Effectiveness of hand held computers

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With the rapid adoption of smart phones and tablets, healthcare professionals have instant access to useful information at the point of care. While it seems likely that this is beneficial to patient care, there is a need to identify where handheld computers have been effective in clinical practice. This information is particularly useful for healthcare managers, educators and innovators as they design and recommend future use of mobile technology. This is a challenging area for research, as the technology is improving faster than the usual turnaround time for designing and conducting research.

Therefore, we designed a scoping review of systematic reviews to provide a quick overview of the published evidence of effectiveness for healthcare professionals using handheld computers in their clinical work. From five systematic reviews, where physicians, pharmacists, or medical students used personal digital assistants, we concluded that handheld computers were useful across four distinct functions;

  1. improved patient documentation through more complete and efficient recording, with fewer documentation errors
  2. easy access to clinical decision support systems and patient management systems, which improved clinical decision making
  3. early access to new information
  4. more efficient work patterns.

While this is a snapshot of effective use by health care professionals, there is a need to understand more details.

Therefore, a deeper systematic review of randomized trials has been completed to focus on investigating the way clinicians use information to make clinical decisions. This review has summarised recent research evidence and suggests that healthcare professionals’ use of handheld computers may improve their information seeking, adherence to guidelines and clinical decision making.

When healthcare professionals used handheld computers to access clinical information, their knowledge improved significantly more than peers who used paper resources.

When clinical guideline recommendations were presented on handheld computers, clinicians made significantly safer prescribing decisions and adhered more closely to recommendations than peers using paper resources.

When clinical decision making tools were accessed on handheld computers together with individual patient clinical data, healthcare professionals made significantly more appropriate diagnostic decisions compared to colleagues who did not have access to these tools. For these clinical decisions, the numbers need to test/screen were all less than 11.

With the rapid adoption of smart phones and tablets, healthcare professionals have instant access to useful information at the point of care. While it seems likely that this is beneficial to patient care, there is a need to identify where handheld computers have been effective in clinical practice. This information is particularly useful for healthcare managers, educators and innovators as they design and recommend future use of mobile technology. This is a challenging area for research, as the technology is improving faster than the usual turnaround time for designing and conducting research.

Impact
Through their provision of real time access to and analysis of clinical information, handheld computers offer promise as a tool to link synthesised research evidence with individualised patient care. When electronic health records can be safely used together with clinical decision support systems in hand held computers, clinicians will have access to the highest level of synthesised evidence at the point of care.

The future impact of this work will need to be tested in feasibility and pragmatic trials. Current dissemination includes an oral presentation in the Innovation section of the Medicine 2.0 World congress on social media, mobile apps and internet in London 2013;  and poster presentations at Evidence Live 2013 and at the 9th Annual Scientific Meeting of the UK Society for Behavioural Medicine in Oxford, 2013.

Publications

Associated media
Sharing knowledge using smartphones? Blogpost