Personal Digital Assistants may change the face of healthcare delivery.  Before you buy that "handheld," look at three immediate uses and one futuristic vision. Four years into the Internet revolution and accompanying technology, diehard science fiction fans can't help but wonder where the inspiration for some of these cool gizmos came from.  In a recent conversation with engineers representing multiple sectors of the economy, the general sentiment was that Captain James T. Kirk and his crew of the U.S.S Enterprise, from Star Trek has spawned the next generation of computer devices.  With one eyebrow raised, the last image anyone has of Captain James T. Kirk (William Shatner) is his clever marketing campaign with a dot com that will remain nameless. 

Never being an advocate of bad attempts and musicianship, it was difficult to accept this truth, until a colleague pointed out how digital phones are morphing into communicators with flip action.  From Atlanta to San Francisco, and places in between, you would think that you are at a Trek convention the way "movers" and "shakers" hug digital links as if Montgomery "Scotty" (James Doohan) was set to "beam them up." 

Nonetheless, a biomedical engineer at the table proposed a theory stating how the PDA/Handheld computers represent the beginning stages of Dr. McCoy's ( Jackson DeForest Kelley) tricorder (Handheld Starfleet device combining sensors, recorders and built-in computing capability. Issued in a variety of models for engineering, scientific and medical uses)- www.startrek.com. It seems that healthcare delivery is light-years away from handheld devices that provide patient diagnosis on the spot; however, current technology can definitely enhance patient care.  

Beaming blood gases

Various information technology companies are diligently creating software and services to allow healthcare providers to receive and request laboratory results in the palm of their hand. The benefits may greatly enhance clinical performance and reduce the frequency of medical errors through the delivery of time-urgent, patient-specific diagnostic information.

Clinical scenario:  A patient is brought to the emergency room complaining of chest pains; clinicians' draw blood to determine oxygen levels; the diagnostic process begins.

Wireless intervention:  Laboratory technician runs tests; results are verified through quality assurance mechanism and are instantly beamed to the physicians' handheld at the bedside of the patient.

Wide-scale integration of wireless technology in healthcare settings is still a couple of years away; yet increasingly healthcare professional are seeing the benefits that handheld devices offer.  Beyond providing clinical decision support through time-sensitive diagnostic tests, wireless technology applied to handheld devices can strengthen care continuity when patients receive care from multiple providers.
 
Linking caregivers at the hip

Collaborative therapy is becoming a benchmarked model of effective healthcare delivery in the 21st century.  Case in point, a recent Archives of Internal Medicine study demonstrated a primary care collaborative model that reduced utilization with chronically ill seniors, while maintaining health status.  Linking wireless technology and handhelds to these care models may support comprehensive care.

Clinical scenario:  During a routine well-child check-up at an outpatient pediatric clinic at a large teaching hospital, a child is found to have elevated lead levels (poisoning). The child's treatment involves a primary care nurse practitioner, social worker, and a health education nutritionist.

Wireless intervention:  The nurse practitioner meets with the social worker and health education nutritionist to establish clinical intervention to reduce the child's elevated lead levels.  The periodic laboratory results, social worker's notes, and health education nutritionist home visits encounter forms are instantly beamed to each provider on the care team for the child.

Coordinating care for complex public health issues takes meticulous planning and precise lines of communication, and wireless handheld device will become a crucial tool linking care teams.  As such, clinical discoveries and health alerts can be constantly streamed over a wireless medium to keep providers well informed of new and exciting care techniques.

Capturing medical journal bytes or bits

There is a general sentiment by healthcare professionals checking the pulse of the system that new care models and delivery te