription if the
is out of the office. In compliance with current regulations, physicians
will not transmit prescriptions for Schedule II controlled substances
through the ePhysician system, which must be handwritten. Visit
for more information.
Saint Francis Hospital, Tulsa
Saint Francis Hospital in Tulsa, OK is using connectivity
software from Tulsa-based Locker Consulting Inc., which the company
developed with Per-Se Technologies Inc., Atlanta. The software brings
to physicians palmtop only select clinical data: height, weight
and allergies; lab results; and medications prescribed and administered.
Most physicians in the program are using Palm PDAs. The system is
expected to include devices using the Pocket PC operating system
Saint Francis Hospital piloted the new hand-held system
in August and began rolling it out in October with five physicians.
The hospital is targeting more than 100 doctors. Data available
to the PDAs is updated hourly, and most physicians download the
data from syncing stations.
The system also enables non-Palm devices to download
data via infrared syncing, a process that takes up to two minutes
for data on 10 patients, compared with 20 seconds through the fixed
cradles, Paulson explains.The only cost to physicians is that of
the PDA. Syncing stations range from $30 to $120.
The hospital has a radio frequency-based wireless
network in place thats used for entering patient vital signs
via cart-based laptops. The physicians found the laptop system too
difficult to work with.
In late January, MercuryMD announced that Novant Health
System - located throughout central North Carolina is rolling out
MercuryMDs MData En-terprise System to 300 health professionals
during the next six months.
Novant Health is a not-for-profit health system with
hospitals and physician practices in the Winston-Salem and Charlotte
regions, serving more than one million people in 32 counties. The
health system consists of seven hospitals with approximately 2,000
Novant Health completed its implementation of MercuryMDs
MData Enterprise System in December 2001 with 30 physicians participating
in the pilot plan. Based on the successful pilot, Novant plans to
roll out MData to 150 physicians by mid-March with an additional
150 using it by June 2002.
According to Toni Kourey, Chief Information Officer,
achieving those numbers is not expected to be a challenge. We
have received an overwhelmingly positive response from not only
our IT staff but also from the physicians currently participating
in the pilot program, said Kourey Our IT team is pleased
with how smoothly the installation went and our physicians praise
how convenient - and time-saving - it is to have patient data at
their fingertips without having to go track it down.
Moses Cone Health System
Physicians and pharmacists at Moses Cone Health System,
Greensboro, N.C., a five-hospital system, are accessing patient
data from an electronic medical records system via PDAs. Clinicians
get patient data by syncing via a mobile infrared system that enables
them to review patient demographic information, diagnosis, lab results
and medications using an application from MercuryMD Inc., Research
Triangle Park, N.C. The system runs on a server from Extended Systems
Inc., Boise, Idaho.
The system went live in October with about 100 physicians
on board by months end. They hope to end up with at least
half of the 600 physicians enterprisewide using the system. Doctors
at Moses Cone can use their Palms to access patient records from
an EMR system by IDX Systems Corp.,
Burlington, Vt. The handheld system soon will accommodate devices
running the Pocket PC operating system.
The goal was to pull out the most vital information
from the patients electronic medical record. The hand-held
system can show up to 2,000 characters of a transcribed report within
the electronic record.Physicians were quick to accept the new system
last summer. Less than three months later it went live.
According to Patrick Wright, a pulmonologist and critical
care physician at Moses Cone Health System, Once or twice
a day before rounds, I would have
to spend at least an hour and a half sitting in front of a computer
terminal, looking up my patients data and writing down information
on little scraps of paper that I would take with me. MercuryMD
was an unknown startup company based in Durham, N.C. MercuryMD founders
were residents at Duke.
The main problem in healthcare IT is that the
systems that do exist dont get used, says MercuryMD
CEO Alan Ying. Rolling laptops - where a laptop is attached to a
cart for the doctor to roll from room to room - cannot be carried
easily from floor to floor, and even laptops are too cumbersome
for most doctors to use while examining a patient. Worse, many doctors
are notoriously technophobic. Ying believed the Palm PDA was a way
around these barriers, since a growing number of doctors were already
using them for calendaring and other tasks. But MercuryMD did not
yet have any customers,
or even a beta user, when Ying visited Moses Cone.
