Digital Doctoring 116
ssajous writes "This is an interesting article in the NY times which talks about PDAs quickly finding their place in the world of medical billing and keeping track of patient's care, there is a lot of money in the medical field, but also currently a lot of unnecessary paper work. I like what I see!!!" I don't think Palm makes a tricorder card yet, but it's only a matter of time. The last time I saw a doctor, he was doing things the old-fashioned way - I would guess it will take a while before this sort of technology is widely used.
newton (Score:4)
Palms are great for patients, too (Score:1)
Palm Pilots in my local hospital (Score:2)
Security concerns aside, this is a really great idea because it allows multiple people to at least read a record (i believe they have a check-out mechanism to prevent more than one person from writing to the chart at a time).
It's a great tool for paramedics too. (Score:2)
Of course, there's the ambulance chasers, who whip out their PDAs and start taking names for litigation. However, the PDA is the number 2 favorite of the ambulance chaser; number 1 is the instantly inflating balloon for putting under women's shirts to feign the third trimester.
There won't be widespread use until.... (Score:2)
Maybe when they have good voice recognition for the Palm, then it might really look like a sexy alternative to pad and pen. But not yet.
Medical Software (Score:1)
Re:Palms are great for patients, too (Score:1)
visor in the emergency room (Score:2)
Problems w/ Digital doctoring (Score:3)
o Resistance
But I've *always* done it this way
o Portability
How do you move from patient to patient and
get data into a centralized database reliably?
o Reliability & Security
Medical data must be valid, authenticated, and
readily available. Having a system crash when
you're evaluating someone's heart condition is
unacceptable.
o Legal considerations
Doctors' notes are considered as legal
documents when looking at medical malpractice
and other legal-medical collisions. How do you
verify that the electronic format is the same
as the paper one when there *is* no paper one?
There are more, of course, but these are the big ones I ran into time and again. The bottom line is that while Hippocrates and other PDA software packages are useful, the likelihood of the medical profession accepting the widespread use of portable technology for medical data entry and retrieval is slim anytime soon.
Definitely... (Score:1)
-=-=-=-=-=-=-
The COBOL Warrior
Re:Palms are great for patients, too (Score:1)
Re:Medical Software (Score:1)
Contamination? (Score:2)
Re:newton (Score:4)
And from what I've read it sounds like the Newton was a very big hit for those who used it to track their patients. The pilot strikes me as too small to use for this purpose. I bought one a few years ago, right before they started to really catch on. I ended up ditching it and hunting down a used Newton MessagePad 2000.
For those interested in a very good article about the use of a PDA in medical settings, I highly recommend reading A Day in the Life of my Newton [risley.net].
Jim
My local dr's office recently upgraded (Score:4)
Re:Palms are great for patients, too (Score:1)
Not yet, but after our current baby is born, I may consider the vasectomy, which apparently involved a bunch of helmet tweaking.
I'll ignore the USian slant to your post which assumes I have a helmet to tweak, instead of the turtleneck that the Europian slashdotters are wont to possess.
Some docs have been doing this for a bit... (Score:1)
Handspring Attacking the Market (Score:3)
The books published by Franklin [franklin.com] for all the hand top OSs. It's just that the hot swap HandSprings allow people to carry several around.
A small piece not mentioned in a good article.
Israel (Score:1)
In my local hospital... (Score:1)
Widespread Palm Use in the Medical Industry (Score:1)
Many doctors and nurses are beginning to use Palms and specialized software to handle patient information, take notes, and do quick research on different medicines (there is a pharmaceutical references Visor module). What's more, I've seen a lot of use of the wireless Palms as well.
For the most part, this is great. However, my biggest concern is the base infrastructure - these PDA's tend to interface with grossly outdated software.
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Re:Palms are great for patients, too (Score:1)
The vast majority of PDAs don't have transmitters. Cel phones do, and can (theoretically) interfere with the nifty cool wireless EKGs heart patients are wearing while hospitalized.
My PDA is no more harmful to medical machinery than the CD player in the nurse's lounge.
