Handhelds in Medicine
This is a book with pedigree. Its authors are pioneers in bringing evidence-based medicine (EBM) to the bedside and the book is the latest example of their efforts.
An earlier example was InfoRetriever. The handheld computer software combines several textbooks and EBM databases. One of these is the charming Patient-Oriented Evidence that Matters (POEM) database created by Dr Ebell and colleagues. As its name suggests it is designed to provide information that makes a real difference to patient care. The InfoRetreiver interface on handheld computers makes that information quickly accessible. For example a PubMed search on the treatment of lacerations from animal bites may take several hours and require a PC with a large screen for looking at all the papers at the same time. A search through InfoRetriever takes only a few seconds, shows the antibiotic dosage and quotes the “numbers needed to treat” statistic from the original paper.
This dogbite soundbite is what every busy clinician craves. With this in mind I was looking forward to reading the book that these editors came up with.
It does not disappoint. It is perhaps the first comprehensive textbook about the medical use of handheld computers. It is covers the usual ground about the bundled organizer software, and the available medical calculators and electronic medical records software. But it also covers software for nurses and auxiliary healthcare professionals. The advanced section gets rather advanced, including a discussion of writing your own software and training other users in your handheld computer projects.
In many sections the book includes step-by-step instructions. For some readers, the chapter on databases alone may be worth the price of the book because it explains the clinically relevant aspects of database theory and includes worked exercises for designing HanDBase databases. For others applying the advice of the chapter on billing software will be enough to recoup the investment because of the increased charge capturing.
The chapters of the book read easily even though so many authors have contributed. The exercises format seems promisingly educational and the CD at the back is rather useful for getting started straight away.
Of course as with all books that tackle the details of computers some details were out of date even as the book went to press. For example PatientKeeper medical records software was discussed as software for Palm Powered devices even though the Pocket PC version has been available for over a year. However for the most part the information is highly relevant and the applications selected are well established – their features may have improved by the time you buy the book but the fact that you should use the software has not changed.
More significant is the lack of discussion of encryption. Compliance with HIPAA legislation is mentioned several times in the book to ensure maintaining confidentiality of information about patients. However the chapter on patient records simply mentions password protection as sufficient for compliance. But this is weak security and getting the message out to readers about the need for encryption is important.
For my personal tastes another problem is the discussion of Palm Powered and Pocket PC packages in isolation. Some applications do exist for Palm Powered devices that are not available on Pocket PCs, and vice versa, but in general these tend to be less mature than cross-platform alternatives. Certainly, plenty of software exists that works on both Palm Powered and Pocket platforms and insisting on these ensures that members of a team can share data together no matter what machine they choose today or in the future. This principle protects clinical data, which is far more valuable than the devices or software.
Overall however the book is excellent and it has been worth the wait. Its price tag and textbook size may put off individuals who just want to get started with their own handheld computer. But hospital and university libraries should definitely buy a copy for their students and clinicians, and anyone considering running a project with handheld computers should make the investment. It is already a well-used part of my bookshelf.
Book details
Title - Handhelds in Medicine : A Practical
Guide for Clinicians
Editors - Scott M. Strayer, Peter L. Reynolds, Mark
H. Ebell
Publisher - Springer
ISBN - 0387403299
Buy the book
From Amazon.com
or Amazon
UK.
