1. Mobile Information and Coordination for Health Care James J. Cimino, Elizabeth S. Chen, Lawrence K. McKnight, Peter D. Stetson, Jianbo Lei, Eneida A. Mendonça Department of Biomedical Informatics Columbia University New York, New York, USA

2. Opportunities for Error Coordination Decision Making Decision Making Decision Making Health Information Clinical Alerting ? ? ? ? Patient Data

3. Opportunities for Error Coordination Decision Making Decision Making Decision Making Patient Data Health Information Clinical Alerting ? ? ? ?

4. Mobil Access to Information Coordination Decision Making Decision Making Decision Making Patient Data Health Information Clinical Alerting Coordination

5. Study of Information Needs - Methods Surveys Focus groups Observational studies Nurses and physicians studied

6. Study of Information Needs - Results Mobile access to patient data Coordination of care Interactions and alerts Health information resources

7. Mobile access to patient data Coordination of care Interactions and alerts Health information resources Mobile access to patient data: PatCIS Coordination of care: Virtual Whiteboard Interactions and alerts: Event Monitoring Health information resources: Infobuttons Study of Information Needs - Solutions

8. Mobile Access to Patient Data: PatCIS WebCIS: desktop-based access to patient data Web browser on phone/Palm Pilot combination Different screen layout Slower access New security problems

9. PatCIS Architecture

14. Coordination of Care: Virtual Whiteboard Database of users and schedules Clinicians’ patient lists in WebCIS Web server application manages messages among team members

17. Interactions and Alerts: Event Monitoring Rule-based monitoring system Waits for trigger events Evaluates logic to determine warnings Medical Logic Modules (Arden Syntax) Web-based, insitution independence: Vigilens “Push” is possible with Palm Phones Not yet developed for integrated with PalmCIS

18. Health Information Resources: Infobuttons Links between clinical data and on-line resources PubMed searches Microbiology results and Medline Culture sensitivity tests and Micromedex

21. Wireless Palm-based Error Reduction Coordination Decision Making Decision Making Decision Making Patient Data Health Information Clinical Alerting Coordination Infobuttons Vigilens Virtual Whiteboard PatCIS

22. Discussion Poor information access  uninformed decisions Ineffective communication  poor care coordination Wireless, hand-held technology can help Technical problems solved Security problems solved Evaluation is the next step

23. Conclusion Wireless hand-held communication and access to information work. But do they work well?

24. Acknowledgments National Aeronautics and Space Administration (NASA) Health Resources and Services Administration (HRSA) New York Presbyterian Hospital (NYPH) Suzanne Bakken (SB, PhD)