Database software comes with some hand-held computers and can be purchased as third-party add-on software for others. Many computer-literate physicians are using database programs to develop their own customized medical applications. For example, physicians can create databases of their patients, with key information such as current medications and diagnoses
We have summarized general-purpose software in Table 4, and medical software for hand-held computers in Table 5. Table 6 includes a list of Web sites for users of handheld computers, including sites that are focused on medical applications. Below, we briefly discuss some medical applications for each platform. The purpose of this section is not to review these software items but rather to make the user aware that they exist.
Palm OS
MedData, Raphael, and PocketChart are all basic medical record systems. Although all 3 packages have some limitations over desktop systems because of size and memory limitations, they offer a remarkably complete set of features. Medical references available for the Palm include the 5-Minute Clinical Consult and the Lexidrugs Drug Information Handbook. In addition, many Palm users have created their own references and collections of pearls. A good source for these is the Palm Central site (www.palmcentral.com) or one of the other Palm sites listed in Table 6.
Windows CE Operating System
Although the number of medical software applications for the Windows CE OS is small, it is growing rapidly. PocketChart is a fully-functional electronic medical record that can either run as a stand-alone program on a single Windows CE unit or be linked using wireless modems to a central server. K2 Medical makes several medical reference applications, including an extensive drug database (Lexicomp), an internal medicine reference (Outlines in Clinical Medicine), and a medical calculator (Archimedes). InfoPOEMs has released a Windows CE version of its InfoRetriever software that contains a variety of evidence-based sources of information, basic drug information, summaries of guidelines, and clinical rules and calculators.
Another option for Windows CE users is to run a program called Citrix WinFrame. This allows users to access and run (usually through a wireless modem) programs and data that reside on a central server computer. This expands the number of electronic medical record programs that can be run on the Windows CE hand-held computer.
EPOC Operating System (Psion)
There is one medical record package available, called MedPalm. It is full-featured and can share information with a desktop computer. We were unable to identify any medical reference software for the Psion, although this may change in the future.
Conclusions
Hand-held computers are finally achieving the combination of price, power, and portability to make them a useful tool. Physicians in particular stand to benefit from their use, and according to Microsoft, half of all Windows CE devices have been purchased by health care professionals. This is a good time to take the plunge and make it possible to access vital information whenever and wherever it is needed.
Acknowledgements
Work on this article was supported by a grant from the American Academy of Family Physicians to establish the Michigan Consortium for Family Practice Research and by a Generalist Physician Faculty Award from the Robert Wood Johnson Foundation. Dr Ebell is author of the InfoRetriever software and profits from its sale.