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It's a Palm III (Score:1)
The reason why.. (Score:1)
Yes it would be nice to have things and organizers like these in HMO's and other places but not in a hospital. I'm sure you wouldn't like it if you knew that a loved one died because some person had to know when his/her next meeting was going to be.
My friend users hers all the time (Score:3)
My friend is a doctor in large hospital in NYC, and she uses her Palm all the time. It has replaced a least a half dozen heavy manuals she used to keep in her pockets. Many companies now sell e-text versions of their reference works. She got it to reduce the number of reference works she had to use, but I think it is better in that it facilitates better searching and indexing. She is young, and young doctors liker her use them all the time, it is the older ones in power that are technologically resistant.
I think that it is unfortunate the medical field has been so slow to adopt technology like this. If anyone knows the history of MYCIN, it is amazing to me that the medical field has ignored such powerful diagonostic tools. In the end I think it is the public that suffers.
Mandatory no-reg link (Score:1)
Personally, I don't see why
Cool Things (Score:2)
Pharm companies giving Visor/Palm to MDs (Score:1)
My doc wasnt too keen on taking it, since he already has one and doesnt use it a whole lot (office, billing, schedule not tied in, etc.) But since its free he might just take one for each of the MDs in his group.
The PDR on springboard looks pretty interesting!
Truth to be found (Score:2)
Anyway, he was one of the first people in Lewiston to buy a PDA, and he's still got one now (Handspring 8MB model). He carries it everywhere with him, keeps all of his stuff in it, and uses it for everything. And oddly enough, this has become typical in that hospital. If there's a market to be had for PDAs, it's probably indeed with anyone who collects data - and doctors fit snugly into that category.
CAP THAT KARMA!
Moderators: -1, nested, oldest first!
Re:Palm Pilots in my local hospital (Score:1)
What will come first? (Score:1)
What do you think we will see in our lifetime, and which will be more difficult to code for:
1. Reliable, 99.99% rock-solid voice recognition? 2. Artificial Intelligence 3. Slashdot being bought by Microsoft 4. Larry Ellison, Bill Gates and Richard Stallman joining a wife-swapping group. 5. Handwriting recognician software that can actually read a doctor's handwriting? (Have any of you actually seen a readable prescription in your life?)
My vote goes to the first four as most likely.
great PDA, iffy platform (Score:2)
But as a software platform, I think they are not all that good. They have megabytes of memory now, but they suffer from 64k limits somewhat analogous to what DOS used to impose on programs. And while PalmOS is conducive to letting experienced PalmOS programmers write tight, simple applications in C, for many custom applications, you want something like Java, Smalltalk, or even VisualBasic.
Palm has made steps to offer Java and to upgrade the processor and OS. Let's hope those will happen soon.
On The Next "E/R"... (Score:1)
Triocorders (Score:1)
My sis uses her Visor for some real med progs, too. Drug interaction lists are a lot easier to carry on PDA than the binders (constant updates) it otherwise requires.
Palm brings serious benefits to Patient side too.. (Score:4)
People diagnosed with Type II diabetes often have to test their blood seven (7!) times a day (or more!) in the first few years, and record the results, time/date, and diet info for their doctors. Manually, this can be a pain in the ass, especially when full records for 2 months need to be given to a doctor.
Right after being diagnosed, my wife found out about Glucopilot (see http://www.healthetech.com/), an award-winning program for the palm OS, which prompted her to buy a Palm V and a hard case. It does a wonderful job of recording, handling, and outputting & graphing the data. With the purchase of a small cable (made one myself, ha!) it can read the output of some blood sugar testers directly and eliminate the manual entry of numbers all together.
Her doctors, both of whom where unfamiliar with the program, were astounded by it and the detailed data it provided when she show it to them, and they began mentioning it to their other patients.
It's not just the Glucopilot software though, My wife found several other programs for the Palm that she uses to track diet, and other medical info like details on her menstral cycle, sudden sickenesses, and anything else.
Where this really makes the impact is on the day-to-day lifestyle front. She has a tiny case that she carries with her eveywhere she goes because it is so compact and totable. It holds her Palm V, and her blood testing gear. Because the form factor is so friendly, and the software provides such immediate feedback on blood-level trends, etc, she has displayed incredible dicipline in taking readings and entering data as it occurs. And that dicipline has seriously impressed me and her doctors, and is probably why they are saying she will be able to control the condition without needing insulin shots, etc.
