PalmCIS: a wireless handheld application for satisfying clinician information needs

Abstract

Wireless handheld technology provides new ways to deliver and present information. As with any technology, its unique features must be taken into consideration and its applications designed accordingly. In the clinical setting, availability of needed information can be crucial during the decision-making process. Preliminary studies performed at New York Presbyterian Hospital (NYPH) determined that there are inadequate access to information and ineffective communication among clinicians (potential proximal causes of medical errors). In response to these findings, the authors have been developing extensions to their Web-based clinical information system including PalmCIS, an application that provides access to needed patient information via a wireless personal digital assistant (PDA). The focus was on achieving end-to-end security and developing a highly usable system. This report discusses the motivation behind PalmCIS, design and development of the system, and future directions.

Figure 1.

WebCIS page showing most recent laboratory results in reverse chronological order and pop-up windows showing graph for Na (sodium). Each page of WebCIS contains several frames. The top frame contains demographic information for the patient as well as links to other WebCIS functions, the left frame contains links to different department results and functions, and the central frames display the requested information.

Figure 2.

PalmCIS client–server architecture.

Figure 3.

PalmCIS sign-on page (a), SecurID hardware token (b), and alternate login pages (password and SecurID token (c) vs. password only (d)).

Figure 4.

PalmCIS strong user authentication scheme using user ID, password, browser cookie, and SecurID token.

Figure 5.

PalmCIS patient list page. Users can expand the list and select a patient or enter a patient's MRN (Medical Record Number).

Figure 6.

PalmCIS patient report. The report presents laboratory, radiology, and cardiology results for the last two days.

Figure 7.

Details for Chem7, CBC, CXR, and EKG results found in the patient report in ▶.

Figure 8.

Accessing previous or other department results via the checklist at the bottom of the PalmCIS patient report. The five most recent results will be displayed for the selected departments. More results can be obtained using the “Get previous!” button.

Figure 9.

A PubMed search for “captopril.” Relevant articles are returned and users can view abstracts and citations.

Figure 10.

PalmCIS microbiology infobuttons. PubMed is searched for articles related to organisms in the result and Micromedex returns information about antibiotics.