2016

PDA and Wireless Devices

BSN
Nursing Informatics

Individual use of information depends on a continuum along several dimensions:

the desired physical size and characteristics of the hardware
the length of time a mobile device runs before requiring recharging
whether the computer functions as stand-alone or as part of a network, the availability of
applications to support an individuals work
the appropriate of security level

Continuum of Information Technology for Personal Computing

A smart phone represents a convergence between computing and communication.
A smart phone fits in a shirt pocket, weighs ounces, has a 2 in. or slightly larger display, has
processing power measured in megahertz (MHz), limited memory measured in megabytes (MB)
,limited storage capacity measured in MB, and can run on battery power in talk mode for 3 or
more hrs. or standby for up to 10 days before requiring recharging.

Desktop Computer vs. Smartphone Physical Characteristics

The distinctions between different forms of computers are relative according to characteristics
such as weight, display size, processing power, memory, storage capacity, and battery life.
In general, a desktop computer is too heavy to hand carry, has a larger display, processing
power measured in gigahertz (GHz), memory capacity up to gigabytes (GB), storage capacity
up to GB, and is not designed to run on internal battery power.

Notebook/Laptop vs. Tablet vs. PDA Physical Characteristics

A notebook/laptop computer is lighter enough to hand carry, has a slightly smaller display, and
slightly less processing power and storage capacity than a desktop computer.
The most important difference between a desktop and a notebook/laptop is that a
notebook/laptop is designed to run on battery power so that in addition to being portable, it can
run without requiring access to an electrical outlet.
The tablet is lighter, has a slighter smaller display, and slightly less processing power and
storage capacity than a laptop.
The most important difference between a notebook/laptop and a tablet is that the display allows
use of a stylus for input on a tablet.
Keyboard and mouse input is possible but not necessary when using a tablet since the user
may employ a stylus for writing or drawing.

PDA (Personal Digital Assistant)

-weighing in at 8 oz. or less, it is a small enough to fit in a shirt pocket.
-comes with a miniature keyboard and a stylus for data entry.
-it is possible to add an external portable keyboard.
-has many characteristics in common with the Smartphone (a hybrid of PDA and telephone), but
tends to have a longer battery life since it need not support voice communication.

Battery Life
Mobile devices depend on batteries. The length of time a battery supports use of the device and
the length of time for the battery to recharge determine the usefulness of the device.
Strategies to achieve longer times between battery recharging include:
dynamic power-consumption-management
procedures.
power aware applications for adaptive power management.
energy-aware interfaces for reducing display demands on the battery.

For mobile technology, the most common types are either some form of a:
Lithium Battery
Alkaline Battery

PDA Operating Systems

The operating system for a computer determines many of the characteristics of the computer
because the operating system controls how the hardware and the software work together. The
most two commonly used operating systems for PDAs are Palm OS or Windows
Mobile.

Mobile Devices
Any computer systems that can be hand carried or rolled around is a portable device.
Computers that are small and light weight enough to be hand carried are mobile devices. A
laptop is considered mobile. The key to a mobile device is the nonbulky display.
A computer that can be held in the palm of one hand and used with the other hand is a
handheld device. A PDA is considered a handheld. The key to a handheld device is the
miniature keyboard.
The Institute of Electrical and Electronics Engineers (IEEE)
- establishes the rules that govern how networks work. A desktop computer typically is
connected to the world through a metal wire cable (e.g., copper wire Ethernet following the IEEE

802.3standard). An alternative way of connecting is through glass or plastic fiber-optic cable,

which means a higher rate of data transmission.

Wireless Devices
For a computer to connect wirelessly there must be a physical component added to the device
to enable wireless communication. Depending on what standard device follows, there is also a
requirement for a wireless access point to the network.With the right card added to the
computer and a wireless local area network (WLAN), it is possible for a wirelessly enabled
desktop computer to connect through an over-the-air interface to a computer. The most
commonly standard used for this is IEEE 802.11 that governs how local area networks (LANs)
connect wirelessly using wireless fidelity (Wi-Fi).

PDA Generic Functions and Their Application to Clinical Practice

The PDA evolved as an information technology to support personal information management. It
provides an:

1.) Address book- is an always-alphabetical list that has fields for name, address, phone
numbers, organization, e-mail, and other data.
2.) Calculator- is a basic function calculator, capable of mathematical operations. Calculators for
specific medical calculations are available.
3.) Date book- allows the nurse to keep track of his/her schedule, from a daily, weekly, or
monthly perspective.
4.) Memo pad- provides a place to compose memos, which can be synchronized with another
computer. One use is to produce and edit project outlines.
5.) Notepad-is useful in jotting quick notes. It allows the nurse to write directly on the screen in
digital ink. It is also useful for changes in patient conditions, changes in orders that occur on
rounds, and taking notes at Continuing Education offerings.
6.) to do list- allows the nurse to create multiple lists and keep track of tasks to be done daily,
weekly, or monthly.
The advantages for healthcare providers using the standard PDA functions include saving time
through improved access to and management of information.

