Mobile Health Clinical Applications

Not only is wireless computing changing the lives of e-health stakeholders, but its effects are also becoming evident on a global and extraterrestrial scale. News articles about medical breakthroughs describe how e-medicine can be transmitted to the North and South Poles and even to outer space, providing e-care services to astronauts on the space shuttle. When one begins to fathom the countless possibilities that mobile computing technology opens up, the result is a growing stream of future applications and opportunities for scientific advances in almost every imaginable occupation. With regard to future-oriented e-patient care, the following list of ideas is only a sampling of the ways in which handheld technology can transform patient-caregiver interactions and provide instantaneous improvements.

• Automated alerts: using cell phones, pagers, and handheld devices to alert patients about doctor's appointments, or remind patients of scheduled medication, vitamins or supplements, self-administered blood sugar tests, walking and stretching exercises, or e-mail prompts for messages from e-providers or home health care personnel.

• E-diagnosis: using e-diagnostic decision support software to input patient symptoms and verify diagnoses using a clinical protocol reference database; obtaining information to support the practice of evidence-based medicine.

• E-patient safety and error reduction: using automated functions to calculate correct dosages and reduce the possibility of dosage errors; to graph and chart medication consumption for e-care monitoring; to flag errors in e-health records due to captured inputs that do not make sense, for example, spelling errors and missing information; and to ease the transmission of patient self-reports by beaming patient input on drug reactions from one device to another, thereby offering immediate alerts in case of errors.

• E-patient monitoring and tracking: recording information such as vital signs, medical history, prescriptions, allergies, and patient laboratory data at the point of care and updating patient records as care is administered or as soon as possible; immediately after patient information has been updated, the information can be transmitted between devices and synchronized with network computers for review by caregivers and e-providers.

• E-referencing: providing reference-based information to e-consumers on various aspects of health care and services and to e-providers, including evidence-based medicine and clinical care protocols as well as information resources such as e-directories of prescription drugs, referrals, and experts.

• E-prescriptions: transmitting prescription orders directly to pharmacies and using specialized software programs to reduce error by automatically checking drug interactions and eliminating errors due to misreading of physical handwriting.

In order for a wireless personal computer (PC) or Palm to be used for medical purposes, a nurse or physician must register the handheld with some support services such as ePhysician, an e-information service model in support of physician's office daily workflow and problems founded by Dr. Stuart Weisman. Registration is accomplished on the first synchronization with ePhysician, which is compatible with over fifty practice management system (PMS) software. Following registration, data stored in the PMS database, which include items such as provider information, patient demographics, insurance information, and appointments, are imported on a scheduled basis into the ePhysician remote database by way of the Patient Data Exchange program.

One application of this kind of wireless technology is an e-prescription system. With the elimination of handwriting, a physician can send an e-prescription order directly to the pharmacy, where encryption programs allow fast and inexpensive verification of the credentials of the prescribing physician. A prescription software package such as ePad requires the provider to customize the drugs, pharmacies, and formulary information that appear on both the handheld and the communicating PC. The selected medications, pharmacies, and formulary information, in tandem with the patient identification information (name, appointment, and demographic information) are then transferred to the handheld unit each time the PC is synchronized with the handheld where data is also transferred from the handheld to the PC. The key benefit of an e-prescription system is therefore the elimination of potential medication errors due to human transcription and increased efficiency and accuracy in the dispensing of medication and refills.

Besides clinical applications, mobile health encompasses health administration applications.

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