PDAs and Handheld Devices in Healthcare: Uses and Benefits

Introduction

Handheld devices and personal digital assistants (PDAs) are being integrated into the healthcare 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 handheld devices and other portable electronics play in healthcare can help inform organizational policy and help healthcare administrators better implement electronic medical records.

History of PDA Use in Healthcare

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 major 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. At that stage, however, 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 expanded feature sets of PDAs 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 healthcare, as PDAs, tablets, and smartphones are set to surpass personal computers in overall sales (Wiggins, 2004, p. 5). Portable devices are therefore the future of medical computing.

Physicians have for many years relied on portable electronic devices such as pagers to ensure timely and quality delivery of care. Paging is now only one of many functions that a handheld computer can offer the practitioner. Radiology was one of the first medical fields to document a need for integrating handheld technology with healthcare, although medical students had already been using them for years (Wiggins, 2004). Survey results by Garrity and El Emam (2006) reveal that the majority of doctors, medical residents, and advanced practice nurses in hospitals are using portable electronic devices. Prevalence has become high and is growing exponentially because of the many uses PDAs have in the healthcare system.

Why PDAs? Key Drivers of Adoption

The reasons why PDAs and other portable devices have become integrated into healthcare are extensive. The amount of information needed to run an effective healthcare organization and to deliver quality care to patients is simply "staggering" (Wiggins, 2004, p. 5). From patient personal information and medical history to test results and patient satisfaction surveys, data is continually being collected, collated, and stored electronically in hospitals and other healthcare centers. PDAs aid all healthcare workers by providing a quick, easy way of collecting and distributing data. Their storage capacities are growing, and they can be synced to computers for backing up and properly cataloging patient information. 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 healthcare institutions. Patient data needs to be accessed quickly and accurately. Portable devices serve as "walking libraries," according to Wiggins (2004, p. 5). Healthcare workers not only need to refer continually to individual patient records; they may also need to access medical databases for critical information on the fly. Information about contraindications for specific medications or 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 the outdated technology warrants integration of paging functions with richer, data-driven capabilities. All members of the healthcare team can stay in touch and communicate at any stage of care delivery when using PDAs, even if individual devices run different operating systems. In the same way that an Apple iPhone user can interact seamlessly with a Samsung Galaxy user, it does not matter whether different institutions use different devices or whether nurses and doctors within the same facility use different models. The technology has evolved to the point where such issues have become largely irrelevant.

Technology advancements have also improved the user experience with PDAs. Many doctors and healthcare workers find that voice recognition software embedded in the devices helps with data entry, while keyboard input methods have also improved considerably. The ability to share data and imagery from tests such as MRIs and CT scans is essential for providing immediate care to patients. As PDA technology continues to improve, the devices will only get better in terms of connectivity to databases, memory capacity, battery life, visual and audio processing, input methods, voice recognition, imaging, and overall user experience.

Patients are also starting to use PDAs in the healthcare setting. Kato (2010) points out that games are a meaningful way of helping certain patient groups. Working with children makes video games especially relevant, but all patient groups can potentially benefit from using handheld devices while receiving healthcare. 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 healthcare is that they have the potential to reduce medical errors significantly. Huang (n.d.) points to the use of PDAs for promoting "greater awareness of medical errors" (p. 11). Medical error rates are staggering in the United States alone, with as many as 98,000 deaths per year occurring due to error (Huang, n.d., p. 11). The cost of medical errors has been estimated at around $15 billion (Huang, n.d., p. 11). With PDAs, information is stored legibly and clearly, with the ability for multiple parties to observe and catch any error. Research has shown that the use of PDAs in healthcare is especially important in emergency settings. Prgomet, Georgiou, and Westbrook (2009) found that the greatest benefits from using PDAs to reduce medical error occur 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 healthcare centers and taxpayers money. The devices are generally inexpensive, especially compared with desktop computers. Considering that up to 46% of a physician's day can be consumed by administrative duties, a PDA can greatly ease the burden of data entry and save both time and money (Huang, n.d., p. 14). Efficiency of service delivery is improved when all members of the healthcare team are connected.

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

Conclusion

Integrating portable devices with electronic medical records is the next major step forward. Medical records are also linked to billing, which can be extremely complex given the number of stakeholders involved, including insurance companies. However, digitizing all patient data is becoming unavoidable, particularly to reduce medication and other medical errors. Using portable devices ensures the accuracy of information, the speed of information sharing, and the ease of accessing the healthcare system. As technology continues to evolve, PDAs and handheld devices will play an increasingly central role in every dimension of healthcare delivery in the United States.

References

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Huang, V. W. (n.d.). PDAs in medicine. PowerPoint Presentation.

Kato, P. M. (2010). Video games in health care. Review of General Psychology, 14(2), 113–121.

Prgomet, M., Georgiou, A., & Westbrook, J. (2009). The impact of mobile handheld technology on hospital physicians' work practices and patient care. Journal of the American Medical Informatics Association, 16, 792–801. doi:10.1197

Wiggins, R. H. (2004). Personal digital assistants. Journal of Digital Imaging, 17(1), 5–17.