1. Maximizing Your PDA Investment & Planning for the Future March 17, 2008 Allison Weich

2. 2 Who is More Likely to Own an MP3 Player? A. U.S. Physician B. 18-34 Year Old Male C. 18-34 Year Old Female Resource: Manhattan Research

3. 3 Can you envision this?

4. 4 The Zen of PDAism

5. 5 “Tip of the Iceberg” Connect the Dots between the Mobile Device, Cell Phone, Desktop & Web

6. 6 Welcome to “e” Electronic Evolution in Mobile Healthcare!

7. 7 Agenda Historical Preview Quick review of the what, when and how of the handheld devices (or PDAs) ROI Can you expect to save time? Enhance efficiencies? Improve quality of care? Handhelds in Healthcare Rapid adoption by healthcare professionals Case Studies What is available today Who is doing what

8. 8 How Did We Get Here?

9. 9 Then (August 3, 1993)… Processor: Motorola processor running at 20 MHz. Memory: 640k RAM and 4 MB ROM. Display: reflective LCD display has a resolution of 336x240 in black & white. Expansion: One PCMCIA Type II card slot Ports: LocalTalk compatible serial port, as well as a low-power, half- duplex, infrared transceiver that transmits at 9600 baud at 1 meter. Battery: 6V AAA alkaline batteries which last 14 hours, and a 4.8V NiCd battery which lasts 4 hours. Remember when?

10. 10 Now! State-of-the-art processors  400MHz+ speed 128 MB Program Memory Storage cards up to 2GB!  Over 100 books in your pocket! 16-bit color Phone/wireless integration Voice Recording Digital & Video Camera MP3 player It’s not just an ADDRESS BOOK any more!

11. 11 Spectrum of Devices Two Piece Wireless data PDA Integrated Wireless data PDA with telephony Voice-centric PDA with data capability Traditional PDA Traditional mobile phone PhonesCommunicatorsPhone PDAHandheldsCampus PDA PDA Phone SmartPhones High-end Mobile phone PIM capability

12. 12 Critical Problem Health Professionals Every day mobile knowledge workers have to make critical decisions – while on the go Unfortunately… Information - is distributed - changes rapidly - not aggregated in-context - not structured for rapid decision making Actionable Information Need to have TRUSTED & UP- TO-DATE information in- context for making informed decisions – rapidly and effectively

13. 13 Handhelds & Healthcare – Perfect Partners Critical Need in Healthcare Need for Point of care access – current technologies are inadequate Quick access to large volumes of information for better decision support Platform is Right Form factor is suitable New devices pack power! Handy & mobile Non-intrusive to the Physician Workflow Applications are Available Personal Information Management Medical References Evidence Based Data Clinical Calculators Decision Support Tools Guidelines Billing and Coding ePrescribing EMR (subset)

14. 14 Rapid Healthcare Practitioner Adoption Physicians are four times more likely as other consumers to own PDAs. 45% of North American physicians own PDAs, compared with 11% of the general population. Almost two-thirds, or 62%, of physicians less than 43 years old own PDAs, while 31% of physicians above age 43 have them Source: 2004 Forrester Research Inc. Majority use PDAs for REFERENCE

15. 15 … including Specialists The Rowin Group A survey of physicians based on three focus groups and 600 questionnaires PDA Use - Specialists: - ID specialists: 66% - Cardiologists: 61% - Oncologists: 50% - Neurologists: 50% - Psychiatrists: 50% - Internists: 44% Over 1600 medical practitioners polled by Skyscape:  More than 78% have at least three medical references on their PDA  88% use PDAs to check drug references

16. 16 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 including large volumes of references when and where it is needed Instantaneous access to Information without Training - Retrieve most information quickly and intuitively Single Unified Interface - Integrate reference information with transactions in a completely seamless manner 47% of hospitals recently surveyed have mobile initiatives (in progress or complete)

17. 17 Intuitive & Comprehensive Quick Reference Clinical Calculators, Tools Charge Capture e-Prescribing Patient Records In-context Alerts & Messages Guidelines & Algorithms

