Health in the Palm of Your Hand
By Jeff Goldman, Mon Apr 09 00:00:00 GMT 2001

Bringing wireless access to the healthcare industry will be a gradual process, but an influential one: a physician?s workload will never be the same.


You're just finishing your annual checkup: aside from a few persistent allergies, everything's fine. But then you notice something odd. While you’re getting dressed, your doctor's sitting in the corner of the room, tapping away at what looks like a Game Boy.

Don't worry: he isn't playing Donkey Kong. He's got much more interesting things to do.

Using a handheld device, your physician can write your prescription for allergy medication, research alternate drug options, record some quick notes on the visit, enter the charges into your account, and look up the records on his next patient. When he's done with that, he might be able to get in a quick game of Tetris.

A recent study by WR Hambrecht & Co predicted that 20% of U.S. physicians will be using handheld devices for transactions by 2004. In the years that follow, analyst Josh Fisher suggests, the growth will continue. "Wireless handheld devices, which fit seamlessly into a physician's workflow, will sweep through the medical profession like they did in the business world," he said.

Doctor on call


The Illinois-based AllScripts Healthcare Solutions is one of many companies offering wireless solutions to organize the medical professional. Its TouchWorks suite of applications has the capacity to put virtually every aspect of a doctor's workload onto a PDA. Most importantly, it allows for a significant decrease in the amount of paper doctors have to deal with, which should result in a decrease in errors.

TouchWorks solutions include Prescribe, which allows a doctor to write prescriptions on a PDA and send them wirelessly to a pharmacy; Dictate, which turns a PDA into a handheld digital recorder; Charge, which facilitates all aspects of patient billing at the point of service; and Pocket Library, which provides an onsite reference tool that includes a complete drug guide.

AllScripts recently announced partnerships with both Microsoft and Compaq to offer its services for the Pocket PC, focusing on the Compaq iPAQ. Doug Gentile, AllScripts' Vice President of Business Development for Channel Health, explains that because of the limitations of Palm devices and WAP phones, the company isn't currently offering solutions for those platforms.

"Physicians want to be able to capture charges, write their prescriptions, surf the web, and do electronic dictation, all on the same handheld device," he said. "Right now, the Pocket PC platform is the only one that supports that: particularly the digital voice capture. But as other platforms and devices support that sort of critical functionality, then will we support them? Sure."

Many other providers in the same market, though, are focused on the Palm OS, most notably the California-based ePocrates. The company's Palm-based solutions include the qRx drug reference guide and the qID infectious disease reference guide. In February, ePocrates announced a partnership with AdvancePCS to offer a wireless prescribing application.

Other wireless solutions for the Palm include eMD, which also offers wireless prescribing; and ePhysician, which provides a complete wireless suite from electronic prescribing to charge capture. iScribe offers wireless prescribing for both Pocket PC and Palm OS. The Baltimore-based MDAnywhere can even provide limited access to medical records using a WAP phone. Revenue models vary, but most companies charge monthly subscription fees for their services.

A digital hospital


The future of wireless healthcare, though, goes far beyond the simple convenience of allowing doctors to upload a prescription from the examining room. Just a couple of weeks ago, Oracle announced an agreement with the American hospital operator HealthSouth to build the world's first fully automated digital hospital, to be constructed in Birmingham, Alabama by the end of 2003.

The 219-bed hospital is expected to cost just over $200 million - and wireless connectivity is key to the plan. Anticipated features include computer systems at every bed with broadband access, digital imaging instead of X-ray film, and a hospital-wide secure wireless network which will allow personnel to use PDAs to update and access patient records while on the move throughout the hospital.

The potential is impressive. A family doctor who's at home when you're rushed to the emergency room could monitor immediate test results on his PDA, and give initial orders before he heads over to the hospital. In the hospital itself, drugs could be scanned into each bedside system before they're administered to the patient, virtually eliminating the medication errors that kill thousands of people each year in the United States alone.

No peeking


Whether in a doctor's office or a hospital, security immediately becomes a huge concern as patient records and other sensitive information start flowing from PDA to server and back again. When you're dealing with highly personal information like medical data, it's easy for the average consumer to get concerned about any system's vulnerabilities.

One of the leaders in the field of security for mobile health applications is the California-based Certicom. In September of last year, Certicom announced an agreement with ePocrates to enable secure wireless prescriptions using its MobileTrust certificates; a similar agreement with ePhysician followed in January.

In the US, the Health Insurance Portability and Accountability Act (HIPAA) has laid out requirements for the privacy of medical records online, but it's under attack in the political system. Andrew C. Herlands, Certicom's Director of Business Development for Healthcare Industries, claims the company isn't too concerned about the specifics of any regulation.

"We've all been watching the political maneuvering going on," he said. "There's some question now as to whether HIPAA will even survive in the form that it's been proposed at all. So we've always taken a best-practices approach, which works regardless of the country and regardless of the set of regulations."

Herlands adds that any discrepancies in technology between the U.S. and the rest of the world are counterbalanced by American business interests. "I think the U.S. is catching up," he said. "Many countries have socialized medicine in Europe, and so it's a much different control than the systems we have in the U.S., where it's more business-driven."

And to encourage the development of an industry standard for mobile health data management, Certicom recently joined with the California Medical Association, AvantGo, ePocrates, MEDePASS, Palm, IPCS Health Systems, and Tunitas Group to form the Jeff Goldman is a freelance writer covering a wide range of topics for a number of online journals. He currently writes regular articles for Internet.com's ISP-Planet. Brought up in Belgium, Jeff spent the last decade in New York, Chicago and London; he now lives in Los Angeles.