REVIEWA review and a framework of handheld computer adoption in healthcare
Introduction
Despite the differences in practice environments, the information needs of health care professionals at the point of care are universal. Most clinicians would benefit from mobile computing resources (such as evidence-based guidelines, medical reference, drug reference and patient information) to meet their information needs. Mobile computing adds value to clinical practice in a number of ways, such as by giving clinicians access to clinical information where and when the information is needed, by improving the exchange of information (thus, reducing medical errors resulting from inadequate access to clinical data), and by providing clinical decision support to give clinicians feedback at the point of care [1], [2], [3], [4].
Personal digital assistants (PDAs) are lightweight, compact handheld computers that literally fit into one's palm or pocket [5]. The terms “PDA,” “handheld computer,” “handheld,” “Palm Pilot,” and “pocket PC” all refer to similar devices with comparable capabilities.
Mobile computing allowed by PDAs is becoming an important tool in health care and has grown in popularity among health care professionals during the past 5 years [6], [7], [8]. A wide range of mobile devices is used by health care professionals to improve efficiency and effectiveness in the delivery of patient care. These devices are designed to assist users in both everyday work and off-duty activities.
As more health-care-related applications are introduced and used, a growing body of literature has been established that can guide the future design and deployment of mobile computing solutions. Those published reports also provide insight into barriers to the wide adoption of mobile computing solutions and the effect of these devices on health care. For example, Fischer et al. [9] assessed the literature for evidence of the impact of handheld devices in terms of patient outcomes. We also systematically reviewed the literature on the use of handheld computing devices, but focused on the issue of their adoption in health care practice. We examined the potential benefits of PDAs as factors that will promote their adoption and identified barriers to their acceptance in health care.
Section snippets
Sources
We used Medline, the National Library of Medicine's searchable database of peer-reviewed publications; the published proceedings of one primary conference (Proceedings of Healthcare Information and Management Systems Society [HIMSS]). In addition, to assess the types of application available for different platforms, we used Internet search engines (Google and Yahoo) and electronic resources (Download.com, CNet.com, Microsoft.com, Palm.com, Blackberry.com, ePocrates.com, MedCalc3000.com,
Operating systems
Most PDAs run either a Palm OS® (operating system) or Window CE/Pocket PC OS. Each system has its own strengths and weaknesses, but the two have much in common. Based on our manual searches from Download.com and PDA Cortex.com, more third-party applications and medical applications are available to the Palm OS (approximately 1450 third-party applications and 527 medical applications) than Window CE (900 third-party applications and 306 medical applications) as of June 2004. We used these two
Cost saving
Silva et al. [26] reported using PDAs to document the services offered by pharmacists to physicians (such as providing drug information and pharmacotherapy consultation). The cost reduction associated with electronic documentation totaled $662,335 during a 6-month period for the four pharmacists and four residents who participated in the study. Potential claims for pharmacists’ cognitive services recorded with PDAs amounted to $1,025,834 during the study period [26].
Education
Leung et al. [35] evaluated
Conclusion
A number of benefits of the use of PDAs in medical care have been articulated and demonstrated in the literature. These benefits include offering clinicians mobility, providing real-time access to data and information, reducing medical errors, saving time, supporting evidence-based practice, enhancing productivity and quality of care, and providing a tool for communication. Along with technology advances (such as wireless connectivity), these benefits contributed to the reported trend that
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