How Technology Will Affect Your Practice

Technology has become an essential component in the practice of medicine, largely due to high information demand. The information and computing needs of the physician are tremendous, especially in light of newer federal regulations regarding security and confidentiality. Information management for the busy physician involves storage, retrieval and speedy access at the point of care. In the last several years, personal digital assistants (PDAs) or handheld computers have become an essential information tool to meet this information need.

Many articles in both health care and technology magazines have been written regarding the use of PDAs in medicine, with diverse topics such as prescription ordering (Hicks, 2001), reference tools (Kelly, 2001) and charge capture (Terry, 2001). Even magazines devoted to handheld computing have had articles specific to the field of medicine (Johnson, 2002). The journal Psychiatric Services has already published three articles regarding PDA use (Grasso and Genest, 2001; Luo et al., 2002; Luo et al., 2001). Clearly, PDAs have become a topic of interest.

The issue of PDAs has also piqued the interest of many health care organizations. The California Healthcare Foundation published a report last October on wireless and mobile computing, examining how soon and to what extent these applications might be integrated into standard health care practice (Turisco and Case, 2001). The Agency for Healthcare Research and Quality has funded four research projects involving personal digital assistants to prevent medical errors <www.ahrq.org/qual/ newgrants/it.htm>. This interest demonstrates how PDA use has become more of an enterprise and systems issue.

In addition to the numerous articles that have been written on PDAs, there are several books (Table) and over 1,000 Web sites devoted to PDAs according to Google <directory.google.com/Top/Computers/Systems/
Handhelds/?tc=1>. Organizations such as the Michigan State Medical Society (Chin, 2001) and the American Psychiatric Association <www.psych.org/sched_events/ ann_mtg_02/
brochure02.pdf> have offered classes to teach physicians how to use their PDAs. Given the tremendous amount of information available, this article will introduce essential concepts and serve as the portal to the wealth of information relating to PDAs in psychiatry.

Most people know that PDAs started as electronic counterparts to their cousins, paper-based organizers. The standard PDA features include a date book, an address book, a to-do list and a memo area for notes. These features function similarly to paper-based organizers but have significant additional capabilities. An obvious advantage is that the entries are made in machine text, which can then be exchanged with other electronic media or devices. What sets these devices apart from paper organizers is their capability to run medical applications or programs.

There are many other advantages to using a PDA. A key element involves their size, which ranges from a pack of cards to a thick checkbook. For the busy physician moving from office to office, a PDA is portable and unobtrusive. Almost all PDAs provide some linkage to information on desktop computers. This allows for the synchronization of data between the PDA and the desktop computer to keep information current. In addition, this synchronization process serves as a handy backup feature when data are lost.

Although the various models and manufacturers make the decision appear difficult, choosing a PDA is really a simple matter. One key concept to keep in mind is that technology improves and changes rather quickly. Within one year, newer models may offer additional features or capabilities that are desirable. Although a wait-and-see approach may mitigate your anxiety that your PDA is obsolete, it will also mean that you will not benefit from using a PDA as efficiently. A good plan of action is to consider keeping your PDA for at least one year, then upgrade only when new features are compelling, such as more memory or wireless capability.