Handheld computers can save you time and increase your accuracy with clinical facts. The computer part means that you can store all sorts of clinically relevant information, and the handheld part means that you can carry the device wherever your clinical travels take you.
Clinical practice entails a lot of information management. Of course, my seniors at medical school tried their hardest to teach me the medical facts that would guide my future practice. But on the wards they also taught me other things: which local protocol to use; the phone number of other specialists for further management; and which parts of the welfare system
would affect clinical outcomes.
And doctors travel a lot. I did not fully understand this until my first few minutes as a doctor: my pager explained to me that I should be heading to another part of the hospital, and it continued to redirect me throughout the day. Such traveling was not just for the inexperienced. My seniors pointed out how much walking they had to do, and their pace put mine to shame. As I began the general practice phase of my rotation, my destinations included not only offices, examination rooms, and committee rooms in the surgery but also patients’ homes throughout the surrounding rural area.
It is difficult to escape the feeling that handheld computers were designed with clinical practice in mind. In fact, handheld computers were originally designed for corporate executives: the devices were a replacement for paper organisms as they included diary, address book, “to do” list, and note functions.
Other software, such as ePocrates Rx, can support prescribing decisions. It is a quick reference of all licensed drugs in the United States and can identify drug interactions. Liability insurance companies and governments have understood the potential of the ePocrates Rx. Med America Mutual, for example, provided clinicians with devices running the software because it believed that this would reduce clinical errors. Last year, the US government ran a three month trial with ePocrates DocAlert to provide clinicians with updates on bio terrorism.
In Britain, a handheld computer version of the BNF (the British National Formulary) has been developed by the Swedish company MedHand (fig 2). MedHand’s software also includes reference textbooks such as the “Oxford Handbook of Clinical Medicine”. American publishers such as Franklin, Lippincott Williams & Wilkins, and Skyscape have long provided clinical textbooks for a range of specialties and experience levels, and the BMJ Bookshop sells many of these.
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