2. Saving Lives, Saving Money--PDAs in Healthcare Kelli Bravo, Director of Marketing, Skyscape, Inc. Steven L. Romiti, MD, ED Director, Northeastern Regional Hospital

3. Mobile Health Presentation 2 Agenda Introduction Market Trends Improved Efficiency examples Case Studies Questions

4. Mobile Health Presentation 3 Can Modern Technology give us a New Way to Look at Medical Information? 30,000 – 75,000 patients die each year due to medical errors Physicians spend 30% of their time on administrative tasks Most physicians carry index cards or scraps of paper in their pockets with patient information 30% of physician return-phone calls come from pharmacies

5. Mobile Health Presentation 4 Healthcare’s Critical Problem Every day mobile knowledge workers e.g. physicians, healthcare professionals, services, have to make business- and health-critical decisions – while on the go They require actionable information to be provided in context for making informed decisions- rapidly and effectively Today’s critical problem – Information is not actionable  Information is distributed over several different sources  Information changes rapidly  Information is not aggregated in the “correct context”  Information is not structured for rapid decision making

6. Mobile Health Presentation 5 Decision Making At Point-of-Care THINKREFERACT

7. Mobile Health Presentation 6 The High Level Benefits of PDAs Improved decision-making – Supports decision making “as fast as medical practitioners can think” Critical Information in Context - Provides the right information when and where it is needed The Power of Medical Reference in your Pocket - Carry large volumes of reference information in handheld devices Instantaneous access to Information without Training - Retrieve most information quickly and easily Single Unified Interface - Integrate reference information with transactions in a completely intuitive manner 49% of hospitals recently surveyed intend on introducing mobile technologies within two years

8. Mobile Health Presentation 7 Rapid Physician Adoption 67% of ACP-ASIM members will use PDAs by the end of 2002 Majority use PDAs for REFERENCE The Rowin Group A survey of physicians based on three focus groups and 600 questionnaires PDA Use Highest Amongst Specialists: - Infectious Disease specialists: 66% - Cardiologists: 61% - Oncologists: 50% - Neurologists: 50% - Psychiatrists: 50% - Internists: 44%

9. Mobile Health Presentation 8 State of the Software Very Encouraging ! Reference Software Charge Capture Medical Records ? E- Prescribin g Clinical Calculator s

10. Mobile Health Presentation 9 Useful, Intuitive Products

11. Mobile Health Presentation 10 Extensive & Growing Portfolio Specialties  Cardiology  Dentistry  Dermatology  Emergency Medicine  Endocrinology  Gastroenterology  Hematology  Infectious Disease  Internal Medicine  Nephrology  Neurology  OBGYN  Orthopeadics  Pediatrics  Pulmonary Medicine  Rheumatology  Sports Medicine  Toxology Representative Titles The Washington Manual of Medical Therapeutics Physicians’ Desk Reference Griffith’s 5 Minute Clinical Consult The Medical Letter The 5-Minute Infections Disease Consult The 5-Minute AHA Cardiac Consult The 5-Minute Emergency Medicine Consult The 5-Minute Sports Medicine Consult NeoFax Drug Facts - A2zDrugs Drug Interaction Facts - iFacts Mosby’s Drug Consult Nelsons’s 2002-2003 Pocket Book of Antimicrobial Therapy Bartlett, 2002 Pocket Book of Infectious Disease Therapy The Johns Hopkins Hospital 2002 Guide to Medical Care of Patients with HIV Infection

12. Mobile Health Presentation 11 What can Mobile Solutions do for you? – Today! Get hardware you believe will last at least for a year and a half Focus on the handheld solutions that…  Help reduce errors (thereby improve quality patient care)  Are intuitive to use  Provide immediate value to your daily activities  Save you time Medical References  A great place to start – mature and stable technologies  Get trusted titles Who from?  Several in the market  Skyscape provides the right solution

13. Mobile Health Presentation 12 Where to Save Time & Money? A patient ask you about a possible drug interaction you are unfamiliar with, you?  Tell her you will get back to her, look it up and call back later  You step out of the room and look it up  You prescribe the medication knowing the pharmacy will look it up  You pull out your PDA, get the answer, convey it and build a stronger relationship with this patient! Saving yourself 2 pharmacy call backs and 1 patient call back while reducing the chance for errors.

14. Mobile Health Presentation 13 Saving Time, Saving Money – Potential Time & Cost Losses Researching  Unfamiliar drug interactions  Unfamiliar diseases  All available drug options  Formulary options Follow up calls from  Pharmacy regarding a drug interaction question  Pharmacy regarding illegible prescription  Patient/pharmacy with confusion on dosage from pharmacy vs. prescribed  Patient/pharmacy when prescribed drug not covered by payer Reading lists of FDA updates/institution updates Searching for  A patient chart  The medical journal that has new information relating to one of your patient’s conditions  ICD9 codes Dealing with billing/admin issues Lugging heavy texts to your other office/hospital/group…

15. Mobile Health Presentation 14 Saving Time, Saving Money – Potential Time & Efficiency Savings ActionTime Savings Savings Instant access to detailed clinical information5 – 20 minCritical patient life saved Instant access to drug databases5 – 20 minTime to return 2 patient phone calls Instant access to drug interaction data5 – 20 minTime enough to visit with another patient; extended time with same patient Instant access to FDA updates, linked to the drug you are prescribing 5 minImproved prescribing and fewer calls from the pharmacy Ability to prescribe & give orders right from your PDA 5 – 10 minFewer errors; fewer calls from pharmacies Ability to check formularies from your PDA10 – 20 minFewer calls from patients & pharmacies when prescription not covered by payer Instant access to dosages5 minFewer errors Ability to get messages5 minAlerted of patient changes or hospital updates Instant access to Journals linked by drug and disease 15 minUp-to-date information instantly available for a patient you are treating Ability to enter diagnosis, ICD-9 and procedure codes in HIS 10+ minFewer errors, fewer billing follow ups, faster payment Instant access to patient history15 minMore quality time with patient and time to visit another patient Clinical references, drug books and interaction guides are all integrated on your handheld 10 minInformation where you need it; No more book carrying; No more back pain!!

16. Mobile Health Presentation 15 Case Study I – Context-Sensitive Clinical, Drug Database and Drug Interaction information

17. Mobile Health Presentation 16 How I use my PDA - Steven L. Romiti, MD How I use my PDA  Double checking to ensure I’ve included all details of a workup  Determining a diagnosis when it’s a toss up between 2  Verifying that I’m asking all the right questions  Drug database information access when prescribing  Checking interactions while prescribing  Patient Communication – let them see the data concerning them

18. Mobile Health Presentation 17 What I use on my Palm M505 PDA – Steven L. Romiti, MD Content  Clinical References 5-Minute Clinical Consult published by LWW powered by Skyscape  Drug Databases A-Z Drug Facts published by Facts and Comparisons powered by Skyscape Physicians’ Desk Reference from Thomson powered by Skyscape  Drug Interaction Guides Interaction Facts published by Facts and Comparisons powered by Skyscape Calendar Address Book  Personal  Work - Hospital Referral lists Other Memory Requirements

19. Mobile Health Presentation 18 Thanks! Kelli Bravo Steven Romiti, MD