Health system CIO Jenkins was extremely skeptical
but was willing to go along with a 90 day pilot. Jenkins picked
a group of about 20 doctors to participate in the pilot. As part
of the deal, they had to have their own Palm OS device. Moses Cone
did not charge them for the application. The initial pilot group
was up and running with MData in April 2001. Moses Cones IT
staff ended up putting in about 100 hours for validation and testing,
but MercuryMD took care of linking the software into the hospitals
primary IDX LastW ord Admission, Discharge, and Transfer system.
The MercuryMD team also built links to the hospitals other
major data sources, including a Cerner radiology system, a SunQuest
lab application, an IDX pharmacy system and a MedQuist transcription
system. In a matter of a few weeks, the users were ecstatic about
the MData application, according to Jenkins.Sixty days into the
pilot, a survey completed by all of the users confirmed the positive
To use the system, doctors insert their Palm into
a Clarinet sync station (located in the physicians lounge,
near the elevators, and in a few other spots around the hospital),
input their PIN and other security data, and wait for the download
to complete, a process that takes about two or three minutes. Then
they can go about their rounds, armed with nearly real-time clinical
information such as lab results, notes, and medication information.
If a patient asks what were the results of his
bone scan, I can pull that data up right then, says Wright.
I can check chemistry and labs and all the vital information
that is supposed to be in the patients chart but usually isnt.
If Wright has a question about a drug, he can look it up in the
ePocrates drug database right on his Palm and get an immediate answer.
Compared to hunching over a PC scribbling down numbers, taking the
time to get to a sync station and download the latest data is nothing,
says Wright. This saves me so much time.
Jenkins rolled out the MData system to 300 doctors
and pharmacists - about half of its medical staff - in November
2001. He is in the process of deciding whether to expand the project
to all the groups doctors and nurses, and whether to charge
them for the application. The current version of the system is read-only.
Future MData versions may support limited physician data entry,
such as the ability to input billing information. Jenkins is sure
Moses Cone will get a return on its investment in MData, but hes
leery of trying to quantify it yet.
Im willing to bet that this doesnt
show up on anyones bottom line - at least not right away.
Right now, we have no evidence that it will do anything other than
save people time. But that is enough of a contribution, he
says. In the long run, it will save us dollars. You just cant
put your finger on it and count that today.
Another bonus: The infrared system lets him postpone
investing in a more costly wireless data network, which he says
he will have to do in the next two years or so. The MData system
will help cut down on errors, raising patient and physician satisfaction,
by giving doctors near-instant data that they previously had to
struggle to access. Says Jenkins, We will get back way more
than we invest.
Some 15 pharmacists were using the hand-held system
by December, says Jan Stafford, a systems analyst and pharmacist.
The hospital pharmacy purchased eight PDAs that are shared among
about 15 pharmacy staff at any given time. The PDAs in use are Palms
or devices from HandEra Inc.,
Des Moines, Iowa, formerly known as TRGpro. Time savings in the
Moses Cone Hospital pharmacy are estimated to be at least 60 minutes
a day, multiplied by 15 pharmacists earning $30 to $50 per hour.
Savings on the physician side are estimated to be 30 to 90 minutes
a day during patient rounds from bypassing workstations and the
time associated with printing patient data on paper. Savings played
a major role in Moses Cone Health Systems decision to buy
an infrared-based hand-held system as opposed to a wireless, radio
Infrared beaming technology is common
among PDAs. Cost per location is about $65,000 compared with about
$500,000 for a similar wireless infrastructure. The delivery system
spent about $250,000 on the initial implementation.
Moses Cone wants to relieve stress on its 3,000 nurses,
as well. So it plans to pilot a hand-held nursing system this year,
says Jenkins, the CIO. He believes the technology has great potential
for another big step for his organization as well as many others:
physician order entry.
Doctors at the delivery system arent doing any
data entry yet, but the hospital is working with MercuryMD to explore
Temple Physicians Inc.