The palm has been great for collecting all my loose data in one place, and I see specialized, easy-to-use medical tracking and info software as providing great benefit to people who have problems that are ongoing and have to shared with their doctors.
Re:It's a great tool for paramedics too. (Score:2)
Whole sites devoted to medical palm pilots (Score:3)
The Healthy Palm [hypermart.net]
and others... [angelfire.com]
Thing is, though, I'm not sure I'd trust, for example, a pregnancy-safe drug list I just got off some guy's home page...
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Re:newton (Score:1)
medical students & palms (Score:1)
Re:Palm brings serious benefits to Patient side to (Score:2)
Palms at Work (Score:1)
g
Re:great PDA, iffy platform (Score:1)
...but the doctors are stubborn... (Score:2)
Re:Contamination? (Score:1)
Clinic uses laptops with wireless networking (Score:1)
I assume they use laptops so that they can more easily be swapped out for maintenance, repairs, etc. And the wireless LAN simplifies a lot of networking issues, I'm sure.
Re:newton (Score:1)
M100 Upgrade. (Score:2)
After I got my m100, I was lookign at memory upgrades. One of the sites I found is by an MD.
802.11b standard? (Score:2)
For that matter, are there any PDAs that work with the current 802.11b standard for PC base stations?
Re:The reason why.. (Score:1)
AFAIK, pagers are allowed without restrictions in a hospital. Every doctor I've ever met has been wearing one, regardless of where they are. Maybe someone with more knowledge of how pager signals work can explain why they are better than cell phones (maybe much less signal power??).
Also, palm pilots are allowed just about anywhere as well. They don't give off any (or much) RF power, and there is little chance of a palm pilot causing "equipment malfunctions while performing operations."
LL
Re:Whole sites devoted to medical palm pilots (Score:2)
--
Re:My local dr's office recently upgraded (Score:1)
It happens when the Kernel crashes, and (surprise, surprise, to all the zealots) it actually has useful post-mortem data on it about why the machine crashed.
So there by definition was no 'Blue Screen of Death' in 1988 at a computer convention. There may have been a system crash that resulted in a frozen screen display of some kind, and it may have even had a blue background. But it definitely was NOT a BSOD. Windows NT didn't exist in 1988.
Re:Pharm companies giving Visor/Palm to MDs (Score:2)
Oh, yes. It's scary the way drug companies court doctors and hospitals. (Even veternarians, too, to a lesser extent.) For example, for one new allergy drug the makers sponsored a seminar: "the invitation included round-trip airfare to California, accommodations at a luxury hotel, and a participation fee of $1,000..." [lycos.com]
My doctor just got a Visor (I think); it wasn't a pharm. company comp, she bought it herself. She's like a kid with a new toy; got a bunch of medical references on it, including the PDR. (That's the Physicians Desk Reference [pdr.net], a honking big book that lists every drug on the market, its actions and contraindications. Worth consulting whenever you are prescribed a new medication.)Tom Swiss | the infamous tms | http://www.infamous.net/
Re:The reason why.. (Score:1)
The devices which are restricted in the hospital are cell phones and other devices which emit a lot of RF. Further, there are probably some hospitals where patient/public-carried electronic gadgets in general are discouraged if they might be a distraction to the patients/staff.
Hospitals Are Slow To Modernize (Score:1)
You might think this is stupid, but there is a reason why they use old technology: it's tried and true. When your rinky-dink website crashes because of a minor bug in the software, that's annoying. When the ICU-1 server crashes, patients die - no joke. We had to operate at < 1 min. unscheduled downtime per month, or we were replaced.
So the palm thing is cool, but don't expect doctors carrying around PDAs to diagnose for quite some time - at least, not in any official policy. On the other hand, my dad is a doctor, and he now has a drug database on his palm, as well as a diagnosis kit, and he loves them both ;)
Re:Problems w/ Digital doctoring (Score:1)
The "portability" factor could be solved by having either an encrypted wireless ethernet connection for the PDA's or maybe an infrared port in each room. The encrypted wireless ethernet would be the most secure.
