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PubMed2003

The perils of PDAs.

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Computers, Handheld↗
PubMed2003

Implementation of a PDA based program to quantify urology resident in-training experience.

INTRODUCTION: There currently is no simple and reliable mechanism for Residency program directors to assess how well their trainees are being exposed to all spheres of their specialty. We report on the use of hand-held personal digital assistants (PDA's) to document all clinical and academic activities of urology residents at one academic institution. MATERIALS AND METHODS: Software was developed to create customized pick lists allowing residents to record all activities on their individual PDA's. Categories included Adult Ambulatory, Pediatric Ambulatory, Adult operative, Pediatric operative, and Academic. Activities were subcategorized into detailed pick lists and time-tracking fields. Residents synchronized with a central database on a standalone hotsync server. RESULTS: In the first 8 months, 21 178 resident-hours and 5333 activities were recorded. Preliminary observations can be made regarding how residents spend the majority of their time: 28% operative, 20% self-study, 19% ward work, 10% Academics, 6% ER consultations, 5% clinic, and 4% inpatient consultations. The most common adult diagnoses encountered while attending to clinic, ward, or ER consultations were lower urinary tract symptoms, urolithiasis and hematuria. Similarly for Pediatrics: neurogenic bladder, antenatal hydronephrosis, infection, and hypospadias were most often reported. Residents reported 5,333 activities, relating to the following spheres of Urology: academics (23%), endourology (18%), oncology (15%), lower urinary tract symptoms (10%), congenital anomalies (5%), urolithiasis (5%), reconstruction (5%), and infection (3%). CONCLUSIONS: This tool provides an objective assessment of resident experience as it relates to selection of rotations, and for addressing curriculum weaknesses. It is applicable at a national level for the study of regional differences in training experience, and trends in graduate Urological education. With minimal effort it could be modified for application to other specialty training programs.

Adult↗
PubMed2003

Tomorrow's transcription tools: what new technology means for healthcare.

The year is 2006, and there are just a few hundred medical transcriptionists (MTs) still transcribing reports, serving only those older physicians who haven't changed with the times--and the times have definitely changed. Physicians have finally recognized the power of electronic health records (EHRs) as well as the fact that this power is realized only if they input clinical data directly into the EHR. The vast majority of physicians are using empirically refined templates, pick lists, and other methods of structured, codified input through the evolved progeny of today's Palm PCs, Pocket PCs, and Tablet PCs. Input methods include touch-screen, speech recognition, handwriting recognition, and perhaps other technology not yet invented. There are no longer any delays or expenses resulting from transcription. Plus healthcare organizations enjoy numerous benefits derived from analyzing codified clinical data. But this is only one vision. Another vision of 2006 incorporates an unavoidable reality: many physicians strongly resist directly inputting clinical data. They believe it slows them down, which outweighs the potentials overall healthcare benefits. Additionally, these physicians believe that structured input of patient information limits the freedom of expression afforded by free text. And frankly, these physicians don't put much stock in the value of clinical practive analysis. So transcription continues. In fact, it expands dramatically. Due to regulatory controls and other pressures, more providers dictate more clinical notes than ever. The need for MTs explodes. In 2006, there are half a million MTs required to convert voice dictations into text, more than double today's number.

Computers, Handheld↗