Temple Physicians Inc. in Philadelphia is implementing
a prescription management system from Allscripts Healthcare Solutions
Inc., Libertyville, Ill.. The delivery system includes six hospitals,
long-term care, homehealth and a 320-physician group practice based
in the medical school. According to chief medical officer, Eric
Mankin, M.D., chief medical officer, charge capture was important
to Temple Physicians, but even more critical was the need to combat
rising costs. We were facing 20%-plus increases in pharmacy
costs in our hospitals, where we accept risk for thousands of patients,
Mankin told local reporters. The Allscripts software allows doctors
to write and track prescriptions and manage drug formulary compliance,
in addition to accessing clinical decision support. We wanted
to show we were formalizing a plan to minimize our malpractice risk,
and prescribing is one obvious area, says Mankin, who was
named 2001 Physician of the Year by Microsoft for excellence among
physicians using PocketPC-based mobile devices to improve quality
The hand-held system operates on a PocketPC platform
and data is transmitted on a wireless network from Lucent Technologies,
Parsippany, N.J. Physicians access data residing in the organizations
practice management system from IDX Systems Corp. via iPAQ devices
from Compaq Computer
The organization piloted the system in three physician
practices in autumn 2000 and began implementation in early spring
2001.Wireless electronic prescribing was phased in from April to
September and included 135 physicians last month. Early results
showed that physician prescribing patterns are conforming to drug
formulary requirements since the system went live. Between
a quarter and a third of all prescriptions show a suggested alternative,
Mankin says. About 70% of these alternatives are accepted,
depending on the doctor and the practice. We ve seen a rise
in total generic drug prescriptions from 39% to a little over 50%.
W e hoped to improve the office efficiency of practices,
Mankin says, because 50% of their phone calls are related
to drugs, including patients and pharmacies calling about nonformulary
drugs and checking pre-scriptions. His group hoped to reduce
front desk staffing ratios and already has seen a reduction in the
number of calls from pharmacies. He attributes this to decreased
drug interaction problems and incorrect dosages related to physicians
having the PDA access to more data.
Carle Clinic Association, Urbana, IL
Carle Clinic physicians, nurses, nurse practitioners
and physician assistants all use Palm devices that access patient
data and track outpatient service charges via a charge capture application
from Durham, N.C.-based MDeverywhere. Clinicians use PDAs for all
outpatient visit charges, with an eye on preventing lost charges
and decreasing the lag between the time of a patient visit until
the charges are entered into the system. Carle Clinic is on the
way to its goal of
getting 98% of charges into the billing system within two to three
days. Before the new charge capture system was implemented in June,
the rate was about 90% within seven days. They are about halfway
to the target.
Clinicians start their day by syncing with a patient
scheduling system from Epic Systems Corp., Madison, W is. Then they
enter services and procedures performed throughout the day. The
charge capture system compares charges with CPT and ICD-9 codes
to ensure correct coding. Another feature of the new system is that
charges are automatically checked against code sets under Local
Medicare Review Policies set by CMS. Nearly 70 clinicians were using
the system in December. The clinic hopes to have at least 200 of
about 345 physicians and midlevel providers using the system by
That goal seems reasonable given the results of a
survey conducted 90 days into the implementation. Physicians reported
a 98% approval rate. The system already is producing cleaner data
and more thorough charge capture and charge tracking.
Return on investment so far is measured in terms of
eliminating paper forms and their resulting storing and filing expenses.
Costs are running about 65% of the paper-based system.
That figure compares favorably to ROI numbers recently
publicized by MDeverywhere that are based on reports from seven
organizations using hand-held
devices to collect patient encounter data at the point of care.
The studies compared claims administration efficiency for a 90-day
period before and after rolling out the devices. Overall, the provider
organizations reduced lost income due to misplaced encounter forms
an average of 95% and slashed lost income from miscoding by 66%.
Daily charge downloading to a practice management system cut claim
write-offs by 85% and trimmed the number of days to reimbursement
by 64%, the study showed.
The Carle Clinic intends to pursue more PDA applications.
It expects to pilot a wireless network in one of the organizations
13 branch locations this year. The goal is to enable access to electronic
medical records, lab results and further charge applications.
Handheld pen tablet computers will also play a key
role. The pilot device likely will come from Fujitsu PC Corp., Santa
Clara, Calif., and will interface with the charge capture system.
The wireless system will be introduced enterprisewide, including
the organizations core hospital.
Other applications already in place include medical
residents using Compaq iPAQs to get class assignments. The organization
also is exploring digital dictation via PDA.
University of Iowa Hospital & Clinics
The University of Iowa Hospital selected a Windows
CE-based system for its wireless handheld PC solution. Dr. James
Flanagan was a key decision-maker involved with the selection. He
is an associate professor of clinical internal medicine who treats
patients and teaches medical students. He also is director of clinical
informatics for the computer patient record program at the University
of Iowa Hospitals and Clinics in Iowa City, Iowa. In that role,
he selected the W indows CE-based Intermec 6651 handheld for the
task of migrating from desktop PCs in the exam rooms to mobile computers.
