Be on the wave or under it™

The News – 02/20/02

Handhelds in Health Care

Wireless is one of those technology areas that always seems to be impending. Each of the last two years has been the year of wireless according to industry boosters. Pundits and prophets breathlessly report each twist and turn in the story. Yet when wireless nirvana hasn’t arrived, detractors have declared wireless a technology in search of a problem.

Wireless is here; so’s the gear. Get used to it.

Want proof? Take a look at health care, particularly in the hospital setting. Now there’s an information management problem. You’ve got doctors roaming around from room to room, changing orders, taking notes, and making life and death decisions. You’ve got nurses and other medical professionals monitoring patients, administering treatments and medications, and sometimes trying to figure out what the doctor said. Hospitals run on information, and the reliable transmission of information.

It’s critical to make sure that all this information is accurate, timely, and always available. That means most hospitals are in the paper shuffling business. Medical records departments are awash in it. For example, the RehabCare Group in St. Louis, an outsourcing staffing firm with 2000 therapists working at nearly 500 sites estimates that their therapists were writing and faxing an average of 3,000 pages of information each week. Many hospitals and clinics spend lots of money on keying services to convert the paper to bits so that the information can be managed.

Some hospitals today are digitizing the information at the source: the doctors and the nurses who care for patients. According to the Doctors Say E-Health Delivers study conducted this fall by the Boston Consulting Group and Harris Interactive, 89 percent of physicians use the Internet, 22 percent use electronic medical records to store and track information about their patients, and 11 percent are prescribing drugs electronically. The study further found that doctors were planning on adopting electronic information practices at a rapid rate.

Many of these forward-thinking doctors are going mobile. For example, about 30 doctors at the University of Minnesota have been testing a modular mobile Electronic Medical Records (mEMR™) software program designed by AllScripts Healthcare Solutions. The modular nature of the AllScripts solution allows doctors to start using one solution and progressively add others. The company offers the following modules:

• WorkFlow: Task Management and Triage Routing
• Charge: Charge Capture
• Dictate - Dictation and Transcription Management
• Document: Dictation, Transcription, and Document Management
• Rx+: Prescribing and Medication Management
• Order: Ambulatory Orders
• Result: Results Review
• Note: Structured Charting
• Pocket Library™: Clinical References
• Physician Homebase^sm : a browser-based information portal

Using the AllScripts TouchWorks™ Dictate system, the Minnesota doctors record patient notes on wireless-enabled Compaq iPac Pocket PCs, creating an audio file that is sent wirelessly to medical transcribers through the hospital’s radio frequency network. The software supports dictation templates that can be customized to match hospital forms.

If the doctor strays outside the hospital’s radio network, when he or she enters an area with a wireless transceiver, the data is transmitted automatically. This is especially helpful since the University of Minnesota's physicians work in more than 150 clinics around the state. Currently, 38 of the clinics are equipped with wireless equipment to capture data and transfer it to traditional land-based networks. The uploaded information is accessible to doctors and others through a Web site using their handhelds or office computers.

The physicians group plans to introduce the software's other functions over a period of time, said Todd Carlson, Chief Operating Officer. After implementing medical transcription, the group will expand to electronic laboratory results, billing, scheduling, patient care and referring physician information.

Security of the data was a normal concern, and one that will become even more important once the HIPAA (Health Insurance Portability and Accountability Act of 1996) regulations come into effect. “We are really afraid of hackers because we're on a college campus and we're afraid students will attempt to hack into our wireless system,” said Carlson. “We did a hacking audit with Ernst & Young at an additional cost because we wanted the system to be safe and secure.”

The Rehab Care Group in St. Louis is in the process of equipping as many as 1,500 of their workers with Palm Pilots, according to Senior Vice President and CIO Jeff Roggensack. The company developed a custom application that works with Palm handhelds. “It streamlines the data collection process for our therapists working in the field, and eliminates the faxes, data entry, delays and handwriting errors experienced with the paper-based system used previously,” said Roggensack. Currently, the workers synch their Palms with desktop PCs for transmission, although wireless access is planned for the future.

Today, 19 percent of physicians own personal digital assistants, and that number should exceed 40 percent by 2005, according to Fulcrum Analytics. A Forrester survey of 44 medical practice managers for a report titled Doctors Connect with Handhelds, found that physician practice managers are actually “overexuberant” about the potential of using mobile computing devices. If their predictions turn out to be true, 86 percent of practices will be processing prescriptions on handheld computers by 2003, whereas only 11 percent of practices do so today. Forrester predicts the market for mobile physician software, devices and management will grow from a $21.4 million market today to a $1.6 billion market in 2007.

According to Taking the Pulse v 2.0: Physicians and Emerging Information Technologies by Fulcrum Analytics and Deloitte Research, more than half of all physicians who responded to a survey hope to view lab results via their PDAs in the future. Of the 30 percent who report that they currently own a PDA, 84 percent maintain their personal schedules and 67 percent manage their professional scheduling through the device.

So the docs are on the leading edge, and are impatient for more wireless applications. They’re not the only ones. Wireless has applications in many industries, according to Summit Strategies analyst Jennifer DiMarzio. DiMarzio suggests considering the use of mobile wireless technology if the location of your workers, or of their next assignment, changes frequently; if timely information improves productivity; and if your company can improve billing if employees can instantly record the work as they finish it.
City Business

Briefly Noted

• Shameless Self-Promotion Dept.: CTOMentor has published a new paper called Basic Home Networking Security that should be of interest to anyone who wants to access at-work networks from home.
  
  The paper covers, in plain language, types of threats, secure home networking practices, and describes the basic home network security toolkit every home user should have.
  
  CTOMentor is also offering a two-part white paper on peer-to-peer technology: Peer-to-Peer Computing and Business Networks: More Than Meets the Ear. Part 1, What is P2P?, is available for free on the CTOMentor Web site. Part 2, How Are Businesses Using P2P?, is available for $50.
  CTOMentor



• Kmart Supply Chain at Fault: Kmart CEO Chuck Conaway blamed many of Kmart's problems on its supply chain. In September, Kmart wrote off $130 million for supply chain hardware and software and another $65 million for replacing two distribution centers. It didn’t help them avoid bankruptcy court. Nonetheless, Kmart plans to spend $1.7 billion or so on a project to improve the flow of goods to store shelves.
  Internet Week

• Defacement Tracking Site Owner Steps Aside: The operator of a great resource for keeping tabs on Web site defacements (changes in Web pages caused by cybercriminals) is calling it quits. The Alldas.de Web site, which archives copies of defaced Web pages, announced that its founder would be retiring and the site moved to a new domain. Stefan Wagner said that dealing with system administrators who blamed Alldas.de for their defaced sites, denial-of-service attacks launched against his site, and a lack of a social life made him hang up his spurs. The site will move to Alldas.org in early March and be run by two staffers and volunteers.
  News.com

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