"reliability & security" - I think that there'd be a heart-monitoring machine in the room with the patient if their heart needed monitoring. Besides, I think we're only talking about hospital records here - not patient monitoring. For reliability I'd imagine that they'd have some sort of failover and clustering server with a large RAID storage system. Security would only be as strong as the designers create it.
And if "Legal Considerations" are taken into account - I would imagine that there would be some sort of "on the fly" encryption that each Doctor's PDA would have that would put a unique digital signature onto each doctor's report.
Re:Contamination? (Score:1)
It's an interesting question, I think. Consider how they wrap or otherwise sterilize everything that comes into contact with you (tounge depressors, ear lookers, etc). Everything in the doctors office either get's thrown away after it's used, or get's sterilized. What happens if a doctor washes his hands, opens up his Palm to look something up, then touches something that get's put inside you. Has he just run an infection risk?
I honestly don't know, but considering how careful they are with everything else, I'd say it's an issue.
Re:There won't be widespread use until.... (Score:1)
Palms in hospitals have been used for years.. (Score:1)
The next phase of the project was to allow the doctors to access patient records via the palm. This of course would require a 'key' in the palm that would allow only that unique palm on top of authentication to the server to have access. It would then be tested with a fake patient database and evaluated. It would then go in front of a board to determine the security and applicability of the process and whether a 'live' test group be started.
At that time (1999) many doctors were very apprehensive about using this, I hope things have changed by now..
Must meed several needs first (Score:1)
Second. Easy to use. Doctors have the worst handwriting on the planet. either they are just plain lazy or have no handwriting skills, but it is universal... doctors can't write. so you expect them to use hand writing recognition system like on the palm?? not likely. Until the doctors are forced to write legibly (as in prescriptions too!) they will not comply.
Third.. Price. Doctors are usually cheap. They will not pay $500.00 per wireless palm and $900.00 for the wireless portal and then $20,000.00 for the software. they will stick with the antique foxbase based dos-text medical system on netware 3.x forever. Why? because what is available out there sucks (ALL medical practice software is a messy joke that can barely be called software. and the Windows based stuff is a collection of bugs at best) and is insanely overpriced.. ($3500.00 per workstation license fees for a program that fits on a floppy and was written in the 80's? bite me buddy!)
The medical field is plagued with many problems.. the first is crappy systems and software that scare the doctors. if we get rid of the crap and start charging sane prices.... maybe the doctors will start looking at it.
Re:Contamination? (Score:1)
Palm Pilots to aid scheduling (Score:1)
ER Doctors (Score:1)
If you add on wireless connectivity and a durable piece of hardware (ie, spillproof, drop-proff), PDA's in ER's would work really well for everyone (no more paper charts till they leave!)
-MR
Re:There won't be widespread use until.... (Score:2)
We have found the following to be true: (Score:3)
o Reliability & Security - NEVER USE MICROSOFT!!! Use AS/400 if you want absolute reliability, or Unix if you want high reliability with ease/cheapness of coding/updating.
o Legal considerations - there are many ways to sign/legally encode a file...discussed elsewhere.
This only leaves the "We've always done it this way" brigade - work on them:)
Frog51
Re:M100 Upgrade. (Score:2)
_____________
Nonsense - read this instead: (Score:2)
Although I have seen a Vodafone antenna siuated on the top of the Royal Infirmary in Edinburgh!!?!
Frog51
Re:Contamination? (Score:1)
Improvement in Quality of Care (Score:1)
Consistent use of handheld computers could very easily improve the care that patients recieve across many settings. For example, the Doc checks off Diabetic and gets a list of recommendations like running certain tests, foot exams, and setting up outside education and consultation, which could also be suggested contingent on certain criteria.
Personally, I'd feel much better if my Doc relied on a standard reference in treating me. Doctors are not all super-intelligent and many have lots of trouble remembering important information, particularly for less common ailments.
Re:Contamination? (Score:1)
Before the pilot there was the Newton (Score:1)
All in all is good to see the technology and uses getting some public recognition.
Real potential lies with Decion Making (Score:1)
It's important, I think, to talk about the real potential, and the real danger, of this kind of automation...