Dr. Flanagan chose the 6651 mobile device for several reasons.
The order entry piece drove us to wanting this technology,
he says. Doctors movefrom room to room every 5 to 30 minutes. We
wanted to introduce the convenience of a personal wireless workstation
so the physician could be logged in all the time. We wanted to collect
information in real-time while the physician was with the patient.
That way the physician could enter data into the handheld simultaneously
and not have to do it as a separate task after the
patient left. That not only saves time for the doctor, but entries
on the handheld automatically generate orders for the nursing staff
(draw blood, take tissue samples, administer a medicine) and sends
prescriptions directly to the pharmacy.
We were looking for a device to give our outpatient
physicians mobility, while maintaining connectivity to the network
so they could access up-to-date patient information in real time.
W e needed a handheld with a larger screen, bigger
than a Palm device, that had touch capability and a keyboard. Even
though the 6651s are pen computers, there is still a need to type
in short pieces of text or individual words in order to search for
something. A comforting part of the transition from desktop to mobile
PC is that the screens on the handheld computers look just like
those on the desktop. That drastically reduced training time and
permitted the physicians to begin working with the units quickly.
About 100 physicians practice in the universitys
General Medicine outpatient clinic and visit with patients in some
36 exam rooms, many of which are equipped with hard-wired desktop
PCs used to access W indows-based INFORMM Patient Record (IPR),
the patient record program developed by the hospital. Now, with
the new wireless network in place, IPR is accessible via the mobile
Through IPR physicians access patient lists, order
tests, review the results of tests and prescribe medications in
real time. They can even call up images of patient x-rays on the
6651s 7.1 inch diagonal screen and view them.
W hen developed over 20 years ago, INFORMM was hosted
on a mainframe computer. Six years ago it is moved to aWindows client
server model. The next step is development of an XML version to
migrate parts of the program to a W eb-based application, a move
that is currently underway. Today, about 10 physicians are using
the 22-ounce model 6651 handheld units instead of the desktop units
during patient visits.
Doctors report several benefits to using the mobile
PCs while treating patients. They can:
face the patients while treating them and easily share with
patients the results of tests or other information;
avoid spending patient time logging on to desktop PCs;
keep the wireless mobile computers with them at all times instead
of taking up room with fixed-location PCs;
save the cost of putting fixed PCs in all those exam rooms;
more easily follow the clinics business procedures, ensuring
proper treatment, payment and reimbursement.
Perhaps the most important benefit of sharing real-time
data about patients throughout the healthcare facility is the increased
level of visibility it provides. For
example, we may have new data in the nursing database that suggests
the patients blood pressure is too low to be given a certain
medication prescribed sometime earlier by a physician, Flanagan
said. A physician can move quickly to prevent a dosage problem if
they see other information we have on the
patient. Its important that all patient information be updated
in real-time, since it is accessed in real-time. Flanagan did not
want to rely on a docking port to upload and download data minutes
or hours after the patient visit. The information by then may be
out of date.
One thing thats driving our use of wireless
mobile computing is the need to comply with Medicare regulations,
Flanagan emphasized. That means making an appropriate diagnosis,
prescribing the appropriate tests or treatments and making sure
the hospital receives payment for services rendered. Our system
is designed to automatically check to determine whether or not a
test I might order for a Medicare patient is reasonable and
necessary. The business rules for Medicare are written into
our system, and that helps reduce the time needed to determine whether
a patient will have to pay for a Medicare treatment. The doctor
enters the test he or she wants to order, enters the diagnosis and
checks against Medicare regulations. If approved by Medicare, the
physician proceeds to order tests or treatments. If the test is
not approved by Medicare, we can see it on the handheld right away
and can alert the patient that if she
wants the test she will have to pay for it.
Monthly Local Medical Review Policy updates to the
IPR software ensure that the records system complies with the latest
rules on what Medicare will and will not allow. The handheld also
provides feedback to physicians on the local medical review policy,
or LMRP, which includes information on tests that are typically
ordered for specific diagnoses.
