How to Choose?
Several factors will influence the type of device you choose. The first is the operating system (OS) that runs the device. There are 4 major OSs: Palm, Windows Mobile, BlackBerry, and iPhone. While most major medical software is available for any of these platforms, there are a few that may only be available for some of them.
Most Windows Mobile devices available now are smartphones, although some Windows Mobile PDAs still exist. Both Windows Mobile smartphones and Windows Mobile PDAs use the same OS. There are still Palm PDAs in the marketplace, though this once-dominant brand is not nearly as prevalent as it used to be.
The Palm Pre, their newest smartphone, runs on a new OS that is Web-based. Additionally, if you have an older Palm app that you can't bear to part with, you can buy an application ("Classic") that allows the Pre to emulate an older Palm OS device and run your legacy app. At this time, the Pre does not have much medical software written for it, though this will likely change in time.
Sources for obtaining applications for your device may be limited as well. Applications for the iPhone are only available at Apple's iTunes store, and all programs must be approved by Apple before becoming available. Programs for Windows Mobile smartphones, PDAs, and BlackBerries are available from a plethora of online sources. For all these devices, some applications are free and some have a cost. This may be a one-time charge or a recurring subscription fee.
Dr. Jones currently uses 2 handheld devices: a Hewlett-Packard PDA running the Windows Mobile operating system and a BlackBerry smartphone. While he acknowledges that some favor using one device for everything, this particular combination best suits his needs at present. His PDA was issued to him by the hospital system where he teaches family practice residents; it has been set up by their computer department so that he can directly access the hospital's electronic medical record (EMR). Dr. Jones says, "This is a tremendous help for me because I can access patients' lab results and chart data in real time." He uses it a lot when performing inpatient rounding with the residents. His PDA is set up so that whenever he walks into the hospital, the device synchronizes with the hospital's EMR, allowing him to pull up the latest data for his patients on demand. "Because of this, I no longer have to ask who a patient's nurse is, find them, and then have them run a printout of, for example, last night's labs. I can just pull it up on my PDA as soon as I'm in the hospital." His device allows him to view data but not enter or change it. It is already set up with wireless security features like data encryption and password protection to protect his patients' data, and the device can be wiped clean remotely if it ever gets lost or stolen.
In the past, accessing an EMR through a PDA or smartphone was not possible. However, more vendors are now making this type of access available. Allscripts, eClinicalworks, and Medent allow you to access their EMRs through a handheld device; you can review medical summaries, check appointments, and perform other patient-related tasks.
Dr. Jones' other handheld device is a BlackBerry smartphone. He doesn't use clinical applications on it because they are already loaded on his PDA, but he finds the BlackBerry invaluable for accessing his email and staying in touch via phone when he's on the go. With all his different roles, Dr. Jones spends a lot of time in transit. With the BlackBerry, he can be reached by phone and can also receive emails from both his hospital and university email accounts no matter where he is. "I find this valuable because I can get my email in real time, which helps me to prioritize which issues need to be addressed first. Often, my email arrives on my BlackBerry before my PC!"
A couple of years ago, only a few medically themed applications were available for the BlackBerry; however, the number of available programs has grown steadily. Now there are a reasonable number of medical applications available for this platform.
While most BlackBerries are similar enough to each other that applications written for that OS work fine on any model BlackBerry, the new BlackBerry Storm uses a touch screen and therefore is a bit different. Some apps written for the BlackBerry may have problems running on the Storm. Be sure to check before you buy.
Medscape Business of Medicine © 2009 Medscape, LLC
Cite this: Andrew E. Craig. PDAs and Smartphones: Clinical Tools for Physicians - Medscape - Oct 09, 2009.
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