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At least 361 records · Page 20Linked to original sources
PubMed2005

Integrating multiple clinical information systems using the Java message service framework to enable the delivery of urgent exam results at the point of care.

The aim of this study is to determine if network-enabled personal digital assistants (PDAs) can be used to facilitate the timely delivery of urgent radiological exam results by reducing the interval from when the radiologist's initial interpretation is available to when it is first viewed by an emergency department (ED) physician. A web- and Java message service (JMS)-based application was built to replace the original fax-based wet-read procedure. The new system allows radiologists to enter wet-reads from the picture archiving and communication system (PACS) display station and to track discrepancies between the wet-read and final report. It also notifies the ED physicians when exam results are available via the PDAs and permits them to view the full text of the wet-read and final reports from the devices. The new system is compared to the original procedure with the results showing improvements with the wireless method. Furthermore, feedback from a qualitative survey of PDA users was positive, suggesting that PDAs may provide one means for accessing urgent clinical data at the point of care.

Computer Communication Networks↗
PubMed2003

Clinician expectations for portable electronic devices as cognitive-behavioural orthoses in traumatic brain injury rehabilitation.

OBJECTIVE: To ascertain experiences and expectations of clinicians as to uses of portable electronic devices such as hand-held computers as cognitive-behavioural orthoses in TBI rehabilitation. DESIGN: Survey study. PROCEDURES: A survey developed and piloted with the input of clinician focus groups was completed by 81 TBI clinicians from a variety of disciplines and work settings. RESULTS: About half of the respondents reported prior exposure to clients with TBI who had used portable electronic aids. Of 10 key cognitive/behavioural areas, respondents saw most potential for devices in the areas of learning/memory, planning/organization and initiation; less potential was seen for social/interpersonal or behavioural difficulties. However, many respondents also identified learning and memory abilities as essential client characteristics for successful use of portable electronics. Cost was identified as a significant barrier to use of portable devices in rehabilitation. Respondents expressed low confidence overall in their ability to guide clients in use of devices; those who reported personal use were significantly more confident than those who did not. CONCLUSION: Clinicians believe that new electronic devices have potential for treatment of some cognitive impairments, but clinical experimentation may be limited by costs of technology and low clinician confidence.

Adult↗
PubMed2003

A rapid speech synthesizing software on a PDA for Japanese with speech impairments.

We developed a Japanese-language, rapid synthesizing software application for use on a personal digital assistant. It has an unrestricted vocabulary and can synthesize words and sentences within 3 s. Eight hundred common sentences and words are preregistered. By touching the first character at the head of a preregistered sentence or word from an on-screen Kana (Japanese alphabet) chart, the user can select the sentence or word to be spoken. Characters on the Kana chart can also be input sequentially. Two Japanese subjects with speech impairments rated the device highly for its portability and quick response. Whereas communication previously had to be done by writing or sign language, it was easy for listeners with or without specialized training in communication with persons with speech impairments to understand the output from this device, making conversation easier which, in turn, improved the quality of life and social activity of these persons with speech impairments.

Asian People↗
PubMed2002

Open source handheld-based EMR for paramedics working in rural areas.

We describe a handheld-based electronic medical record (EMR) for use in certain rural settings. The system is based on the Linux operating system and allows access to large mobile databases. The open source system is designed for paramedical health workers serving remote areas in rural India. A PDA loaded with the handheld-based EMR provides workers who have little access to medical doctors with different kinds of decision support and alerts. It addresses two important problems in developing countries: prenatal care and child health. This paper describes the technical challenges and innovation needed in the design, development, adaptation and implementation of the handheld EMR in a real setting in India

Allied Health Personnel↗
PubMedDate not supplied

The next level of distributed learning: the introduction of the personal digital assistant.

Handheld technology has grown in both popularity and capabilities. Studies continue to be done on their impact in numerous fields. At The Ohio State University Medical Center, a handheld program was started in 2001, initially involving third- and fourth-year medical students and residents. The presence of these digital devices presented the opportunity to examine their use in taking traditional materials and delivering them in a personal digital assistant-friendly format. The objective was to offer these materials within an "anytime anywhere" set-up, thereby positively affecting the learning experience while also laying the foundation for other such uses.

