Exploring Digital / Wireless Application In Healthcare

Presentation of Research

Mohammad Al-Ubaydli, M.D.

December 3, 2007

© 2007 The Advisory Board Company 2

Roadmap for Discussion

I. Introductions and DefinitionsI. Introductions and Definitions

II. Scholarship Sponsored by EpocratesII. Scholarship Sponsored by Epocrates

III. VCU Hospital: Admissions and BillingIII. VCU Hospital: Admissions and Billing

IV. Refining the Medication Reconciliation ProcessIV. Refining the Medication Reconciliation Process

Introductions and Definitions

I

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Introductions

The Advisory Board Company IT Insights team Mohammad Al-Ubaydli

Doctor, University of Cambridge Programmer, National Center for Biotechnology Information Management Consultant, The Advisory Board Company

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Definitions

Handheld computer: a computer small enough to hold in your hand

Personal Digital Assistant (PDA): a handheld computerSmartphone: a handheld computer that can make

telephone calls Mobility: small form factor and long battery life Connectivity: cellular, WiFi, infra-red Ubiquity: every clinician already knows how to use

their phone

Doctor’s Dream Device

Addition, not Replacement

Scholarships Sponsored by Epocrates

II

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Avoiding the Mistakes of Others

The challenge At the start of 2006 there were over 600 papers in PubMed™ that dealt with

handheld computers. Many lessons have accumulated in the clinical literature but we need to understand and assimilate these lessons.

The challenge is to provide these lessons as peer-reviewed and unbiased summaries based on scientific fact, not marketing hype.

The Scholarships Five exceptional students from around the world will be selected each year to

review selected literature and make summary reports that will be published in the Mobile Medical Computing Reviews journal. The Scholarship winners will be mentored and trained by Dr. Mohammad Al-Ubaydli, author of four books, including “Handheld Computers for Doctors”.

The results Once complete, the reviews will be published and freely available through the

website of the new journal Mobile Medical Computing Reviews. Each student will be able to quote their own reviews in their list of publications.

www.handheldsfordoctors.com/research

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Teaching Tomorrow’s TeachersDr. Yunan Chen, China Dr. Adesina Iluyemi, Nigeria

PhD candidate atDrexel University

PhD candidate atUniversity of Portsmouth

Dr. Emily MacDonald, UK Joshua McAllister, USA Dr. Devashish Saini, India

Medical Student atUniversity of Cambridge

Medical Student atUniversity of Texas Medical Branch

Resuscitation Sciences Fellow atUniversity of Alabama at Birmingham

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Teaching Tomorrow’s TeachersDr. Mina Hafzalah, Iraq Dr. Craig Huang, USA

Completing a fellowship in Pediatric Critical Care at the University of Chicago

Professor, Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, Texas

Dr. Mizna Murza, Pakistan Dr. Alfonso Rodriguez-Morales, Venezuela Dr. Iman Tavassoly, Iran

Completing a Public Health Informatics Fellowship at the Centers for Disease Control and Prevention, Atlanta, GA

PhD candidate at the Tropical Medicine Institute, Central University of Venezuela

Resident at the Mehran Health Network, Ilam University of Medical Sciences, Ilam, Iran

Matching the Wireless Device to Clinical Needs

III

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Success on the Move

VCU Health System

779-bed academic medical center

Located in Richmond, VA

Physicians perform electronic charge capture and review clinical results with PocketPC (Treo) Smartphones

Successful only after failed attempts with PocketPC PDAs and Palm OS Smartphones

$800,000 annualized revenue for 1 department from: missing charge rate 15.7% --> 0.07% and charges within 10 days 25% --> 90%

Will deploy to 600 physicians after the success of the pilot with 40 physicians

Case in Brief

Software on smartphone includes:

Patientkeeper integrating with Cerner EMR

UpToDate medical reference SPB Software and integrating with corporate contacts

Google Maps, local weather Show missed pages

Infrastructure Secure VPN tunnel

through Sprint PCS Remote PocketPC

monitoring through MobiControl

Lotus Notes to PocketPC via iAnywhere

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Pocket PC PDA Confusing to Clinicians

Pocket PCs connect to Wi-FiWiFi network available throughout hospital.

Reconnecting to different wireless stations around the hospital too complicated

Battery life too low because of Wi-Fi usage and failure to recharge would lead to cumbersome reinstallation of software

Physicians refused to use devices

Project Almost Abandoned

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Palm operating system does not have multi-tasking Physician must log into electronic medical record and e-

mail software Switching to application expires authentication of

previous application Clinical work relies on constant switching between tasks

Switching Too Cumbersome

Palm OS Smartphone Lacked Multitasking

Log into EMR

Log into EMR

Log into e-mail

Treo Smartphones with Palm Operating System Promising

Friendly user interface and constant connectivity through cellular network

Refining the Medication Reconciliation Process

IV

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Nurses’ Perceptions Slowing Adoption of Bar Coding

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Striking a balance

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Combining the Best of Both Worlds

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Raising Awareness, Reducing Errors

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Avoiding the Mistakes of Others

www.handheldsfordoctors.com/research

Mohammad Al-Ubaydli, MDalubaydm@advisory.com

202-266-5425