W ireless connectivity between the 6651 handhelds
and the thin client Citrix server is established through seven Intermec
2101 access points strategically placed through-out the outpatient
clinic. Access points are radio frequency transceivers, usually
installed in the ceiling, which permit the wireless mobile computers
and the server to communicate. Citrix software allows any application
that runs on a desktop PC to run on a properly configured mobile
Each handheld contains a standard 2.4 MHz 802.11 compliant
radio card to communicate with the server via the access points.
Built-in W ired Equivalent Privacy, or W EP128 protection, provides
a high level of security on the Intermec wireless network.
Patients find the handhelds pretty unobtrusive, Flanagan
said. They do seem to notice if you are checking on their records
in front of them, and they do appreciate it because they see you
are really up to date on their information.
On the other side of the screen, it did not take much
effort to convince some of the physicians in the clinic to begin
using the 6651 mobile computers. Theres always a certain set
of physicians who are most eager to be involved in these kinds of
things, Flanagan said. We had several volunteers come forward to
try these handhelds. They were early adopters who were looking for
solutions to the problems they face in the practice of medicine.
Physicians are finding that with our application, which is designed
to show a lot of info on the screen, they can adjust the flow of
information. They like that very much.
What s the next technology move at the University
of Iowa Hospitals and Clinics? Dr. Flanagan says hes ordering
more mobile equipment for the clinics to replace the fixed location
PCs in the exam rooms. Flanagan expects to add a medication administration
record (MAR) software package to the system. When the MAR package
goes live, bar coded patient bracelets will be introduced to further
enhance patient safety and reduce medical errors. Wireless handheld
computers with built-in bar code scanners will be used to scan the
patient bracelet before medicines are administered to ensure the
right patient gets the correct dose at the proper time.
Even though healthcare compliance issues may be driving
the implementation of wireless technology at the University of Iowa
Hospitals and Clinics, Dr. Flanagan is expecting improved patient
care and safety. Thats a prescription the healthcare industry
can take in good conscience.
Concentra Managed Care Services, Inc
Concentra Managed Care Services Inc. began a pilot
project for using PDAs in case management early this year. The software
is a project management application from Changepoint Corp. in Toronto.
The PDA-based software tracks and manages referrals; manages resources,
schedules and workflow; and generates invoices for 1,200 case managers
and administrators located throughout the United States and Canada,
says Larry Carr, president of Concentras case management division,
based in Waltham, Mass.
Concentra Managed Care Services had several goals
for its new system. First, we wanted more accurate and timely
communications from the main office to remote case managers,
Carr says. We wanted to improve the quality of our data and
improve the case managers quality of life. To do that we had
to reduce the administrative burden on them so they could allocate
more time to practicing their art.
Changepoint software, accessed via iPAQ devices, enables
Carr to take existing information systems that capture assignments
from client insurance companies, third party administrators and
their customers, and package and deliver them to the appropriate
case manager. And its all accomplished effortlessly, Carr
contends, by hot syncing the iPAQ with the central database.
Case managers exchange data by syncing their iPAQs through a cradle
connected to a virtual private network or encrypted dial-up line
via the Internet.
On another level, the hand-held system can relieve
the administrative load on case managers by enabling more timely
communications. The software lets them record their activities,
time and expenses, Care says. And voice recording capability
enables them to dictate clinical notes on the fly. The software
accumulates all the data and produces a record of billable, or appropriate,
Case managers save up to three hours per night that
no longer is dedicated to paperwork. At the same time, Concentra
Managed Care Services gets cleaner, more complete data from its
field force, helping them reduce errors and resulting expenses.
Costs for the hand-held system, includ-ing
hardware, software, and internal and external transition labor are
expected to fall between $3 million and $3.5 million, Carr says.
W e expect to reach the break-even point before the end of
the year, he adds.
The next generation of hand-held tech-nology, available
in two years or sooner, will enable entering full clinical notes
on handheld devices, Carr says.