General Freeware, Shareware, and Commercial Applications

The 3 types of general applications: document, and image viewers, office automation
applications, and Web browsers.

Document viewers, allows the nurse to download and read text files. Document allow formatting,
indexing of content, and special characteristics to be preserved when documents are download.
A graphics viewer for image viewing may be useful for individuals practicing in specialties where
images are a basic requirement. Firepad Picture Viewer is a commercial application that may be
downloaded and is useful for creating, viewing, and sharing images, videos, and multimedia
presentations as well as acquiring free Internet images.
PDA database programs are available to read data files and can be used to create databases.
Two common applications
are Hand base and Jfile. Filemaker Mobile 7 allows multiple PDA to synchronize with one
central databases, which is especially useful for remote data capture of research data that is
aggregated in one central database.
Web browsers are another popular application for PDAs. This application may function as offline HTML document readers.

Clinical Applications by Functional Categories

There are applications that support clinical care (e.g., medications, treatment, documentations,
clinical decision- making), administrative functions (e.g., reporting), research, (e.g., data
collecting), and education (e.g., presentation).
Available healthcare applications range from simple reference material, to interactive tracking
databases, and to highly sophisticated decision support systems.
Clinicians utilize their PDAs to support their workflow by having ready access to relevant
information at the point of care.

Clinical Applications by Category

Categories of clinical references include journals, general specialty references, pharmacologic
references, medical calculators, and decision support tools for treatment and/or clinical
consultation.
PDA clinical references include applications that scan journals for specified topics, general and
specialty practice electronic resources, pharmacology resources, medical calculators, and
clinical decision-making applications.

Pharmacologic databases are probably the most frequently used PDA application. All
applications contain drug information for prescription drugs and some are bundled with
additional application that supports clinical decision-making.
Epocrates Rx is the most frequently used comprehensive pharmacology database. It is
available as both a free application and a commercial expanded product.
MobileMicromedex is available by subscription and many health sciences libraries hold a
subscription so their authorized library users may access this application for free.
Lexi-Complete is a subscription that offers access to 15 databases related to drugs and clinical
consultation.

Medical calculator are available to assist providers who use standard formulas for calculation of
body mass index (BMI), creatinine clearance, and so forth.
Several drug database programs to aid in the selection of antibiotics are available and function
as clinical decision support tools.
The Johns Hopkins Antibiotic Guide is marketed as a decision support tool, designed to bring
clinicians information about the diagnosis and treatment of infectious diseases at the point of
care.
Infectious Diseases Notes is also a combination drug database and clinical decision support
tool.

PDAs can be optimized for clinical practice through the utilization of applications designed to
support healthcare providers by providing ready access to journals and electronic resources,
pharmacology databases, medical calculators and clinical decision support tools. Bringing this
to the point of care should improve patient outcomes.
Patient tracking software is a handheld patient management tool that allows the provider to
track a variety of patient information.
Billing and coding applications are designed to document charges for patient visits, procedures,
and medical diagnoses.

HIPAA Implications
The HIPAA administrative simplification provisions include electronics and code sets, security,
unique identifiers, and privacy. If a computer has individuality identifiable health information or
protected health information stored on it, the person who maintains or transmits that information
is responsible for reasonable safeguards.

Asynchronous Communication and a PDA

A reasonable level of security for a PDA with individuality identifiable health information is to
have the device protected by having to enter an ID and password in order to use it.

Synchronous Communication and Wireless Devices

All the considerations for asynchronous communication remain, but in addition, when a device is
wireless enabled, the individuality identifiable health information that is transmitted must be
protected during the process of transmission as well as when it resides on a PDA or the
receiving machine. This is typically done through encryption. The data exchanged is encrypted
when it leaves and is decrypted when it arrives at its destination.
Encryption and decryption take time, so system performance will be slower than if the data were
not encrypted.

Evaluation of Clinical Application

A systematic approach to evaluating clinical applications starts with an understanding of the
goal of the nurse selecting and using that software. The software selected must be compatible
with the operating system of the PDA. Factors to consider include the amount of time and level
of effort required to install and successfully run the application.