Automating the delivery of recommendations from medical Guidelines improves the quality of care because physicians are often too busy to consult lenthy, complicated print guidelines. Having them in electronic format alone isn't much help -- these systems have to pull patient characterists from existing medical record systems and offer recommendations based on those variables. In other words, they have to be able to step through a series of logical statements and offer an evaluation to the physician. This will, in the long run, greatly improve patient care, because decisions will more often be based on empirical evidence rather than on convention or tradition.
The danger is NOT that physicians will blindly follow recommendations (any good system should offer a natural language explanation of how it arrived at a recommendation, which the physician can then accept or reject), but that HMOs and insurance companies will tweak these systems so that the underlying algorithms favor reduced cost rather than highest patient quality of life.
Unfortunately, physicians are no more or less computer literature than any other professional group (which is to say, not very), and so we, as developers, have an ethical obligation to articulate very clearly how these systems function, both to the clinicians who use it, and to the public.
Having said this, I would much rather have my physician pull out his handspring and look at survival curves for various drug treatments than to have him give me 'drug x' because that's simply what they 'do' for my condition!
Re:It's a great tool for paramedics too. (Score:1)
Add to that the fact that any WinCE device crashes on execution of any program (provided and downloaded alike), and you have a troublesome PDA.
Re:Palm Pilots in my local hospital (Score:2)
PDAs still have a ways to go in regards to managing patient data. Currently, it takes too long to access each patient's information and make the necessary changes to be worthwhile. However, the PDAs have great drug databases(epocrates), physiology calculators(MediCalc) and pregnancy calculators(Pregcalc). Also, when checking out patients to the person on call, you can beam your patient list to their PDA. It would be interesting to see the software that querist mentions in the above post.
scary passage in the article (Score:1)
Just what I need when I'm hemorraging--my quack checking his RHAT shares...
Re:Problems w/ Digital doctoring (Score:1)
Re:newton (Score:1)
Re:Contamination? (Score:1)
Yes, everything that comes into contact with the patient. The PDA will not come into contact with the patient. In cases where a transducer connected to the device comes into contact, it will be disposable or sterilizable.
Nothing new, no new issues at all.
Voice Recognition and Healthcare (Score:1)
See this link for healthcare product info at L&H [lhsl.com].
See this link for L&H's press announcement about L&H's Linux PDA [lhsl.com].
See these slashdot stories about L&H's Linux PDA:
http://slashdot.org/article.pl?sid=00/03/31/14322
http://slashdot.org/article.pl?sid=00/02/05/09282
http://slashdot.org/article.pl?sid=99/11/10/18592
this tech is definitely being accepted. (Score:1)
Re:Contamination? (Score:1)
No they don't. A protective jacket would not do any good because the jacket would then be gathering germs and transfering them from one patient to the next instead of the PDAs case. Yes you could have disposable jackets made, but these would have to be custom made and because of this, (and the fact that it is for medical equipment) it would become extremely expensive.
Earlier this year we purchased a number of portable computers to be used by the nurses to reduce the amount of paper that the nurses had to transport between patient rooms and nursing stations. During this the same issue arose.
Electronic medical equipment must be cleaned after each patient. If you see medical equipment in a hospital that is grimy or looks like it may have been used before, you have the right to refuse the use of that equipment or you can report it to the hospitals Infection Control Officer or your State Board of Health.
Also all AC powered medical equipment should be checked by the facilities Biomedical dept before being placed into service.
Doctors, nurses, and other hospital personel may carry pagers and cell phones, but these should be checked with the hospitals Biomedical dept. to ensure that they do not interfere with other hospital equipment such as telemetry systems. These may be worn into patient care areas as long as the patient is not in isolation, in which case no equipment is to be brought into or removed from the room unless it is under controlled conditions by authorized personel.
Also a doctor should not be handling any unsterilized equipment while in gloves, this includes personal electronic equipment like PDAs. This prevents the spread of infection from the patient to the equipment and therefor on to the next patient.
