Introduction

One morning in May 1998, the College porter burst through my door. This was during the final year of my degree. In particular, it was 9.15 am, and my exam was already 15 minutes underway - I thought the exam was in the afternoon.

At 9.20, I was out of my room.
At 9.25, I arrived at the wrong exam hall - the lethal cocktail of morning drowsiness and chronic disorganisation.
At 9.29, I was in the correct place, rushing past a Professor who found this all too amusing.

There is a happy conclusion to this story - I got my degree, and progressed to clinical school. However, another good thing happened. I had finally had enough with my disorganisation, and bought a handheld computer. Within one month, I had transformed from the least well-prepared student, to the most organised within a three-mile radius.

Every day, I would open my diary. Unlike my friends' paper versions, which were littered with tiny scribbles and repeated crossing out, my day always appeared clear. Changing appointments was easy, and scheduling them as regular events took no effort. As I went through the day, I would pick up the names of good patients to see on the wards, and add them to my to-do list.

I had my entire course's lecture notes in my pocket. I took them during the lecture, often faster and always more structured than my 'papered' colleagues did. Ward rounds were also a place for clinical pearls, which I scribbled down eagerly. When I saw another of my friends with a handheld, I beamed those notes to them. Beaming involves lining up the two machines, and seamlessly transferring information using infrared. You really have to try this to appreciate its elegance.

When I saw patients on-call, I could clerk them on my handheld. For this level of text-input, I switched from handwriting to typing - I kept a pocket keyboard in, which unfolded into a full-size keyboard, and was a great way to make friends with the patients. They loved to play with it. In the morning, before the ward round, I would add the results of investigations to the record, and proceed to distance myself from the notes trolley. When I began working as a doctor, I convinced my colleagues to get a similar machine. Morning handovers no longer involved frantic scribbling of patients' details. We just lined up our handhelds, and beamed away. Then we discussed the most important details... while having a coffee.

Nevertheless, despite all of this efficiency, medicine involves a lot of waiting - especially as a medical student. I no longer found this irritating. I bought books that I never thought I would have time to read, and devoured them during such waiting times. I downloaded the latest newspapers, which I digested at my own pace. One such publication was the New England Journal of Medicine, although, in truth, I only downloaded it to create an impression of hard work.

Then there were the games.

Organised disorganisation

A few years on, however, I began my house job . The feeling of being disorganised returned.

I truly loved that year, above all because I so enjoyed the company of those around me. Hardworking, honest, and often hilariously funny, my colleagues made the job a great deal of fun.

However, there was an overwhelming amount of information to deal with, and the only tool we had for dealing with it was paper. This was not enough, and it was getting worse. Talking to my colleagues in the NHS and around the world, this experience seemed to be commonplace.

What surprised me most was how few clinicians seemed to realise the role that handheld computers could play in their work. Most clinicians' experience with computers in the workplace was of complicated, expensive and unreliable equipment. They expected a handheld to be even worse, because many thought it to be brand new and only experimental technology.

Typically, it only took a few minutes of demonstrating the machines for a doctor to change their mind. At seminars and presentations, the audience would quickly become enthused about the technology. And articles I had written were convincing many to take the plunge and invest in their own machine.

Who am I?

My name is Mohammad, and I graduated as a doctor in the UK. During my medical studies, however, I kept up my interest in computers. During my third year, I worked at a wonderful place, Cambridge University's Clinical and Biomedical Computing Unit. The folks at CBCU were constantly trying out the latest technology to see if it would be useful in a clinical context. I was hooked.

After graduation, I worked there for six months as part of Project Palm. The team's aim was to create software for handheld computers to aid clinical medical students in their education across the region. It was a fascinating experience. During this time, I learnt a lot about handhelds and medicine, and how the two worked together.

Dr Laura Dean was also part of Project Palm. At the start of her studies at the university, she had never used a computer. By the time she had reached CBCU, she was already teaching her colleagues how to use them. Project Palm pushed her teaching skills to the limit because her students had the full spectrum of IT literacy.

As Laura and I began our house jobs at the same hospital, it was inevitable that we would put our computer skills to work. Slowly, we convinced our friends to invest in the technology; then a few departments asked for our help; and then we were invited to speak around the country about handheld technology.

My vision is for the Government to provide every doctor with a handheld computer as they arrive at their hospital. I hope that this book helps to achieve this.

Who is this book for?

This book is for anyone trying to cope with the information overload in medicine. This includes doctors, nurses, other healthcare professionals hospital managers, clinical IT staff, medical librarians, and medical students who are late for exams.

From this book, I hope you will realise that handheld technology can make a real difference in your clinical practice today, so you will be encouraged to buy a machine. I also want to give you the tools to help your colleagues get a handheld, and take advantage of their group-work features.

To achieve such changes in your working lives, you do not have to be good with computers, or even like them. I recommend handhelds to everyone because I know that anyone can learn to use them.

How to use this book

I have tried to keep this book short and entertaining. This is because I want you to enjoy reading it, and then enjoy setting up your own handheld projects. The book is in three sections:

Section 1, or 'Why Star Trek is Science Past.' Many people around the world think that Star Trek is good science fiction. However, it was only after several million Palm Pilots were sold that we saw episodes in the series featuring actors writing on small handheld computers. Star Trek is not really about the future, just today's technology working a little faster . I want you to think of handhelds in the same way. They are not futuristic gadgets, just today's technology working well for busy people including clinicians around the world.

Section 2, or 'Why two handhelds are better than one.' The handheld technology becomes particularly impressive when you begin using it with your colleagues. This section discusses three teams who put the handhelds to different clinical uses.

Section 3, or 'On being a project champion.' If you have got this far, you are probably already your department's expert on, and champion of handheld technology. This section explains the tools and techniques you will find useful as you introduce the technology to your team.

Begin at the beginning, with Chapter 1. After this, feel free to dip into the other chapters in the order that interests you. I wish you a pleasant read.

What would you like to do?