The Handheld Revolution

The Handheld Revolution
Few Answers Given to Protecting Patients from Technological Fomites

By Kelli M. Donley

Officials from Palm, Inc., and McKesson Corporation have partnered to provide healthcare workers (HCWs) with handheld computers to improve patient care.

While physicians have said having a vast array of patient information instantaneously at their fingertips is beneficial, few will discuss the possibilities of pathogens being transferred via personal digital assistants (PDAs).

Daniel Diamond, MD, who works in a multispeciality practice in Silverdale, Wash., says he's used a handheld Palm computer for more than three years. He says he doesn't wipe it down and he doesn't think infection control concerning such devices is necessary.

"I'm not worried about it a bit," he says.

Instead, he says, the devices provide a needed relief from wasting time with paperwork.

"It is nice to have information available at the point of service while I am doing an examination," he says. "I don't have to carry in a wheelbarrow of books."

While officials at Palm, Inc., were hesitant to speak on the record about the company's official policy concerning preventing pathogen transmission via their device, one engineer says an alcohol wipe could be used to clean the instrument. However, the Palm employee also says that they do not recommend a moistened cloth be used on the instrument because it may discolor the outer housing of the handheld unit.

The Palm/McKesson partnership was announced June 11. McKesson is a leading provider of information technology. The partnership's first joint effort outfitted 50 physicians and residents at Humility of Mary Health Partners in Youngstown, Ohio.

Clair Jaberg, director of physician services at the facility, says he too does not know how to prevent infectious matter from being transferred from patients to the handheld and vice versa.

"I am not aware that we've done anything in that regard," he says.

However, Jaberg also noted that the partnership and technology is giving physicians more time with patients and less time overwhelmed with charts and research.

"With this technology, we can give them (HCWs) better information in a more timely way," he says. "One of the main clinical decision making tools is laboratory data, X-ray data, transcribed operative reports, history of a physical, etc. ... That is all provided on a mainframe through the McKesson system. We can download that information so that a resident or a physician can lay his Palm down and get it synced before he makes patient rounds and have the latest clinical data on the tests that were ordered. They do not have to go to a printer and print it off, or look it up before they go and try to remember it all."

Bruce Kantelis, vice president of mobile computing for McKesson Information Solutions, says this is the first agreement linking the company with a hardware provider for the healthcare industry.

"We are developing global products that run on PDAs at McKesson and rolling them out to our hospital customers," he says. "We've released products on other platforms as well and I expect you will see other agreements with other manufacturers. Palm was the first at is an important partner to us."

Kantelis says McKesson, a $44 billion-plus dollar-a-year company, has looked into expanding their information technology into infection control.

"We are starting to get requests for these mobile applications in the infection control arena," he says. "We have infection control practitioners in hospitals using these portable devices to get patient data as they make their rounds as well."

Pat Tydell, RN, MSN, MPH, a risk manager at the North Chicago VA Medical Center, says her hospital is completely computerized. Some handheld devices, which are covered with plastic sheaths, are used, although she was unclear on how often the plastic barriers were changed.

"The plastic completely encases them," she says. "I don't know if they have a cleaning ritual or not."

Such devices can provide the perfect resting ground for pathogens. Officials at the Centers for Disease Control and Prevention (CDC) report an average of 88,000 people die annually from nosocomial infections. CDC officials say VRE and MRSA are the major gram-positive pathogens infection control practitioners should be worried about preventing.1 The major gram-negative pathogens include P. aeruginosa, Klebsiella and Enterobacter.

Robert A. Weinstein, MD, is chair of the Division of Infectious Diseases at Cook County Hospital in Chicago, and director of Infectious Diseases Services for the Cook County Bureau of Health Services. Weinstein writes there are three major reasons for noscomial infections:

  • Increased antimicrobial use
  • Hospital personnel don't follow infection control mandates
  • More patients are immunocompromised.1

There is no clear word on how such technological devices can be cleaned to prevent pathogenic transmission. Palm and Mckesson officials plan to jointly market their solutions to increase physician and clinician use of the technology.