Most doctors I am acquainted with make this a strict practice in order to not bring infections/ illnesses home to their family or themselves. I know of some doctors do not do this, I also know that none of these doctor will ever practice medicine on myself if I can help it.
signature (Score:1)
yes. bad doctor joke...
Tricorder (Score:1)
The tricorder for Palms is here [jeffjetton.com].
Can't live without it. How else would I know if the people I meet are terrestrial or not?
Lab results in digital format (Score:1)
This Doc, and I assume most others who work out of hospitals, has access to a text-based computer system that, among other things, allow him to check on lab results remotely.
He and I were discussing the fact that, while entering in data at the patients bedside is fairly easy, going back and entering lab results as they come in is a major drag.
Does anybody know anything about the computer capabilities at these medical labs and wether or not there is any history of these people allowing third party software vendors to access this information in a standard format like XML or text files? It seems to me that in order for desktop and Palm-based medical applications to be really useful, there needs to be some way for the application to dial into the lab and query the server for the latest lab results.
Of course, the security ramifications boggle the mind.
Moderation Flamebait?? You are joking! (Score:1)
Basically the Windows operating system is just not as solid as Unix, and Unix is not as solid as OS/400.
OS/400 can run non-stop, even during upgrades of hardware and software.
Some Unixes can give you 99.99999% uptime
Top documented MS cluster gave 99.2% uptime
This may sound like a very small difference, but when 20 minutes downtime can cost upwards of £4 million, it just makes sense to use a mature OS.
Flamebait - I think not:)
Frog51
Security, Portability, Cost and Software (Score:1)
Re:802.11b standard? (Score:1)
I have a Comapq [compaq.com] iPaq that works great with either wired or wireless NICs (PC Card type II). I'm going to be using it with the Ricochet PC Card as soon as they hit the market.
This could be a baaaad thing (Score:2)
My husband and I were in the ante-something area at the hospital (the pre-delivery room), and the staff OB had just confirmed that I was really in labor. My husband whips out his Palm to get our OB's home phone number, and the next thing I know, here's the doc pulling his slightly-different-model out and they're doing compare-and-contrast.
Now, while I like techtoys as much as the next geek, at that particular point (contractions every two minutes) I felt it was more important to yell "HEY, CAN I GET SOME DRUGS HERE?"
Palms are the future (Score:1)
Anyways, I think the fact we (doctor-types) get labeled as "always want to do it the old way" is a sign of intelligence. Systems for med info can't tolerate the kind of crap you have to put up with your standard freshmeat development cycles(ie. paper and handwriting may suck, but it works). However, I think once you have an exmaple of a breakthrough and useful and reliable UI, like epocrates and some others, there pretty much >80% incorporation across the resident housestaff at the big hospitals.
Don't forget the network effect when it comes to patient tracking software because of the Palm-to-Palm beaming. Once some programmer-doodz figure out a quick checkbox way to initiate patient records, you'll get widespread acceptance. It really is only the patient record setup time that is the bottleneck now, as I see it. I would kill to have an accurate Palm-based patient census. We're carrying ~10-50 patients per, and right now it's the lowest level team member's (ie. intern) job to type an MS Word file EVERY 3AM with all the updated info.
Re:Voice Recognition and Healthcare (Score:1)
Re:The reason why.. (Score:1)
The usual IANAD, etc.
Big Benefit: Patient Confidence (Score:1)
I've heard from more than one doctor who prefers electronic texts on a handheld not only because it makes access easier, but because of how it makes the patient feel.
Even the best doctors need reference works. But patients expect doctors to be omniscient, or near it. They get anxious when they see a doctor consulting a book before making a diagnosis. A doctor who nods thoughtfully and gazes at the screen of a Visor, on the other hand, seems like a tech-savvy, all-knowing genius.
Two things (Score:1)
1) Most hospitals DON'T have a lot of money to spend on these things. (Despite what you may think when you get a bill.) If you don't believe me, just ask your next ER doctor about the latest cost cutting measures -- or if you want to hear a more realistic answer ask a NURSE about the latest cost cutting.
2) While PDA's may not be cutting edge technology, 95 percent of hospitals are on the trailing end of the technology curve. (Many of our client are still mainframe or DOS based!) Don't expect this to catch on like is implied above.