Academic Medical Centers↗
PubMed2005

Use of handheld devices in critical care.

Emergencies happen everyday in the acute care environment and demand nurses to make decisions quickly that can have serious, if not potentially fatal, ramifications. Being prepared to make decisions is partly the results of experience, but having access to ready resources can provide even the newest nurse with the potential to make critical decisions accurately. Handheld devices, such as personal digital assistants, can provide access to resources that can improve patient safety and, ultimately, patient care delivery.

Acute Disease↗
PubMed2004

Approach to mobile information and communication for health care.

Evidence suggests that inadequate access to information and ineffective communication are proximal causes of errors and other adverse events in-patient care. Within the context of reducing these proximal causes of errors, we explore the use of novel information-based approaches to improve information access and communication in health care settings. This paper describes the approaches for and the design of extensions to a clinical information system used to improve information access and communication at the point of care using information-based handheld wireless applications. These extensions include clinical and information resources, event monitoring, and a virtual whiteboard (VWB).

Computers, Handheld↗
PubMed2002

A novel paradigm for telemedicine using the personal bio-monitor.

The foray of solid-state technology in the medical field has yielded an arsenal of sophisticated healthcare tools. Personal, portable computing power coupled with the information superhighway open up the possibility of sophisticated healthcare management that will impact the medical field just as much. The full synergistic potential of three interwoven technologies: (1) compact electronics, (2) World Wide Web, and (3) Artificial Intelligence is yet to be realized. The system presented in this paper integrates these technologies synergistically, providing a new paradigm for healthcare. Our idea is to deploy internet-enabled, intelligent, handheld personal computers for medical diagnosis. The salient features of the 'Personal Bio-Monitor' we envisage are: (1) Utilization of the peripheral signals of the body which may be acquired non-invasively and with ease, for diagnosis of medical conditions; (2) An Artificial Neural Network (ANN) based approach for diagnosis; (3) Configuration of the diagnostic device as a handheld for personal use; (4) Internet connectivity, following the emerging bluetooth protocol, for prompt conveyance of information to a patient's health care provider via the World Wide Web. The proposal is substantiated with an intelligent handheld device developed by the investigators for pediatric cardiac auscultation. This device performed accurate diagnoses of cardiac abnormalities in pediatrics using an artificial neural network to process heart sounds acquired by a low-frequency microphone and transmitted its diagnosis to a desktop PC via infrared. The idea of the personal biomonitor presented here has the potential to streamline healthcare by optimizing two valuable resources: physicians' time and sophisticated equipment time. We show that the elements of such a system are in place, with our prototype. Our novel contribution is the synergistic integration of compact electronics' technology, artificial neural network methodology and the wireless web resulting in a revolutionary new paradigm for healthcare management.

Adolescent↗
PubMed2005

Improving ambulatory prescribing safety with a handheld decision support system: a randomized controlled trial.

OBJECTIVE: To evaluate the effectiveness of a personal digital assistant (PDA)-based clinical decision support system (CDSS) on nonsteroidal anti-inflammatory drug (NSAID) prescribing safety in the outpatient setting. DESIGN: The design was a randomized, controlled trial conducted in a university-based resident clinic. Internal medicine residents received a PDA-based CDSS suite. For intervention residents, the CDSS included a prediction rule for NSAID-related gastrointestinal risk assessment and treatment recommendations. Unannounced standardized patients (SPs) trained to portray musculoskeletal symptoms presented to study physicians. Safety outcomes were assessed from the prescriptions given to the SPs. Each prescription was reviewed by a committee of clinicians blinded to participant, intervention group assignment, and baseline or follow-up status. MEASUREMENTS: Prescriptions were judged as safe or unsafe. The main outcome measure was the differential change in unsafe prescribing of NSAIDs for the intervention versus the control group. RESULTS: At baseline, the mean proportion of cases per physician with unsafe prescriptions for the two groups was similar (0.27 vs. 0.29, p > 0.05). Controlling for baseline performance, intervention participants prescribed more safely than controls after receiving the CDSS (0.23 vs. 0.45 [F = 4.24, p < 0.05]). With the CDSS, intervention participants documented more complete assessment of patient gastrointestinal risk from NSAIDs. CONCLUSION: PARTICIPANTS provided with a PDA-based CDSS for NSAID prescribing made fewer unsafe treatment decisions than participants without the CDSS.

