.KEYWORD practice
.FLYINGHEAD HEALTHCARE APPLICATIONS
.TITLE Basic productivity solutions for the healthcare market
.FEATURE
.SUMMARY Dr. Darwin J. Liao shares some of the exciting ways he’s discovered to use customized, basic productivity solutions to help you manage your healthcare information.
.AUTHOR Darwin J. Liao, MD, MPH
As a physician and surgeon, I’m faced with managing large volumes of patient, insurance, and hospital information on a daily basis. Whether moving within my clinic from exam room to exam room or traveling to a nearby hospital or surgery center, I must be able to access relevant clinical information at each location. With the advent of managed care and the complexities of medical insurances, the paperwork involved in patient care can be quite challenging.
For many years, technology has played an important role in healthcare, starting with pagers and cellular phones. I’m in constant need to communicate and interact with other healthcare professionals and to be able to perform patient care tasks from remote locations. Although desktop computers and Internet solutions have become more prevalent in healthcare information management, I’ve found these solutions within hospitals to be poorly implemented. Even when there’s a desktop solution that’s somewhat valuable to use, workflow is hindered because doctors must go to computer stations to access that data instead of being able to manage data at the patient bedside or point of care.
.H1 Palm solutions
The one piece of technology that has had the most significant impact on my professional life is my Palm Vx. The last couple of years have been extremely exciting in healthcare, as I’ve witnessed the growth and popularity of Palm solutions among my colleagues and within the healthcare industry as a whole. This is especially exciting since, as a group, physicians have historically been accused of resisting change and technology, particularly when such changes affect the way we practice medicine.
.CALLOUT The use of Palm devices in healthcare is shaping the way healthcare professionals are practicing medicine in the new millennium.
I can tell you that with the popularity of Palm handhelds in healthcare, physicians have finally found a device that can solve the challenges of managing healthcare information with the security, mobility, and connectivity required in this marketplace. Further, the use of Palm devices in healthcare is shaping the way healthcare professionals are practicing medicine in the new millennium.
In this article, I’ll try to summarize and highlight some practical ways to use customized, basic productivity solutions to manage your healthcare information.
.H1 Database solutions
Almost everyone can benefit from using a database application, such as JFile (at http://www.land-j.com/jfile.html), HanDbase (at http://www.ddhsoftware.com/software.html?view=handbase), Pendragon Forms (at http://www.pendragon-software.com), or Satellite Forms (at http://www.pumatech.com/Satellite_Forms_Standard.html). These solutions allow you to create custom fields to store just about anything you can imagine. When I was in my residency, I created a procedure log in JFile to track my surgical procedures. This was a great time-saver for me since I could enter procedures as soon as they were completed and the details were readily available.
The old way of accomplishing this task was to use an index card to enter the procedure and give it to the residency secretary to enter. At any moment, I could check back in my personal log to see what patients I had operated on and what procedure was performed. I’d have to say that most residency programs across the country have already moved to an electronic-based procedure log system, but most are Web-based. The added flexibility of being able to bring this capability to the handheld makes entering the data more efficient and accurate.
The great thing about all of the solutions I’ve listed is that they can synchronize with desktop databases, such as Access and Filemaker (at http://www.filemaker.com). Satellite Forms also has an Enterprise Edition (at http://www.pumatech.com/Satellite_Forms_Enterprise.html) that can link to any ODBC (Open Data Base Connectivity) database. Besides procedure logs, you can set up databases to track anything you want, such as ER visits, diagnostic testing results, etc.
.H1 Spreadsheet solutions and Documents to Go
Some physicians ask me whether there are any spreadsheet solutions for the Palm OS that can talk to Excel on the desktop side. Their reasoning is that they prefer to store their data in a spreadsheet format since they already have a template they want to use, or they actually want to calculate data as it’s entered. Both QuickSheet (at http://www.cesinc.com/quicksheet/index.html) and TinySheet (at http://www.iambic.com/pilot/tinysheet3/) for the Palm OS are spreadsheet applications that can synchronize with Excel.
For those wishing to simply view and edit spreadsheet data on their Palm devices without having the full power to edit formulas and such, I would recommend DataViz’s Documents to Go at http://www.dataviz.com/products/documentstogo/index.html. The latest version allows you to download Microsoft Word and Excel files to your handheld for editing and viewing. This is a great solution that’s quick and easy to use.
Another use of Documents to Go in healthcare is for medical charting. I’m frequently asked at speaking engagements how users can download an existing Word template for a medical exam for editing. As a low-cost electronic medical records solution, many physicians simply store their charts in a Word document for each patient. Using Documents to Go, they can now edit chart notes using their Palm devices.
.H1 Internet portals and MyPalm
Even an avid Palm device user like myself is sometimes caught without my handheld on my person. As much as I would love to be attached to my Palm device one hundred percent of the time, this is simply not realistic due to the highly mobile nature of healthcare. It seems that few users realize that the MyPalm Internet portal (formerly AnyDay.com) is available for non-wireless Palm device users at http://www.palm.net.
For those of you not familiar with the service, MyPalm offers you the ability to synchronize your handheld data with an Internet-based PIM (Personal Information Manager). You can then access your synchronized data from any computer with an Internet connection and a Web browser. It’s an entirely free service and one that I highly encourage other physicians to use, since it also solves another issues that I’ll explain now.
Many physicians tell me they love their Palm devices, but they don’t want to enter the data themselves. Rather, they want their nurses or administrative assistants to enter the information for them. However, they don’t want to give up their device for entering data directly on the handheld. Also, they prefer not to give access to their desktop PC to allow others to enter data via the Palm Desktop software. That’s where the MyPalm Internet portal comes in.
