PDAs are evolving at breathtaking speed from cool, novelty items to 24/7 caregiver companions. Nearly 30% of U.S. physicians own a PDA, according to a 2001 survey by New York-based Fulcrum Analytics Inc. and New York-based Deloitte Research. The firms project almost 50% of U.S. physicians will own one by 2005.
Many clinicians have been reluctant to rely on PCs and their myriad information systems for a variety of reasons. From many clinicians' perspectives, PC computing can protract the ways they're accustomed to doing business and require lengthy training with a long learning curve. Further, PCs simply cannot always be where one needs them-they're rather sedentary by nature.
As for laptop computers, they may be mobile, but they must be lugged around like a heavy medical textbook. And laptops share desktop PCs' propensity for being more complex than the space shuttle. And though the new class of tablet computers introduced in mid-November offers built-in small keyboards and other enticing options, health care users may wait for the devices' relatively high costs to come down before considering a purchase (see January 2003 Newsline section for complete coverage).
So imagine the excitement many clinicians feel when they discover PDAs-inexpensive, easy-to-use, five-ounce computers that fit in their pockets. For health care CIOs, though, the burning question is: What's next? While PDAs have been embraced by many doctors, nurses and other caregivers-along with many administrative staff-some experts say there are a lot of "buts" regarding their future.
Applications for hand-held computers suddenly are popping up in all kinds of health care I.T. offerings. However, some CIOs and industry experts are unsure of the role PDAs ultimately will play. Some believe they will be an integral part of tomorrow's health care delivery system. Others say that PDAs have, and always will have, technological limitations that hinder their usefulness.
Still, many agree that the future of PDAs will be shaped in large part by innovations in software and wireless networks that will enable caregivers to harness the full potential of these highly mobile devices.
"PDAs are the greatest thing since sliced bread," contends Jim Toth, director of information technology at Spectrum Health, a Grand Rapids, Mich.-based delivery system. "But there are limitations-some that can be solved, others that might be very challenging."
Getting tougher
Regardless of the challenges, some bets on the PDA's future seem like sure things, says John Distefano, vice president and head of North American mobile commerce at Cap Gemini Ernst & Young Consulting, New York. For one, PDAs will become more rugged and able to withstand the punishment inflicted upon them by clinicians and the PDA-hostile environment they work in, Distefano predicts.
The fragility of today's devices is a little-discussed but significant obstacle for PDA adoption at provider organizations, Distefano contends.
"I don't see it publicized much, but many provider organizations and individual physicians have started using PDAs only to discard them because they keep breaking after being dropped-or malfunction because chemicals or water dripped on them," he says. "In health care, we're not sending people down mines or climbing across oil rigs, but it is a very tough environment."
PDA hardware vendors note that "ruggedization" is not a top priority right now, Distefano says, but some say that by 2004, devices on the market will be made of more durable materials and components, and will have airtight and waterproof casings.
"This will make PDAs a more viable option to become a pervasive technology. This really is one of the things holding them back in health care. In the next few years, though, those problems should be solved."
In addition, many current hardware concerns-such as battery life, processing speed and on-board memory-will be alleviated by the high-tech industry's relentless drive forward, Distefano predicts. "Performance in these areas will continue to improve. There's little debate on that point."
However, there are a few seemingly intractable limitations to PDAs. Their small size, which makes them so convenient, also limits the size of their screens and makes keyboards impractical, says Jim Mormann, CIO at Iowa Health System, a Des Moines-based, three-hospital delivery system.
"That's the killer-in that way their size works against them, and you can't get around it," Mormann says. "I don't see how you can possibly create a bigger screen without making the device too big to fit in a pocket, which is the main selling point for physicians."
There are prototypes of PDAs that have clamshell-like screens that unfold to the size of a tablet computer screen, Distefano says, but he's not confident such a device will ever catch on. "They seem kind of odd, like pulling an umbrella out of a wallet."
The killer app
Even those who lament PDA size limitations, however, are optimistic they can work around the small screens and lack of keyboards if other technological pieces fall into place.
Some CIOs and industry observers say the future of PDAs depends on the release of what many see as the "killer app" for mobile technology-speech recognition software, which would enable physicians to do computer order entry and dictation via voice input instead of using an undersized keyboard or pen stylus.
"Transcription is the biggest headache we have right now in our clinical processes. If speech recognition software that can be used on a PDA comes to market, that would change everything," says Mark Hopkins, CIO at the University of Pittsburgh Medical Center. "The future will depend on speech recognition. At some point, physicians are going to want to use their PDAs during the entire care process, and if they can't, well, how many devices are we going to ask them to carry?"
Be the first to comment on this post using the section below.