Physicians' Use of the Personal Digital Assistant (PDA) in Clinical Decision Making

Article excerpt

Purpose: This study examined how frequently attending physicians and physicians in training used personal digital assistants (PDAs) for patient care and explored physicians' perceptions of the impact of PDA use on several areas of clinical decision making.

Setting/Subjects: The 108 participants included 59 attending physicians and 49 physicians in training from teaching hospitals in Tennessee, Florida, Alabama, Kentucky, and Pennsylvania.

Methodology: Respondents completed a questionnaire designed to explore PDA use in a clinical setting.

Results: Eighty-seven percent of the respondents reported PDA use for patient encounters. Fifty-five percent of respondents reported frequent use, and 32% reported occasional use of a PDA for patient care. Of the frequent PDA users, 85% said PDA use had influenced their overall clinical decision making and 73% mentioned treatment alterations specifically. Approximately 60% of the participants reporting occasional PDA use indicated that the PDA had influenced their overall clinical decision making, while 54% specifically mentioned a change to their patient's treatment plan.

Discussion/Conclusion: Attending physicians and physicians in training who used a PDA during patient encounters perceived that even occasional PDA use had an impact on their clinical decision making and treatment choices. Health sciences librarians are perfectly positioned to provide PDA training and assistance not only to physicians who are frequent PDA users, but also to those who are occasional users.

INTRODUCTION

Information retrieval for health care professionals is a subject of major interest, but it also poses a formidable challenge. Previous studies addressing this issue from the standpoint of health care professionals' information needs have focused specifically on the needs of physicians [1-3], nurse practitioners [4], nurses [5, 6], interns, and residents [7, 8]. Handheld computers, usually called personal digital assistants (PDAs), have introduced a new tool and venue for information retrieval. The portability of the PDA facilitates information retrieval at the point of patient care. Recent research on PDAs has focused on prominent PDA use among physicians, medical students, residents, and interns [9-11]. Recent studies have also reported on the frequency of PDA use by clinicians [9, 11-14]. This study was conducted to build on the data from previous research on medical use of PDAs, to examine the frequency with which attending physicians and physicians in training used PDAs for patient care, and to explore perceptions of the impact of PDA use on clinical decision making, diagnosis, treatment, test ordering, and patient length of stay.

METHODS

This study was a multistate effort using physicians in teaching hospitals from 5 states, with the sample recruited at 5 hospitals. The convenience sample was comprised of 64 physicians from Tennessee, 26 from Florida, 10 from Pennsylvania, and 4 each from Alabama and Kentucky. The 108 participants included 59 attending physicians (55%) and 49 physicians in training (45%). For purposes of this study, the terms "physicians in training" and "trainees" applied to medical students, interns, and residents. The attending physician group (attendings) consisted of 17 females (29%) and 42 males (71%), while the trainee group was composed of 18 females (37%) and 31 males (63%). Study participants were required to have and use a PDA, but prior training with a PDA was not required because the study intended to determine the participants' perceived PDA skill level at the time of the survey. None of the participating libraries offered PDA training prior to the study's completion.

The PDA study was marketed by librarians sending emails and making announcements at medical meetings, morning reports, and hospital seminars. Data were collected from questionnaires distributed to physicians and collected at medical meetings and by email, mail, and facsimile. …