Palm-based Clinical Information System (PalmCIS)

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Palm-based Clinical Information System (PalmCIS)

Palm-based Clinical Information System (PalmCIS) is a wireless handheld clinical information system that provides clinicians with real-time access to a subset of patient data found in the patient record. PalmCIS was deployed in August 2002 at New York Presbyterian Hospital (NYPH).

It provides direct access to the clinical data repository and serves as an extension to Web-based clinical information system (WebCIS). WebCIS is the Web-based clinical information system at NYPH that enables clinicians to browse the content of their patients' medical records. WebCIS is implemented as a set of Common Gateway Interface (CGI) programs written in C, which generate Hypertext Markup Language (HTML) and Javascript.

The motivation behind PalmCIS was to satisfy clinician information needs by providing needed patient information anytime, anywhere. It aimed at providing knowledge about patient-specific clinician information needs utilizing an automated technique and to introduce the concept of “shortcuts” as a means for accessing needed information quickly,

Two major concerns for design and development of PalmCIS were end-to-end security and usability. Two goals for the PalmCIS user interface: to present relevant information when it is desired and to present information in an organized way that keeps in mind the limitations of the wireless handheld environment such as screen size and bandwidth.

PalmCIS is platform independent and is based on client–server architecture. On the client-side, wireless handheld devices run their respective browsers, which interact with the user to display the requested information. Applications on the secure server are responsible for retrieving this requested information and formatting it for display. The Kyocera QCP 6035, SprintPCS, and EudoraWeb provided the base for PalmCIS. Since it is a platform-independent solution, PalmCIS can not only be used on the Kyocera QCP 6035 but also on other handheld devices as well as laptops and desktops running other operating systems such as PocketPC, Linux, MacOS, and Windows 9x/2000/XP. Browsers that offer direct SSL encryption, such as Netscape Communicator and Internet Explorer, can be used on these devices. PalmCIS interacts with the CDR, MED, and LDAP server. The server application is implemented in C and uses CGI and a subset of HTML.

PalmCIS seeks to provide users with a concise view of their patients through presentation of a patient report, which contains a summary of results for the last two days. If necessary, users can obtain details for the results as well as access previous results. Our system consists of five major steps to accessing needed patient information: sign-on/login, patient list, patient report, result details, and previous results. Aside from viewing the patient list and patient report, the more frequently used PalmCIS functions include viewing of laboratory results (50%), viewing previous laboratory results (14%), viewing consult or sign-out note details (6%), and viewing microbiology result details (6%).

Through a search mechanism and infobuttons, it provides users with access to medical knowledge like query PubMed. Infobuttons allow users to receive answers to patient data-driven queries from outside health information sources.

Other extensions are the Virtual Whiteboard, team scheduler, and event monitor.

References: • Chen, Mendonça, McKnight, et al. PalmCIS: A Wireless Handheld Application for Satisfying Clinician Information Needs. . J Am Med Inform Assoc. 2004 Jan–Feb; 11(1): 19–28. • Lei, Chen, et al. Development of Infobuttons in a Wireless Environment AMIA Annu Symp Proc. 2003; 2003: 906. • Chen, Hripcsak, et al. Automated Identification of Shortcuts to Patient Data for a Wireless Handheld Clinical Information System AMIA Annu Symp Proc. 2003; 2003: 809. • Mendonça, Chen, Stetson, et al. Approach to mobile information and communication for health care International Journal of Medical Informatics (2004) 73, 631—638