Trading paper for Palm Pilots

Information Management Journal, Nov/Dec 2002 by Swartz, Nikki

The New York Times recently reported that, someday soon, hand-held computers will be as ubiquitous as the stethoscope in U.S. healthcare environments. Industry professionals are adapting to new federal regulations regarding the privacy of medical records and working to overcome the problem of doctors' illegible handwriting for records and prescriptions.

Increased scrutiny of medical recordkeeping as a result of new regulations such as the Health Information Portability and Accountability Act (HIPAA) and the growing use of laboratory testing and technologies, has created a climate for change from paper-based records systems.

"Federal Express could keep better track of a package than we could track patients," Dr. Redmond Burke, chief of cardiac surgery at Miami Children's Hospital, told the Times. "We were walking around with 5-by-7-inch index cards as the hospital database. They got lost. You couldn't access them."

But today, Burke and other doctors can use a hand-held personal digital assistant (PDA) for a variety of patientrelated tasks, such as consulting electronic drug reference manuals before writing prescriptions. Research firm Harris Interactive estimates that about 17 percent of doctors use a hand-held in some way.

Burke's department introduced its first system using Palm Pilot PDAs in 2001. However, that system was abandoned because it required doctors to put their organizers into cradles regularly to download and receive patient information. Doctors sometimes forgot, effectively walking out with people's medical records in their pockets because the patient data would remain on the devices. The department's current system uses the hand-helds as dumb terminals that can access and read data but not store it. In this system, Web servers collect data from all the hospital's computer systems to handle billing and test results and then convert the data into standard Web pages. The servers also store the digital patient files, which can include photos and videos of procedures, as Web documents, allowing them to be read by any computer or hand-held.

The idea of wireless devices collecting and transferring patients' personal information may be unnerving to some. But doctors say properly managed electronic records protected by encryption and security devices are more secure than paper records, which can potentially be stolen, lost, or copied.