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In such cases, Martin typically would get into his car and drive back to the hospital to review the most recent clinical data and visually check the patient. But new mobile software has changed the way he operates, so to speak.

Using a smart phone, Martin logged into the hospital's network and checked the patient's lab results and real-time vital signs. In addition, he downloaded the most recent CT scan, and was able to review the image on the small smart phone screen, using pan and zoom functions.

Martin determined the patient had pneumocephalus, a condition where air collects in the head. Medication and changing the patient's recline position took care of the problem, and the patient recovered normally.

Besides being able to review patient data all on one screen, including real-time telemetry, "you can view the images just as you would at a desktop PACS," Martin says. Initially there were some problems with the length of time it took to download the images to the smart phone, but now it takes two to five seconds. "A few seconds per CT scan beats the heck out of a drive to the hospital," he adds.

Mobile software has come a long way from just a few years ago, when mobile computing was limited to using a desktop computer to upload and download limited amounts of data to PDAs. It's now commonplace for clinicians to wirelessly pull data from disparate systems onto a variety of devices, including PDAs, smart phones and Tablet PCs.

While no new "killer apps" recently have emerged, improvements in the functionality of mobile software, as well as the capabilities of wireless networks and mobile devices, are changing the face of mobile computing.

Perhaps the most significant change is how the new generation of mobile software is fitting into physicians' workflows.

Instead of just being able to check information on a screen, mobile applications are enabling physicians to establish a flow of information to and from mobile devices.

New software is converging previously standalone functions into single applications, further enhancing workflow. In addition, vendors are embedding mobile functions into conventional applications, such as practice management systems, to provide a bridge between old work processes and new ones that take advantage of untethered data access.

But despite all the advancements in mobile software, the applications still can be a roadblock to efforts by some organizations to standardize on a single device for physicians to use for mobile computing.

The mobile application used at UCLA Medical Center-developed with the help of UCLA physicians and marketed by Aliso Viejo, Calif.-based Global Care Quest-was conceived to get information from disparate systems onto one screen, Martin says. "Previously, we would have to log into two or three systems," he explains. "There was no integrated interface."

But the software, which also is used on desktop PCs, has evolved into a much more comprehensive application. Not only can remote physicians get real-time telemetry data and review radiology images, they also can access live video of the patient via bedside cameras or cameras in the operating rooms.

Martin primarily uses the system in two ways. If he gets paged outside the hospital regarding a patient he uses his smart phone-a Treo 6700 from Overland Park, Kan.-based Sprint Corp.-to review the CT scan and plan a course of action.

"For example, if a patient has a brain hemorrhage I may decide that surgery is needed," he says. "In the past, everyone waited for me while I drove to the hospital. But now I can remotely decide what to do and staff can prep the patient before I get there, so we can cut 30 minutes from the time it normally takes to perform a procedure."

Martin also uses the software to perform a virtual round from home before he turns in for the evening.

"I can often pick up problems that can be managed proactively and avoid the need for the nurse to contact me at 2 a.m.," he says. "It's not a system that is resulting in pure remote care, but it does enable us to augment our standard in-person rounds with remote rounds to check on specific anomalies."

Global Care Quest is working on building alerts into the software that will pick up on clinical anomalies and analyze statistical trends, Martin adds.

First steps

Mobile applications have been used at many facilities to introduce physicians to electronic data and begin the transition from paper records to an automated care environment.

But these stepping stones to increased automation sometimes had the opposite effect because of the limitations of the mobile applications. Mobile rounding reports were nice to have, but physicians often had to rely on paper forms or desktop PCs to create their reports and transfer the data to other information systems.

However, provider organizations wanting to dip their toe in the water of automation have new options thanks to the industry trend of "mobilizing" information systems.

Norwalk, Ohio-based New Beginnings Pediatrics, for example, implemented a practice management system-from Microsys Computing Inc., Boardman, Ohio-that comes with embedded mobile functions that are helping the practice move a few steps closer to an electronic medical record.

"For me, using a computer is not a problem," says Glenn J. Trippe, M.D., founder of the practice. "But for some of the other docs it's a different story-some aren't computer literate. This is a good stepping stone before taking the deep dive into EMRs."