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From the October 2001 Issue HIPAA and MCOs: Administrative Simplification or IT Modernization? |
Information Where It’s Needed Function-rich and diverse applications make point-of-care data access a healthcare reality.
The term “mobile computing” has been a buzzword in healthcare for several years, but the absence of useful applications—except those that could be run on a laptop mounted to a cart—has traditionally restricted growth. That’s changing now as the major providers of healthcare information systems have rolled out modified versions of their applications suited for pocketable Personal Digital Assistants (PDAs). These mobile devices, coupled with proliferating wireless local area networks (WLANs) in hospitals, are proving a potent mix for increasing caregiver productivity and reducing medical errors. Applications Rule the Day Mobile computers only provide value if they do at least one of three things:
That is just what most hospital information systems providers have targeted. Some of the applications that have been rolled out include: positive patient identification; lab ordering; medication ordering; and viewing lab results, vital signs and supply management. Interestingly, all these applications have returns-on-investment that pay for themselves in months, not years. One of the most exciting mobile applications being deployed in healthcare today is medication administration. Using a mobile computer with an integrated bar code scanner at the patient’s bedside, the clinical staff scans the patient’s wristband, which has a bar code printed on it. The caregiver scans his own badge and finally scans the unit dose medication. The mobile computer then communicates via radio to the hospital’s IT system to insure that the right patient is receiving the right medication, at the right time, via the right route and in the correct dose. It also electronically documents who gave the medication and when it was given. These systems have been so successful in reducing errors in hospitals that the American Society of Health System Pharmacists has recommended to the FDA that it require all medications to carry bar codes. A number of well known healthcare IT companies have already deployed this technology, and more are sure to follow. IS Department’s Perspective
As the suite of healthcare specific applications grew and the “me-too” factor among the clinical staff kicked into high gear, IS departments were faced with a challenge. How would they support multiple devices running multiple versions of multiple operating systems while controlling sensitive patient data? The answer was clearly that they could not. It was this situation that inspired the current usage model for mobile devices in the hospital—application specific devices, owned and maintained by the hospital’s IT staff. The clinical staff picks up the devices at the beginning of the shift, and leaves them at quitting time. Additionally, IS staffs have realized that mobile devices being deployed for healthcare have unique requirements that consumer type devices are ill-suited to address. The first is battery life. Mass consumer devices are designed for how a typical consumer uses the device—turn it on for a short period, enter or retrieve data, and shut it off. Mobile computing devices deployed in healthcare are not used like that. They are turned on for a good portion of the entire shift and have radios communicating constantly with the hospital’s information systems, another drain on the battery. The minimum requirement for a device being deployed in a clinical setting is that it gets at least a shift’s worth of battery life per charge. If it doesn’t, acceptance by the staff will be seriously jeopardized. The second challenge facing the IS department, as well as clinical staff, is that a deployed device must be resistant to pathogen contamination when it comes in contact with bodily fluids, and it must be fully cleanable when it has been exposed. Finally, the device has to be more “rugged” than consumer grade devices. The dynamic and fast-paced environment in which clinicians work invariably leads to handheld devices being dropped and bumped. The mobile device needs to survive this treatment and perform flawlessly moments later. A patient’s well-being may depend on it. All of these device requirements point to “industrialized” PDAs, the type (not coincidentally) on which most healthcare information system providers have deployed their mobile applications. These devices address the concerns noted above—namely they are designed with increased battery life and integrated radios, they are sealed to prevent contamination and allow for cleaning, and they are “ruggedized” to survive the treatment they are likely to see in a healthcare setting. Coming Soon to Your Hospital The nursing shortage, along with increased scrutiny on reducing medical mistakes, has dramatically increased the rate at which hospitals are adopting mobile computing technology to enhance productivity and improve patient outcomes. Traditionally, all of the hospital’s information systems were only accessible at the nurses’ station, which from a workflow perspective is neither where information is needed most, nor where the actual data collection occurs. Mobile computing has forced a paradigm shift to retrieving and recording data at the point of activity – namely at the patient’s bedside. With HIS vendors developing useful mobile applications that interface to their existing network applications, and returns-on-investment that would make any CFO smile, your clinical staff will be using mobile, handheld computers sooner than you think. © 2001 Nelson Publishing, Inc |
By
Jeff Schou, director of worldwide healthcare markets for
Early adopters of mobile computing technologies used their independently acquired PDAs to access the information they needed to do their jobs. They would load up their schedules or a database of drug interactions and then do their rounds.