Personal Digital Assistant in an orthopaedic wireless ward: The HandHealth project

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Abstract

Personal Digital Assistant devices are becoming a frequently used device for the bedside care of the patient. Ways of application are many, but limitations are also numerous. Input device and monitor resolution are limited by the device size. Moreover, the choice of specific programs and the amount of storable data are limited by the quantity of memory.

During HandHealth project a system was developed using a different point of view. Personal Digital Assistant is only a means to access data and use functionalities that are stored in a remote server.

Using that system patient ward note can be showed and collected on the handheld device but saved directly on the Hospital Information System. Medical images can be showed on the device display, but also transferred to a high-resolution monitor. Large amount of data can be dictated and translated by remote continuous speech recognition.

Section snippets

Introduction and background

Nowadays, Information Technology (IT) is broadly used in healthcare environment. Applications are several and one of them is the ward time management. There are several ways for time optimisation and more and more the answer to these problems are Personal Computers. Today, it is not unusual to find PCs in hospital wards, especially in physicians and nurses offices. Nonetheless, it is still difficult to access patient information during bedside care. This implies gathering information before the

Design considerations

The developed system framework is described (Fig. 1). The PDA can dialog anywhere and any time with the Health Information System (HIS) by means of a web server. Data were directly read and written in the HIS database, no synchronization was needed.

A continuous speech recognition server was used. It was possible to send a maximum of 2 min voice file to a large continuous speech recognition software by using the PDA. The translation was copied in the HIS via web server. Once the translation was

Safe data access

Every user had to authenticate himself in order to access to patient data. Authentication was done by means of a RFID badge. Thirty-two personal badges were distributed to 21 nurses and 11 orthopaedists. User name and personal password were stored in the RFID badge. The used badges were passive, and during the authentication procedure were activated by the PDA. The excited badge could be powered by the emitted radio waves so as to send back the information stored. The range of the RFID antenna

Status report

During the HandHealth project, a framework with wireless access to HIS was developed. A 2 months demo was realized in orthopaedic ward. Orthopaedists and nurses carried out 362 accesses by using 5 PDA. A barcode was assigned to 197 patients and 1435 nurse reports were obtained. Two-hundred and twenty RX images were available for PDA visualization. Sixty-three vocal reports were saved and translated during the orthopaedists ward rounds. To give a descriptive indication of the demo's results some

Lessons learned

The present study aims to develop a novel approach to handheld device integration in healthcare environment. In contrast to the common way of considering a PDA as a portable PC, we developed a system in which PDA was used not only as a means of displaying remote data, but also of using remote functionalities. This approach permitted to access the huge amount of data stored in the HIS of the Rizzoli Institute during the ward round and at the bedside. Problem of PDA memory were completely

Future plans

A system was developed in which PDA was used as a means, not only to display local data but also to access remote data and to use remote functionalities. The system was completely wireless and did not need synchronization. A similar approach was not found in literature. Such a kind of framework permitted real-time access to data stored into the HIS. It also presented the preview of clinical images on PDA display with the opportunity of fast visualization on high-resolution monitor. Finally, a

Acknowledgments

The HandHealth study was carried out with the support of Datalogic S.p.A. within a project funded by Emilia-Romagna Region. We also would like to thank the health administration, the assistant service and the first orthopaedic division staff of IOR, for the kind support offered during the project.

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