Handy Handhelds

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Tablet PCs and PDAs are bringing radiology images anywhere they need to go around the healthcare enterprise. See how a variety of healthcare providers in radiology, cardiology, orthopedics and neuroradiology are using handheld computers in innovative ways.

Handheld computers - tablet PCs and PDAs - are being deployed across the healthcare enterprise. Emergency physicians, orthopedic surgeons, neurosurgeons, cardiologists and a few radiologists are discovering these handy devices can improve the business of medicine and enhance patient care by providing anytime/anywhere access to critical patient data. Key points to remember are:

  • There is a handheld device for everyone. The key is deciding what works for each individual, not forcing a certain device on every user, says Ben Bresnick, coordinator of physician relations and technology for Central DuPage Hospital in DuPage, Ill. Even 'tech-phobics' who prefer pen and paper can now go high-tech.
     
  • The image quality of even the highest resolution handheld devices is debatable for diagnostic viewing. But if users consider images in terms of informational quality (vs. diagnostic quality), handhelds' utility for image display becomes apparent. A surgeon, for example, may determine whether or not he needs to see a patient immediately via an image viewed on a handheld.
     
  • A number of enabling technologies are poised to converge on the market. Vendors are improving hardware with more rugged tablets and larger, higher-resolution screens on next-generation PDAs. And more applications for the handheld uninitiated, particularly for radiology and cardiology users, are hitting the streets.

PDAs: GOOD THINGS COME IN SMALL PACKAGES

Jerome Kolavo, a partner with Orthopedic Associates of DuPage (DuPage, Ill.), uses a palmOne handheld (palmOne of Milpitas, Calif.) equipped with Horizon MobileCare Rounding (McKesson of Alpharetta, Ga.) to simplify the business of medicine and better meet his patients' needs. Kolavo's palmOne is tied into the hospital server, allowing him to access radiology reports, patient vital signs, lab results, dictations and patient census information. "Basically, what I'm looking for is data," he says. "The palmOne is user friendly, portable and multifunctional. With one device I can view patient data, send and check emails and receive phone calls. Eventually, this will replace my pager."

Kolavo admits that the palmOne isn't great for images, but says it doesn't need to be. "If I really need to view images, I want a good high-resolution monitor," explains Kolavo. Still, he admits, he is just scratching the surface of the device's capabilities. Bresnick, who initiated the PDA program at Central DuPage Hospital, believes surgeons can realize the biggest gains from handhelds because they can remotely view photos and x-rays of injuries, such as dog bites or severed fingers.

While clinicians like Kolavo are riding on the PDA bandwagon, radiologists have been slower to climb on board. Adam Flanders, MD, professor of neuroradiology at Thomas Jefferson University Hospital (Philadelphia, Pa.), explains why. "The biggest problem with handheld computers right now is that there are no killer applications for radiologists. It's hard to build a compelling application for radiologists who are surrounded by $80,000 high-resolution, high-fidelity workstations with instant access to voice recognition, HIS and other tools."

Radiologists using PDAs generally limit their use to PIM (personal information management) applications. Radiology-specific applications include Elsevier's (Philadelphia) PocketRadiologist. The walking reference library provides decision-support through images, diagrams and text. But power applications for radiologists may be right around the corner.

"The big growth area for PDAs is the digital dashboard," Flanders says. The digital dashboard could allow mobile radiologists to monitor their practices, providing instant access to patient wait times, number of cases and other critical information that can help the radiologists optimize their time. Flanders relies on an internally developed dashboard tool for his PDA to keep an eye on his work when he's away from the office. "I can check on the number of cases piling up when I'm on the train and decide whether I should go to my office or straight to the reading room."

THE IMAGE QUALITY ISSUE

Right now, the display resolution on PDAs is not sufficient to deliver diagnostic-quality images. But, Flanders says, "Resolution is