This is a great solution that allows your employees to enter data for you on the Web portal. Then, when you synchronize your device, all the information will be updated. In a case where you might be on a hospital network using Ethernet Cradles and a HotSync Server, you could even HotSync your Palm device over the network and get the latest contact and schedule information without having to go back to the cradle attached to your desktop computer. This is a simple workaround to a common problem. Because of this, I personally think Internet solutions such as My Palm, coupled with the handheld device, are tremendously valuable in the healthcare market.
While we’re talking about Internet portals, it seems that Palm has acquired another Internet-portal connectivity company, WeSync (at http://www.wesync.com). The way it works is similar to MyPalm, and it offers a solution to yet another frequently asked question: multiple calendars and group contact lists. Clinic and office managers are able to view multiple calendars side by side using the WeSync solution. Also, multiple users can synchronize data with a single company or department-wide contact list or calendar of events, thereby saving the time of having to enter redundant data. Both of the solutions have tremendous potential, and Palm recognizes this value, as it has acquired both solutions.
.H1 Development tools
Besides the database solutions mentioned above for development of custom databases, I must highlight AppForge, a new development tool, at http://www.appforge.com. This incredible solution allows you to create Palm applications using Visual Basic. Yes, you heard correctly, Visual Basic. Not only is the solution incredibly easy to use, it’s very powerful.
You can take any existing Access or ODBC compliant database and import it using a utility that comes with the AppForge kit. This creates a Palm database (PDB) file that you can then connect to and manipulate via your front-end. You have to try it to believe it. As if this weren’t enough, the Pro version of AppForge has a conduit manager so the applications you create can easily synchronize with a desktop data store!
If you’re a Visual Basic programmer or a programming novice looking to write applications for the Palm OS without having to learn C or use CodeWarrior (at http://www.codewarrior.com), you have to check out AppForge. I can guarantee that many in-house developers will create some pretty impressive Palm healthcare applications using this product.
.H1 Connectivity
Most of you HotSync your Palm device with your desktop PC, however, using infrared transceivers from Clarinet Systems or the Ethernet Cradle and HotSync Server from Palm, you can synchronize data from any location on your network. Wireless connectivity is achievable with wireless Internet solutions, such as the Palm VII, or wireless LAN solutions. Before thinking about wireless connectivity, you really need to make sure the application that you’re running is functional. If the solution doesn’t work well for you in general, it doesn’t matter if it’s wireless or not. The solutions for wireless capabilities are out there.
Having just returned from the New Orleans healthcare show, I have to put to rest some of the fallacies that were circulating on the show floor. Many developers with Pocket PC solutions stated they chose that platform over Palm because Palm doesn’t integrate with SQL or Oracle. Those of us familiar with Palm know that there are many middleware solutions available for this type of integration. Some competitors say that Palm doesn’t have a wireless 802.11b device, but this is only partly true. While Palm itself doesn’t produce a hardware device with wireless LAN, Symbol Technologies (at http://www.symbol.com) produces devices with integrated barcoding and wireless 802.11b.
.H1 Security
With HIPAA (Health Insurance Portability and Accountability Act) on the horizon, I just want say a few things about security, since there’s some concern about security and handheld devices in order for them to be HIPAA compliant. This Act pertains to the security and transmission of patient information and has yet to be fully defined. However, one of the key components in achieving HIPAA compliance is PKI (Public Key Infrastructure) support. Without going into the details, I just have to say that Certicom (at http://www.certicom.com) already provides PKI for Palm, and the entire industry has yet to see what the final HIPAA guidelines will be. Rest assured, the developers in this industry will be ready to act on the guidelines when they’re finalized.
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.H1 Summary
Using Palm solutions has improved my personal and professional efficiency and improved my clinical and practice management. Palm produces the handheld device of choice for many physicians.
.BEGIN_SIDEBAR
.H1 Product availability and resources
For more information on JFile, visit http://www.land-j.com/jfile.html.
For more information on HanDbase, visit http://www.ddhsoftware.com/software.html?view=handbase.
For more information on Pendragon Forms, visit http://www.pendragon-software.com.
For more information on Satellite Forms, visit http://www.pumatech.com/Satellite_Forms_Standard.html.
For more information on Filemaker, visit http://www.filemaker.com.
For more information on Satellite Forms Enterprise Edition, visit http://www.pumatech.com/Satellite_Forms_Enterprise.html.
For more information on QuickSheet, visit http://www.cesinc.com/quicksheet/index.html.
For more information on DataViz’s Documents to Go, visit http://www.dataviz.com/products/documentstogo/index.html.
For more information on the MyPalm Internet portal, visit http://www.palm.net.
For more information on WeSync, visit http://www.wesync.com.
For more information on AppForge, visit http://www.appforge.com.
For more information on CodeWarrior, visit http://www.codewarrior.com.
For more information on Ethernet Cradles http://www.palm.com/products/enterprise/ethernet.html
For more information on Symbol Technologies, visit http://www.symbol.com.
For more information on Certicom, visit http://www.certicom.com.
For more information about Palm computers, visit http://www.palm.com.
.H1 Bulk reprints
Bulk reprints of this article (in quantities of 100 or more) are available for a fee from Reprint Services, a ZATZ business partner. Contact them at reprints@zatz.com or by calling 1-800-217-7874.
.END_SIDEBAR
.BIO Darwin J. Liao, MD, MPH, puts his Palm device to work at Seattle Eye M.D.s Ophthalmology Clinic and Optical Shop at http://www.eyemds.net.
.DISCUSS http://powerboards.zatz.com/cgi-bin/webx?50@@.ee6f11c
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