Ambulatory Care Information Systems↗
PubMed2005

Direct comparison of a tablet computer and a personal digital assistant for point-of-care documentation in eye care.

New mobile computing devices including personal digital assistants (PDAs) and tablet computers have emerged to facilitate data collection at the point of care. Unfortunately, little research has been reported regarding which device is optimal for a given care setting. In this study we created and compared functionally identical applications on a Palm operating system-based PDA and a Windows-based tablet computer for point-of-care documentation of clinical observations by eye care professionals when caring for patients with diabetes. Eye-care professionals compared the devices through focus group sessions and through validated usability surveys. We found that the application on the tablet computer was preferred over the PDA for documenting the complex data related to eye care. Our findings suggest that the selection of a mobile computing platform depends on the amount and complexity of the data to be entered; the tablet computer functions better for high volume, complex data entry, and the PDA, for low volume, simple data entry.

Attitude of Health Personnel↗
PubMed2003

Mobile technology in a clinical setting.

Wireless technology can offer clinicians access to the latest patient data when they are located outside of the hospital campus. It allows physicians to be more effective with their time by enabling a new method of delivering clinical information, thus improving patient care. Imagine being stuck in traffic, or at a conference in another state, when a call comes in for the patient's latest lab results. With a wireless handheld device, and a web-based application, the physician can access this information in minutes.

Attitude of Health Personnel↗
PubMed2005

OOPS: test of a structure for recording patient safety events.

An Ontology Of Patient Safety (OOPS-II) for handheld interfaces was developed from a 6-axis primary care taxonomy of errors. Using a hand-held Electronic Student Encounter Log (ESEL), 3rd year medical students were asked to record data from 3 written scenarios involving medical errors. Students were encouraged to use a series of drop down menus to record error types. Students could augment their selections with free text. Although some variation existed, students' answers were much more consistent than in our previous interfaces.

Adult↗
PubMed2006

Effectiveness of prehospital wireless transmission of electrocardiograms to a cardiologist via hand-held device for patients with acute myocardial infarction (from the Timely Intervention in Myocardial Emergency, NorthEast Experience [TIME-NE]).

Percutaneous coronary intervention for patients with ST-segment elevation myocardial infarction (STEMI) decreases morbidity and mortality if performed within the first 2 hours of symptom onset. However, the American College of Cardiology/American Heart Association guideline for percutaneous coronary intervention door-to-balloon time (<90 minutes) in patients with STEMI is a infrequently accomplished goal. This study enrolled 277 patients with STEMI who were self-transported or transported by emergency medical services to NorthEast Medical Center for primary percutaneous coronary intervention. This study tested the hypothesis that prehospital wireless transmission of an electrocardiogram to a cardiologist's hand-held device results in shorter emergency department door-to-reperfusion time. A comparison was made between patients whose electrocardiogram was successfully transmitted during the intervention phase with (1) patients transported by the emergency medical services in the preintervention, (2) patients self-transported in the intervention phase, and (3) patients whose wireless transmission failed in the intervention phase. During the preintervention phase (2001 to 2003), 48 patients were enrolled. During the intervention phase (2003 to 2005), the following patients were enrolled: 101 self-transported patients, 24 patients with successful electrocardiographic transmission, and 19 patients for whom transmission failed. The median door-to-reperfusion time for patients with successful electrocardiographic transmission was 50 minutes, which was significantly shorter than a preintervention time of 101 minutes (p <0.0001), an intervention phase self-transport time of 96 minutes (p <0.0001), and a failed transmission time of 78 minutes (p <0.0001). In conclusion, prehospital wireless electrocardiographic transmission to a cardiologist's hand-held device significantly decreased emergency department door-to-reperfusion time, thus achieving the American College of Cardiology/American Heart Association guideline for patients with STEMI.

