Improving interdepartmental communication through the integration of clinical information systems and the application of mobile computing technology

As clinical workloads have grown, the increasing mental and physical demands placed upon physicians and nurses have required the reexamination and reengineering of clinical processes. This is especially true in an urgent care setting where the need for accurate and rapid access to information is paramount to ensure patient safety. It has been suggested that clinical information systems integration and mobile computing technologies hold the key to improving patient care by facilitating rapid inter-physician communication and reducing the number of medical errors related to the poor exchange of information.;The aim of this study is to determine if network enabled Personal Digital Assistants (PDAs) can be used to facilitate the timely delivery of urgent radiological exam results at the point of care. The project examines and redesigns radiology and emergency department (ED) workflows with the intent of reducing the interval from when a radiology exam is scheduled to when the results are first viewed by an ED physician.;Digital replacements were sought for the original paper and fax based procedure. A system for notifying the radiologist of the presence of an urgent unread exam was instituted. Furthermore a web and Java Message Service (JMS) based application was built to enable the electronic capture and delivery of wet-reads. The new system allows radiologists to enter wet-reads from the PACS display station as well as track discrepancies between the wet-read and final report. It also notifies ED physicians of when exam results are available via the PDAs and permits them to view the full text of the wet-read and final reports from the devices.;The new system is compared to the original procedure with the results showing improvements with the wireless method in both the time to interpretation availability and the physician's first encounter with the results. Furthermore, feedback from a qualitative survey of PDA users was positive, suggesting that PDAs are a viable means for accessing urgent clinical data at the point of care. Finally the use of the PDA and wet-read module has opened the door to additional applications that extend the scope of the original pilot project.