The Handheld Revolution
Few Answers Given to Protecting Patients from Technological Fomites

By Kelli M. Donley

Officials from Palm, Inc., and McKesson Corporation have partnered to provide healthcare workers (HCWs) with handheld computers to improve patient care.

While physicians have said having a vast array of patient information instantaneously at their fingertips is beneficial, few will discuss the possibilities of pathogens being transferred via personal digital assistants (PDAs).

Daniel Diamond, MD, who works in a multispeciality practice in Silverdale, Wash., says he's used a handheld Palm computer for more than three years. He says he doesn't wipe it down and he doesn't think infection control concerning such devices is necessary.

"I'm not worried about it a bit," he says.

Instead, he says, the devices provide a needed relief from wasting time with paperwork.

"It is nice to have information available at the point of service while I am doing an examination," he says. "I don't have to carry in a wheelbarrow of books."

While officials at Palm, Inc., were hesitant to speak on the record about the company's official policy concerning preventing pathogen transmission via their device, one engineer says an alcohol wipe could be used to clean the instrument. However, the Palm employee also says that they do not recommend a moistened cloth be used on the instrument because it may discolor the outer housing of the handheld unit.

The Palm/McKesson partnership was announced June 11. McKesson is a leading provider of information technology. The partnership's first joint effort outfitted 50 physicians and residents at Humility of Mary Health Partners in Youngstown, Ohio.

Clair Jaberg, director of physician services at the facility, says he too does not know how to prevent infectious matter from being transferred from patients to the handheld and vice versa.

"I am not aware that we've done anything in that regard," he says.

However, Jaberg also noted that the partnership and technology is giving physicians more time with patients and less time overwhelmed with charts and research.

"With this technology, we can give them (HCWs) better information in a more timely way," he says. "One of the main clinical decision making tools is laboratory data, X-ray data, transcribed operative reports, history of a physical, etc. ... That is all provided on a mainframe through the McKesson system. We can download that information so that a resident or a physician can lay his Palm down and get it synced before he makes patient rounds and have the latest clinical data on the tests that were ordered. They do not have to go to a printer and print it off, or look it up before they go and try to remember it all."

Bruce Kantelis, vice president of mobile computing for McKesson Information Solutions, says this is the first agreement linking the company with a hardware provider for the healthcare industry.

"We are developing global products that run on PDAs at McKesson and rolling them out to our hospital customers," he says. "We've released products on other platforms as well and I expect you will see other agreements with other manufacturers. Palm was the first at is an important partner to us."

Kantelis says McKesson, a $44 billion-plus dollar-a-year company, has looked into expanding their information technology into infection control.

"We are starting to get requests for these mobile applications in the infection control arena," he says. "We have infection control practitioners in hospitals using these portable devices to get patient data as they make their rounds as well."

Pat Tydell, RN, MSN, MPH, a risk manager at the North Chicago VA Medical Center, says her hospital is completely computerized. Some handheld devices, which are covered with plastic sheaths, are used, although she was unclear on how often the plastic barriers were changed.

"The plastic completely encases them," she says. "I don't know if they have a cleaning ritual or not."

Such devices can provide the perfect resting ground for pathogens. Officials at the Centers for Disease Control and Prevention (CDC) report an average of 88,000 people die annually from nosocomial infections. CDC officials say VRE and MRSA are the major gram-positive pathogens infection control practitioners should be worried about preventing.1 The major gram-negative pathogens include P. aeruginosa, Klebsiella and Enterobacter.

Robert A. Weinstein, MD, is chair of the Division of Infectious Diseases at Cook County Hospital in Chicago, and director of Infectious Diseases Services for the Cook County Bureau of Health Services. Weinstein writes there are three major reasons for noscomial infections:

  • Increased antimicrobial use
  • Hospital personnel don't follow infection control mandates
  • More patients are immunocompromised.1

There is no clear word on how such technological devices can be cleaned to prevent pathogenic transmission. Palm and Mckesson officials plan to jointly market their solutions to increase physician and clinician use of the technology.

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