Aged↗
PubMed2006

Usability of a barcode scanning system as a means of data entry on a PDA for self-report health outcome questionnaires: a pilot study in individuals over 60 years of age.

BACKGROUND: Throughout the medical and paramedical professions, self-report health status questionnaires are used to gather patient-reported outcome measures. The objective of this pilot study was to evaluate in individuals over 60 years of age the usability of a PDA-based barcode scanning system with a text-to-speech synthesizer to collect data electronically from self-report health outcome questionnaires. METHODS: Usability of the system was tested on a sample of 24 community-living older adults (7 men, 17 women) ranging in age from 63 to 93 years. After receiving a brief demonstration on the use of the barcode scanner, participants were randomly assigned to complete two sets of 16 questions using the bar code wand scanner for one set and a pen for the other. Usability was assessed using directed interviews with a usability questionnaire and performance-based metrics (task times, errors, sources of errors). RESULTS: Overall, participants found barcode scanning easy to learn, easy to use, and pleasant. Participants were marginally faster in completing the 16 survey questions when using pen entry (20/24 participants). The mean response time with the barcode scanner was 31 seconds longer than traditional pen entry for a subset of 16 questions (p = 0.001). The responsiveness of the scanning system, expressed as first scan success rate, was less than perfect, with approximately one-third of first scans requiring a rescan to successfully capture the data entry. The responsiveness of the system can be explained by a combination of factors such as the location of the scanning errors, the type of barcode used as an answer field in the paper version, and the optical characteristics of the barcode scanner. CONCLUSION: The results presented in this study offer insights regarding the feasibility, usability and effectiveness of using a barcode scanner with older adults as an electronic data entry method on a PDA. While participants in this study found their experience with the barcode scanning system enjoyable and learned to become proficient in its use, the responsiveness of the system constitutes a barrier to wide-scale use of such a system. Optimizing the graphical presentation of the information on paper should significantly increase the system's responsiveness.

Activities of Daily Living↗
PubMed2003

On Track: a database for evaluating the outpatient clinical experience of internal medicine residency training.

Residents in internal medicine training programs spend an increasing amount of time in the outpatient setting, creating the potential for substantial variability in educational experiences among residents. We developed a data management system (On Track) that combines information on clinical experiences collected from an electronic medical record (EMR) and handheld personal data assistants (PDA). This information is translated into easily interpretable graphics and reports that provide insight into the overall residency curriculum as well as the experiences of individual residents.

Ambulatory Care↗
PubMed2006

Development and use of behavior and social interaction software installed on Palm handheld for observation of a child's social interactions with the environment.

In settings in developing countries, children often socialize with multiple socializing agents (peers, siblings, neighbors) apart from their parents, and thus, a measurement of a child's social interactions should be expanded beyond parental interactions. Since the environment plays a role in shaping a child's development, the measurement of child-socializing agents' interactions is important. We developed and used a computerized observational software Behavior and Social Interaction Software (BASIS) with a preloaded coding scheme installed on a handheld Palm device to record complex observations of interactions between children and socializing agents. Using BASIS, social interaction assessments were conducted on 573 preschool children for 1 h in their natural settings. Multiple screens with a set of choices in each screen were designed that included the child's location, broad activity, state, and interactions with child-socializing agents. Data were downloaded onto a computer and systematically analyzed. BASIS, installed on Palm OS (M-125), enabled the recording of the complex interactions of child-socializing agents that could not be recorded with manual forms. Thus, this tool provides an innovative and relatively accurate method for the systematic recording of social interactions in an unrestricted environment.

Activities of Daily Living↗
PubMed2003

NICU Notes: A Palm OS and Windows database software product and process to facilitate patient care in the newborn intensive care unit.

This is a database software application for information a neonatologist routinely considers in the newborn intensive care unit (NICU). Users enter data at the point of care on a handheld device that also encrypts the data. Data management follows synchronization via an ODBC DSN to a secure Microsoft Access application. User feedback guides software modification over time. The poster illustrates the data model, the software user interface, and data management products.

Computers, Handheld↗