• Handheld computer: a small mobile device that is part of your computing toolbox
• Forget Palm, Pocket PC
• Forget PDA and smartphone
• Forget the fancy
  • Fingerprints, photos and phones*

* Aziz et al. "Handheld computers and the 21st century surgical team: a pilot study."BMC Medical Informatics and Decision Making 2005, 5:28.

• For the first time, IT departments are behind the clinicians in adoption
• Schedule, of course
• Personal notes
• Personal textbooks
  • Personal Digital Educators*
  • NLM mobile, e.g. "Clinical Methods"

* Cimino et al. "Personal digital educators." N Engl J Med. 2005 Mar 3;352(9):860-2.

Internal medicine department in large teaching hopsital in USA

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In the beginning

- Senior asks IT department what the best available device is
- Junior doctor tells medical students that handheld computers essential for their studies

Investment

- $150,000
- 60 devices, WiFi
- UpToDate site license

Result

- 40 unopened boxes
- few residents and no medical students aware of UpToDate

Abbas bin Firnas, died 887 A.D.

An Arab Andalusian inventor. He also introduced eastern music to Andalusia. He produced glass from stone and created a machine to calculate time. He tried to fly wearing a robe of feathers.

A handheld computer is good for storing and displaying information that is the size of your hand, not your arm

• x-ray images vs x-ray reports
• complete medical records vs blood results and jobs lists

Result - search more textbooks in your hand than an entire bookshelf full of books

Perhaps the best computer ever designed for clinicians

• Mobility
• Synchronization
• Beaming

Databases

There are many ways of storing your data

- Memo Pad / Notes
- Spreadsheets
- Simple databases
- Bespoke databases

Memo Pad / Notes

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Fast and simple
But... limited

Security

Five steps to analyse security systems

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1 - What assets are you trying to protect?

2 - What are the risks to those assets?

3 - How well does the security solution mitigate those risks?

4 - What other risks does the security solution cause?

5 - What costs and trade-offs does the security solution impose?

Beyond Fear by Bruce Schneier
Springer; 1 edition (July 28, 2003)
ISBN: 0387026207

Scenario 1

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One handheld computer storing

- appointments (clinics and personal)
- addresses (ward phone numbers, computer passwords)
- tasks (including name of the patient)
- memos (lecture notes, patient summaries)

Fives steps:

1 - What assets are you trying to protect?

2 - What are the risks to those assets?

3 - How well does the security solution mitigate those risks?

4 - What other risks does the security solution cause?

5 - What costs and trade-offs does the security solution impose

Scenario 1

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One handheld computer storing

- appointments (clinics and personal)
- addresses (ward phone numbers, computer passwords)
- tasks (including name of the patient)
- memos (lecture notes, patient summaries)

Encryption

Scenario 2

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One handheld computer storing

- appointments (clinics and personal)
- addresses (ward phone numbers, computer passwords)
- tasks (including name of the patient)
- memos (lecture notes, patient summaries)

- patient medical records

Synchronise with

- home PC
- work PC
- secretary's PC

Scenario 3

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