The Handheld Revolution

The Handheld Revolution
Few Answers Given to Protecting Patients from TechnologicalFomites

By Kelli M. Donley

Officialsfrom Palm, Inc., and McKesson Corporation have partnered to provide healthcareworkers (HCWs) with handheld computers to improve patient care.

While physicians have said having a vast array of patient informationinstantaneously at their fingertips is beneficial, few will discuss thepossibilities 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. Hesays he doesn't wipe it down and he doesn't think infection control concerningsuch 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 withpaperwork.

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

While officials at Palm, Inc., were hesitant to speak on the record about thecompany's official policy concerning preventing pathogen transmission via theirdevice, 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 moistenedcloth be used on the instrument because it may discolor the outer housing of thehandheld unit.

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

Clair Jaberg, director of physician services at the facility, says he toodoes not know how to prevent infectious matter from being transferred frompatients 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 givingphysicians more time with patients and less time overwhelmed with charts andresearch.

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

Bruce Kantelis, vice president of mobile computing for McKesson InformationSolutions, says this is the first agreement linking the company with a hardwareprovider for the healthcare industry.

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

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

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

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

"Theplastic completely encases them," she says. "I don't know if they havea cleaning ritual or not."

Such devices can provide the perfect resting ground for pathogens. Officialsat the Centers for Disease Control and Prevention (CDC) report an average of88,000 people die annually from nosocomial infections. CDC officials say VRE andMRSA are the major gram-positive pathogens infection control practitionersshould be worried about preventing.¹ The major gram-negativepathogens include P. aeruginosa, Klebsiella and Enterobacter.

Robert A. Weinstein, MD, is chair of the Division of Infectious Diseases atCook County Hospital in Chicago, and director of Infectious Diseases Servicesfor the Cook County Bureau of Health Services. Weinstein writes there are threemajor 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 toprevent pathogenic transmission. Palm and Mckesson officials plan to jointlymarket their solutions to increase physician and clinician use of thetechnology.

The Handheld Revolution
Few Answers Given to Protecting Patients from TechnologicalFomites

By Kelli M. Donley

Officialsfrom Palm, Inc., and McKesson Corporation have partnered to provide healthcareworkers (HCWs) with handheld computers to improve patient care.

While physicians have said having a vast array of patient informationinstantaneously at their fingertips is beneficial, few will discuss thepossibilities 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. Hesays he doesn't wipe it down and he doesn't think infection control concerningsuch 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 withpaperwork.

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

While officials at Palm, Inc., were hesitant to speak on the record about thecompany's official policy concerning preventing pathogen transmission via theirdevice, 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 moistenedcloth be used on the instrument because it may discolor the outer housing of thehandheld unit.

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

Clair Jaberg, director of physician services at the facility, says he toodoes not know how to prevent infectious matter from being transferred frompatients 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 givingphysicians more time with patients and less time overwhelmed with charts andresearch.

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

Bruce Kantelis, vice president of mobile computing for McKesson InformationSolutions, says this is the first agreement linking the company with a hardwareprovider for the healthcare industry.

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

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

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

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

"Theplastic completely encases them," she says. "I don't know if they havea cleaning ritual or not."

Such devices can provide the perfect resting ground for pathogens. Officialsat the Centers for Disease Control and Prevention (CDC) report an average of88,000 people die annually from nosocomial infections. CDC officials say VRE andMRSA are the major gram-positive pathogens infection control practitionersshould be worried about preventing.¹ The major gram-negativepathogens include P. aeruginosa, Klebsiella and Enterobacter.

Robert A. Weinstein, MD, is chair of the Division of Infectious Diseases atCook County Hospital in Chicago, and director of Infectious Diseases Servicesfor the Cook County Bureau of Health Services. Weinstein writes there are threemajor 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 toprevent pathogenic transmission. Palm and Mckesson officials plan to jointlymarket their solutions to increase physician and clinician use of thetechnology.