Baptist Health, Arkansa
In mid-January another health system announced going
with MercuryMD: Leading Healthcare System Quantifies Efficiency
And Enhanced Workflow By UsingMercuryMDs MData Hospital Systems
Annual Estimated Savings To Exceed $500,000 Research Triangle Park,
NC; January 16, 2002 - MercuryMD, a company that integrates hospital
data and delivers patient information to healthcare professionals
handheld devices, today announced that user research from Baptist
Health - Arkansas largest healthcare system - in Little Rock,
Arkansas shows MercuryMDs MData Enterprise System saves money,
allows healthcare professionals to spend more time with patients,
and significantly expedites the hospitals clinical workflow
David House, Baptist Health Chief Information Officer,
expects that the time savings achieved with MData will enable his
organization to redeploy about 11 full-time employees, thus saving
the company $550,000 annually in staffing costs alone. In Baptist
Healths survey of MData users, nearly 70 percent of respondents
said they used their time saved to spend more time with their patients.
Spending more time with patients translates into improved
of care, House said. The survey also found that:
75 percent of respondents believe hospital-wide
use of MData will reduce treatment and medical errors,
83 percent of respondents believe MDatas use will facilitate
more efficient use of hospital resources, and
92 percent of respondents believe overall quality of patient
care is improved with the use of MData.
Additional cost-avoidance analyses from Baptist Health estimates
that hospital staff will save a combined average of 63 hours per
day by year-end, since they no longer had to manually gather patient
data for physicians and themselves. The group with the most significant
time savings were nurses, who often spent a significant amount of
time gathering data for physicians before physicians began using
According to House, MercuryMDs seamless integration into
the hospitals existing IT systems, and the simplicity of the
MData user interface were major selling points for the Baptist Health
IT staff. One of our driving principles is to offer technology
that maximizes adoption, and this survey research demonstrates the
usability and benefits of the MData Enterprise System.
These results serve to validate our compelling value proposition,
not only for the hospital, but for MData users as well, says
Alan J. Ying, MercuryMDs CEO. Baptist Health is Arkansas
largest healthcare pro-vider. A teaching healthcare system, the
company has five hospitals, 1,200 beds and 7,000 employees.
Swedish Medical Center, Seattle, WA
Palms are starting to be as common as stethoscopes in Seattle.
The University of W ashington s OBGYN department and Swedishs
family practice program hand out Palms to residents who dont
already have them.
Our residents use them for gathering statistics, said
Dr. Dee Fenner, an associate professor of obstetrics and gynecology
at the UW . We have to keep very accurate specifics, in terms
of the number of surgeries they perform, the number of outpatients
they see and the number of babies they deliver.
W e have forms that are put out by the Residency Review Committee
that have been adopted for the Palmt.
Fenner said her residents began testing Palm use three years ago,
but it wasnt until this year that her program eliminated the
paper tracking system. Residents store all kinds of information
that helps when counseling patients. They can have data on ultrasound
measurements, labor and delivery, and various lab values right in
the palm of their hands. They also often exchange information by
beaming tables and databases from one handheld to another.
Doctors have pointed to ePocrates ePocrates Rx, which is available
free on the Internet, as a particularly valuable tool, The San Carlos,
Calif., company that created the database, (www.epocrates.com)
says ePocrates Rx provides doctors with an electronic guide
to the most commonly prescribed drugs. The database has reached
more than 94,000 of Americas 600,000 physicians since it came
out in late 1999.
Handheld technology works well with the way that a physician
practices medicine, said Michelle Snyder, vice president of
marketing and strategic planning for ePocrates. Theyre
not sitting at their desks during the day. They go to clinic or
the hospital or maybe the emergency room. Its perfect
because they have the information with them wherever they may go.
The convenience factor also makes it more likely that doctors will
check for drug interactions. If Im in a room with a
patient and I have to go outside to my library to look up a drug,
thats just not something I am likely to do, one resident
says. But I carry my Palm in belt. If all I have to do is
pull it out and look it up, I am much more likely to do that.
In a study of ePocrates users conducted by a Harvard Medical School
teaching affiliate hospital, half the physicians who participated
said that ePocrates Rx 4.0 helped them avoid at least one adverse
drug reaction each week, according to the company.
Columbia University: Nursing School Moves to Handhelds
Columbia University School of Nursing, New York, has outfitted
its students with Palm m500 handheld computing devices from Palm
Inc., Santa Clara, Calif. Loaded with software from ePocrates Inc.,
San Carlos, Calif., the handhelds give students point-of-care access
to medication dosages, side effects and other drug information.
The university also has loaded self-developed software enabling
students to document their experiences, including diagnosis, intervention
and outcomes data, for later analysis by hospital officials. Collecting
some of the data also is a requirement for professional credentialing.
Continued in Part II