'Computing Potential Of PDAs Can Be Exploited For Various Reasons'

Trauma critical care specialist, attached to MIOT Hospitals, Chennai, Dr Balaji Bikshandi has conceived the concept of 'Lean PDAs' for medical purposes. The device, presented at the Royal Society of Medicine, London, is a dedicated, cheap and efficient hand-held computer for medical computing purposes. Basic PDA functions include a calendar, contact/address book, meeting alerts and e-mail. He spoke to Express Healthcare Management about the benefits of the devise.

Please tell us about the features of PDA that you have specially devised for doctors.

PDAs are more than just organisers. The potential of these devices are widely under-utilised. Most PDAs have a computer built in to them. The computing potential of these PDAs can be exploited for various reasons. Doctors were one of the first groups to exploit this potential, especially in developed nations like the US and the UK.

Generally, a medical professional encounters overwhelming amount of data in practice. Voluminous data needs to be remembered, recalled, analysed and interpreted to provide optimal patient care, irrespective of the specialty. Hand-held computer devices have greatly eased and improved the quality of medical practice in this regard. In addition, almost every day, many drugs are added to the current international pharmacopoeias and equal numbers are deleted due to various reasons.

It would prove to be extremely difficult to keep track of these changes without pocket pharmacopoeias, which synchronise over the internet with standard drug formularies. In the same way, new clinical studies are published almost everyday which can be accessed and even continuing medical education programmes can be completed with hand-held computer devices. Patient information including lab data, even images such as X-rays and ultrasound pictures can be ported to hand-held devices by making them available to the doctor at the 'tap of the stylus'. Intra and inter-networking as well as the e-mail function of these devices opens up multitude of possibilities in healthcare information exchange. It can greatly aid clinical studies.

How will patients benefit from this devise?

Patients benefit directly and indirectly. Direct benefits include reduction in the number of medication prescription errors, formulation of ideal drug infusion rates, and avoidance of inadvertent drug interactions, to name a few. In addition, a hand-held computer-based Health Information System (HIS) can dramatically improve the speed and accuracy with which the patient's lab results and other data are conveyed to the healthcare provider. Indirectly, by providing the latest information to doctors and other healthcare professionals, patients receive the best of treatment conforming to international standards and protocols. All these can dramatically reduce the cost and improve efficiency of healthcare systems — both at the hospital community and national level.

Have you devised both the hardware and software of the PDA? Can it be applied with any operational system?

I have conceived the concept of 'Lean PDAs' for medical purposes. That is, combining the reliable and trustworthy software from a few years ago and the new smaller, efficient devices available in the market at present (which were not meant for medical purposes). I configured a basic palm based hand-held device to run important clinical applications by performing minor tweaks. The configured device is currently operational and capable of synchronising over the internet and even checking e-mail. I have also conceived the idea of providing a SPIX (single point information exchange), which is a blueprint for an elementary network using the built-in infra-red port provided with many hand-helds in a hospital/clinic set up. The design can network doctors and other healthcare professionals in an institutional setting with no specialised hardware requirement or huge investment.

How does your PDA score over the conventional one?

The conventional high-end PDAs have many disadvantages at the bedside. Radio frequency interference caused by them prevents their use in telemetry units (cellular phones are not permitted in most hospitals for this reason). Also their energy consumption is higher (less battery life), are heavier to carry comfortably and have multiple sub-devices (cameras for instance), which make them cumbersome in bedside use. The bottom line is lack of focus and dedicated performance. Many devices are also subscription-based, either for the cellular service and/or internet service. They may be of more use as a status symbol than a clinical workhorse!

Do we have PDA for doctors in the market?

Currently, there is no other dedicated device than the one I configured. But, virtually any hand-held can be utilised for its medical computing potential. In the Royal Society workshop, we discussed the possibility of manufacturing dedicated hardware for medical application.

How are you planning to market the PDA that you devised? How will you price it? By what brand name you plan to market it?

The device I have configured is aimed at healthcare professionals at all levels from medical/dental/nursing students to doctors/nurses/physical therapists. Lean PDAs can impact several areas of medicine from critical care to primary care — both from an individual healthcare provider's perspective and the institutional perspective. In addition to its role in cutting-edge medicine, the rural healthcare system in India, which is technologically-deprived can be dramatically improved by the incorporation of these devices.

Currently, the prototype model fulfilling my concept of 'Lean PDAs' costs less than Rs 10,000, which can be brought down considerably if the demand multiplies. I do not want to restrict myself to one particular hardware or operating system. The concept gives room for development of indigenous software and hardware too. It also opens up an enormous area for R&D. The need of the hour is the promotion of awareness of this technology among medical students, doctors and other healthcare professional. Training programmes and seminars should be conducted at various levels to promote this technology. Hospitals, research institutions and governmental institutions should come forward to promote the usage of these devices and enhance its penetration among the medical fraternity.

ehm@expresshealthcaremgmt.com