What’s in Your Pocket?Mobile Medical Applications

Michelle Kraft, MLS, AHIPNovember 5, 2008

Brief History

Mobile medical applications not new 1993 Apple introduced first PDA (

Newton Message Pad) In 2001 Ovid created Ovid@Hand Computers, Handheld introduced as

MeSH Term 2003 Original PDAs required direct sync Wireless PDAs evolved

PDA to Smartphone

Huge trend shift from PDA to Smartphone Traditional PDAs saw 43% drop in sales

from 2006-2007.1 Most PDA owners (69%) say their PDAs

double as cell phones. This trend is also rapidly increasing; in 2006 only 26% used their PDAs as cell phones.2

1.PDA Market Continues Steep Decline. Palm InfoCenter. August 8, 2007.http://www.palminfocenter.com/news/8767/pda-market-continues-steep-decline/

2.Networked Workers. Pew Internet & American Life Project. September 24, 2008.http://www.pewinternet.org/pdfs/PIP_Networked_Workers_FINAL.pdf

Palm Handheld & Smartphone Growth

Figure 1: Palm Analyst Day –Revenue Smartphone/PDA's over the last few financial years. April 10, 2007. http://palmaddict.typepad.com/

PDA vs Smartphone

PDAs had no phone capabilities PDAs do not require carrier contracts

Smartphones now have PDA style programs and functionality Smartphone subsidized by carriers

Growth and Evolution

Wide acceptance “Swiss Army Knife” of devices iPhone adoption grew by 48% among those earning

$25,000 - $50,000 per year 3

Perceptions have changed People no longer “unplug”

63% men have smart phone 69% can’t live without Internet vs. 31% who can’t live

without TV4

More functions available Internet always available No longer need multiple communication devices

Easy and Fun

3. iPhone Appeals to All Buyers. TheStreet.com Oct. 31, 20084. Break Media Research Paints Portrait of Men 18-34. Oct.7, 2008

Evolution and Growth in Applications

Previously two primary systems now has grown to seven different systems

Thick vs. thin client, move towards thin client applications

Syncing updates and Real time downloads

US Smartphone Market Looks Like BlackBerry Pie. Just Another Mobile Monday (JAMM). May 31, 2008.http://justanothermobilemonday.com/Wordpress/2008/05/

Smartphone Platforms

Windows Mobile 6.0 Not PocketPC Relies heavily on Internet connectivity Internet surfing not as seamless as other devices Limited availability of medical software

Blackberry Relies heavily on Internet connectivity Often used standard device for institution/business email Lags in medical software availability but improving

Palm Multiple types of phones available Very similar to Palm PDA systems Many models are NOT wifi capable Has the most medical software available

Smartphone Platforms

PocketPC Not Window Mobile 6.0 Multiple types of phones available Has the most medical software available Does not play well with MACs and is designed primarily to

sync with Outlook iPhone

Two versions 1G and 3G and relies heavily on Internet connectivity

Very seamless transition with phone, contacts, maps, email, SMS and Internet

Lots of memory Video and audio ready Some medical software available, primarily via Internet

Smartphone Platforms

Google G1 Android Relies heavily on Internet connectivity Open operating system Applications limited

Symbian Open source Requires unique network capabilities Least amount medical software

Smartphone Comparison

Figure 3: Surfing the web: practicing medicine in a technological age: using smartphones in clinical practice.Clin Infect Dis. 2008 Jul 1;47(1):117-22.

Medical Applications

Administrative Tasks Most popular

Billing & coding, calendar & scheduling, email, patient charting

Other applications Word processing, calculator, charge

capture, procedure documentation, outpatient tracking, resident hours, dictation, password management

Medical Applications

Patient Care Most Popular

Prescribing, patient record, medical calculator, lab value reference

Other applications Medical References (texts, articles),

patient tracking, patient reminders, clinical decision pathways, managed care, diagnostic imaging & radiology

Where to Look?

Fee based services UnBound Medicine

http://www.unboundmedicine.com/ Skyscape http://www.skyscape.com/ PDAMD http://www.pdamd.com/

Where to Look?

Free Resources Epocrates Rx http://www.epocrates.com/ Diagnosaurus

http://books.mcgraw-hill.com/medical/diagnosaurus/index.html

MedCalc http://med-ia.ch/medcalc/ NLM Mobile http://www.nlm.nih.gov/mobile/

PubMed for handhelds, WISER, NCBI bookshelf Shots 2008 http://www.immunizationed.org/

Platform Specific Software

Surfing the web: practicing medicine in a technological age: using smartphones in clinical practice.

Clin Infect Dis. 2008 Jul 1;47(1):117-22.

Drawbacks and Concerns

Primarily point of care tool Formatting

Images, text, layout design Internet sites

Functional but not always efficient Word processing, quick emails, quick

research

Drawbacks and Concerns

Institutional buy in Email and Outlook sync

BlackBerry only? Intranet / Internet access

EMR Access and Integration? Institutional platform compatibility

EpicOnHand runs on Windows Mobile or Pocket PC devices

Other issues regarding HIPAA

Drawbacks and Concerns

Security Patient information

Scheduling and Calendars, tracking software, notes, dictation

Web security Theft of personal information, financial

information, scammers Encryption varies

VOIP security Spam, Interruptions, Eavesdropping,

Drawbacks and Concerns

Patient’s Health Smartphones might cause medical

device malfunctions Newer phones generate less EMI than

older ones but Internet devices cause more than phone

1 meter debate FCC looking to expand usage in “white

space”

Where Do We Go From Here?

Library and IT support Buying power and synchronization Training

Library and IT Support

Be familiar with the technology Make library web pages mobile

friendly Decide amount of library support

Work with IT to coordinate support

Buying Power

Decide upon purchase plans and licensing Site licenses

Can be very costly, count potential users not actual

Downloads or concurrent users Purchase a set number of downloads Concurrent user only works if web based

Add ons Value added option but if no specific

license agreement for product, access could change

Buying Power

Discount purchases Users purchase with institutional/library

discount Electronic loaning

NetLibrary, Overdrive approach

Synchronization

Work with IT Get the message out!

Have product and purchasing information available on website

Catalog Advertise, advertise, advertise

Training

Many are uniformed of possibilities Young adopters are usually new to

profession Older potential users unfamiliar with the

technology Ensures adopters are aware and

select appropriate quality resource

Training

Demonstrate improved patient care Better access to point of care resources Answer patient questions real time

Demonstrate time savings Scheduling Patient care

Questions?

Michelle Krafthttp://www.kraftylibrarian.com