Healthcare Hand-held devices and portable digital assistants (PDAs) are being integrated into the health care setting in the United States. It is important to understand which devices are being used, how they are being used, what they are being used for, and why. Understanding the role that hand-held devices and other portable electronics play in health care can help to inform organizational policy, and help health care administrators better implement electronic medical records.

History of use

The first documented PDA was the Newton MessagePad, issued by Apple in 1993. It was described as being "revolutionary" (Wiggins, 2004, p. 5). Palm, Inc. developed the next big handheld device: the Palm Pilot, in 1996. By the late 1990s, PDAs were equipped for Internet access, and memory capacity and other features improved with each product release. Microsoft also entered the portable electronic devices marketplace in the 1990s. The devices were not yet being integrated into the healthcare system.

Since the new millennium, smartphones and other handheld devices have become standard items in both personal and professional settings. The increased power and expansion of PDA features have made them particularly effective and useful in the healthcare setting. The evolution of PDA use in healthcare shows the remarkable potential for full integration with every aspect of care management and delivery. Trends in the consumer market parallel trends in health care, as PDAs, tablets, and smartphones are set to surpass personal computers in terms of overall sales (Wiggins, 2004, p. 5). Therefore, portable devices are the future of medical computing. Physicians have for many years relied on portable electronic devices like pagers to ensure timely and quality delivery of care. Now, paging is only one of many functions that a handheld computer can offer the practitioner. Radiology was one of the first practicing medical fields to document a need for integrating handheld technology with health care, although medical students have been using them for years (Wiggins, 2004). Survey results by Garrity & El Emam (2006) reveal that the majority of doctors, medical residents, and advance practice nurses in hospitals are using portable electronic devices. Prevalence has become high, and is growing exponentially because of the myriad of uses that PDAs have in the healthcare system.

Why PDAs?

The reasons why PDAs and other portable devices have become fully integrated into health care are extensive. For one, the amount of information needed to run an effective health care organization and then to deliver quality of care to patients is simply "staggering" (Wiggins, 2004, p. 5). From patient personal information to patient medical history; from results from tests to patient satisfaction surveys, data is continually being collected, collated, and stored electronically in hospitals and other health care centers. PDAs are aiding all health care workers by providing a quick, easy way of collecting and distributing data. PDAs have the ability to store a lot, even if temporarily. Their storage capacities are growing, and they can also be synced to computers for backing up and properly cataloging patient information. In this manner, the extensive amount of information being shared in the health care setting is facilitated by the use of PDAs. Portable devices "allow for a great deal of knowledge in a small package," (Wiggins, 2004, p. 5).

As electronic medical records become more commonplace and standardized, the use of PDAs will become even more apparent in health care institutions. Patient data needs to be accessed quickly and accurately. Portable devices serve as "walking libraries," according to Wiggins (2004, p. 5). Not only do health care workers need to continually refer to individual patient records; they might also need to access medical databases for critical information on the fly. Information about contraindications for specific medications, or for evidence-based practice for acute procedures can be accessed via PDAs linked to databases and networks.

The communication potential of PDAs and other portable devices is tremendous and cannot be underestimated. Doctors have been using pagers for years, but their outmoded technology warrants the integration of paging functions with other more data-rich needs. All members of the health care team can stay in touch and communicate at any stage of care delivery when they are using PDAs, even if their individual devices are using different

In the same way that an Apple iPhone user can interact with a Samsung Galaxy user, it does not matter if different institutions are using different devices and require communication; or if nurses and doctors in the same facility are using different devices. The technology has evolved to the point where such issues have become irrelevant.
Technology advancements have improved the user experience with PDAs. Many doctors and healthcare workers find that voice recognition software embedded in the devices helps with data entry; whereas the keyboard input methods have also improved. The ability to share data imagery from tests like MRIs and CAT scans is essential for providing immediate care to patients. As the PDA technology keeps improving, the devices will only get better in terms of connectivity to databases, memory capacity, battery life, visual and audio processing, keyboard and other inputs, voice recognition, imaging, and aspects of the user experience.

Patients are also starting to use PDAs in the health care setting. Kato (2010) points out that games are a critical way of helping some patient groups. Working with children might make video games especially relevant, but all patient groups can benefit potentially from using handheld devices while receiving health care. Patients can also access their own medical records, review their medication history, and become more informed and empowered about their condition.

One of the most important reasons why PDAs and other portable electronic devices are being integrated into the healthcare setting is that they have the potential to reduce medical errors significantly. Huang (n.d.) points out the use of PDAs for promoting "greater awareness of medical errors," (Huang, n.d., p. 11). Medical error rates are staggering in the United States alone, with as many as 98,000 deaths per year are occurring due to error (Huang, n.d., p. 11). The cost of medical errors has been estimated to be around $15 billion (Huang, n.d., p. 11). With PDAs, the information is stored legibly and clearly, with the ability of a number of different parties available to observe any error. Research has shown that the use of PDAs in health care is especially important in emergency settings. Prgomet, Georgiou & Westbrook (2009) found that the best benefits from using PDAs to reduce medical error is in the most critical situations: when "time is a critical factor and a rapid response crucial," (p. 792). Future research will reveal the ways in which PDAs can best be designed as specialized instruments for each medical department.

Furthermore, PDAs can save health care centers and taxpayers money. The devices are generally inexpensive, especially compared with computers. Considering that up to 46% of a physician's day can be taken up with administrative duties, a PDA can greatly ease the burden of data entry and save time as well as money (Huang, n.d., p. 14). Efficiency of service delivery is ensured when all members of the health care team are connected.

Because medical students are already using PDAs in their courses of study, there is almost no need for training programs. Low learning curves make it so that implementing PDA programs in the health care setting is cost-effective. Doctors and other health care workers are in fact demanding that PDAs be more available in their workplace (Huang, n.d.). There are few known barriers to using PDAs in the health care setting, even while many institutions and physicians are resisting the complete transformation to electronic health records (Garrity & El Emam, 2006). With the cost of health care rising, it makes sense to integrate technology into all aspects of care delivery in the United States.

Devices Being Used Now

Healthcare-specific needs are driving the PDA manufacturers to create devices that are specifically used in the healthcare setting. It is not enough to adapt an iPhone for use in a hospital. The hardware needs to have inputs for patient monitoring and other information, and the software also needs to be able to handle the vast amounts of information being transmitted over the networks. As Fornell (2008) points out, the SOTI Company is designing software for portable devices specifically for the healthcare sector. The software will facilitate interfacing with electronic medical records as well as drug databases.

Conclusion: The Future

The wave of the future is with wearable electronics, and patient PDA integration. Wearable devices can be used to monitor patients who are at home or in an out patient setting. This will help drive down costs of health care, while also empowering patients to be more in touch with the progress of their health. Already patients use technologies at home, such as blood pressure monitors and blood sugar monitors. The integration of PDAs into the health care regime makes sense, especially given that many patients already have smartphones. Alerndar & Ersoy (2010) point out that wireless sensors are saving patient lives, and that these types of devices can be linked with…