-Derek
We use them (Score:1)
Like the rest of the planet we are looking into wireless networking. The UK National Health Service hopes to sort out an electronic patient record for everyone.
Maybe we will see that paperless office one day?
Privacy, security, and HIPAA (Score:1)
handheld device (or anywhere on a computer system, for that matter).
Generally speaking, security and patient privacy are the reasons why
hospitals and clinics are reluctant to put many types of patient information
online (particulary chart information). If a hacker gets your credit card
number, you generally are not out much (if anything), and you can replace
the number easily. If a hacker gets your medical information (or, more
likely, if some employee at the hospital or clinic decides to look up your
info during the employee's coffee break), it can be well nigh impossible to
undo the damage there. Plus, as mentioned in the article, HIPAA (Health
Insurance Portability and Accountability Act) will require healthcare
providers to take much better care of their confidential patient data (or
face stiff penalties).
This is not to say that paper records are that secure. In fact, it is
probably the case that electronic records can be much more tightly
controlled than paper ones. It's really analogous to airplanes and their
safety. The airlines may have fewer accidents and fatalities per mile
travelled and per passenger, but the accidents that do happen are real
doozies.
Re:Cool Things (Score:1)
Yeah, it was early in the morning, and much of it isnt clear in retrospect, but hell, at least I have the balls to take credit for my words, inane or not.
Re:Must meed several needs first (Score:2)
I thought the Newton had a lot of potential and even hacked up a few things in Newton script to help with rounds, but the thing was too slow until the 2000 came along. A doc acquaintence started a successful software company with it though.
I guess we're cheap if you're talking about charging me $20,000 for software that I can put together for free with existing GNU/open source/free tools such as Linux/BSD/Apache/gcc/perl/interbase/postgres.... Free software is a great idea for medical applications that will catch on. You're right about the antique software that's still used by a lot of hospitals and clinics.
Re:Real potential lies with Decion Making (Score:2)
Experience and intuition (together with a basic medical fund of knowledge) are still much more effective in diagnosis and treatment than automated systems. There are so many important visual and nonverbal clues that come into play - and this is where "automated decision making" falls flat. This kind of problem requires serious AI that is nowhere near fruition. Perhaps one day we will have a medical "Deep Blue", but not any time soon. The heuristics are much more complicated in medicine than in chess.
The real potential lies not in aids to decision making. After all, it is only the rare & unusual case that forces a trained doc to hit the journals & books anyway. But there is big potential in saving time, since docs are incredibly busy and time pressured. Palms are very helpful in this respect.
The other areas where software and computers are going to be helpful is in pattern recognizion. Reading EKG's is commonplace (though still pretty bad). Automated reading of EEGs, XRAYs, and pathology slides will be common soon enough. Docs are also very interested in robots since they are potentially more precise and do not fatigue during surgery.
But I must agree wholeheartedly with you about the darker side of your type of software - it will be used as a tool for insurance companies to cut as many corners as possible and exert more control over medical decisions for their shareholders under the pretense of the computer software "knowing what's best for the patient". Like it or not, the vast majority of important advances in medicine are not based on quantitative scientific studies, but are instead the result of a experience-based darwinian process resulting from reasonable practice variability. Once the insurance companies (armed with your software) impose widespread mediocre (but cost effective) "practice guidelines", then I fear that medical progress will be slowed and medicine will lose its heart and soul.
Re:newton (Score:2)
Re:newton (Score:2)
2) I'd actually dispute that, having used it for some time. I found it reasonably inaccurate and very slow. The WinCE system seemed better in a short play but I now can't see myself leaving the world of keyboards and my Psion 5. As accurate as any keyboard and nearly as fast as a normal keyboard. Lots less inconvenient than it looks, too.
I'd rather have something supported too, but there are better supported products. The PalmOS really isn't the be all and end all of handheld computing - in fact, I'd say it's a pretty bad solution.
Re:newton (Score:2)
2) Surely a significant part of the problem though is trying to scrawl them down in a hurry? Whereas graffiti, if it's to achieve usable accuracy, really needs you to be slow and precise...
3) Gladly, but it seems daft to deliberately pick such a poor choice.