18. 18 Wireless Alerts

19. 19 Context Oriented Linking & Messaging

20. 20 How to Go Mobile Today! Focus on the solutions that…  Help reduce errors (thereby improve quality patient care)  Are intuitive to use  Provide immediate value to your daily activities  Save you time Hardware Options  Get hardware you believe will last at least for a year and a half  Consider Leasing if appropriate Solution Options  Medical References - a great place to start, minimal paradigm shift  Several applications to support Charge Capture, HIS integration, Clinical Documentation, etc

21. 21 Case Studies

22. 22 Scenario - Academic Setting University of Louisville  1 st – 4 th year medical students Drexel University  ACE, Co-op and BSN Nursing students Vanderbilt University  7 nursing specialties UTMB  Nursing program East Carolina University  3 rd year students

23. 23 Product Mix University of Louisville Stedman ’ s Concise, 5MCC, A2Z Drugs Drexel University Diseases & Disorders: Nursing Therapeutic Manual, Lab & Diagnostic, Drug Guide for Nurses, Nursing Procedures, Taber ’ s, Assessment across the lifespan UTMB Nurses Pkt Guide, Nurse ’ s Fast Facts, Procedure manual, Drug Guide for Nurses, 5MCC East Carolina University Tabers, Drug Guide for Physicians, 5MCC

24. 24 Categories of Information Resources Dictionaries Clinical References Drug Databases Drug Interaction Guides Lab & Diagnostics EBM Alternative Medicine Coding Calculators & Tools Board Review Material Guidelines Dynamic Information Resources Drug News & Alerts CDC FDA NIH AHRQ Societies & Colleges: ACC, ACP, APPI

25. 25 Scenario – Private Setting – (Adoption Rate) PDA adoption Institution wanted to validate that physician adoption was creating measurable ROI  Charge Capture Solution on Pocket PC devices  In addition Physicians from 9 departments were given PDAs with 5 references.  At the end of 8 weeks, results from survey to find out: How often they used their PDAs How much time physicians saved doing research using a PDA The % of medical errors avoided by using the PDA at the point of care

26. 26 Scenario – Private Practice – (Determine ROI in Messaging) Messaging Institution wanted to provide a network of physician users with access to medical references and context sensitive messaging  The solution was developed to assist physicians during point-of-contact encounters with patients  The project included a list of preferred drugs, a list of pharmacies, and a messaging application  Internal content management for all applicable sections, internal / external security was also included.  The solution provided bi-directional linking capabilities between the messaging application and the drug reference applications

27. 27 Scenario – Institution – (Customization) Corporate Directory for Handhelds  Institution wanted to put its employee information on handheld devices so that it was easily accessible when employees were on the go  The information Was indexed by employee name for easy access & seamless navigation Included –Contact information –Location, job title, and phone number Was regularly updated  Security was also implemented via a password and encryption on the handheld device

28. 28 How Often Do You Use Your PDA? Survey from PDA Users (>400K) Survey Results based on responses from all specialties 100% Users Access PDAs at least 1-3 times per day! 6-10x Per Day 36% 11-25x Per Day 24% 4-5x Per Day 19% >25x Per Day 11% 1-3x Per Day 10%

29. 29 Immediate Benefits Measure the following:  Time Savings  Improved Patient Care  Improved Patient Satisfaction  More Patient Encounters  Faster Patient Discharges  Improved Compliance to Procedures/Guidelines  Improved Coverage/Communication between Peers  Improved Physician Autonomy/Satisfaction Set up Personal Expectations Incremental Functionality Institutional Goals Your mileage may vary!

30. 30 5- 10 min 5- 20 min Instant Access to detailed Clinical Information 5- 20 min 5+ min 5 min Instant access to drug databases, drug interaction tools Prescribe & give orders right from your PDA Ability to get messages, alerts 10 min Ability to enter diagnosis, ICD-9 and procedure codes in HIS Instant access to patient meds & patient history 15 min Ability to access guidelines Check Formularies PDA’s Save Time, Improve Efficiency

31. 31 A Full Range of Specialty Titles Are Available From a Number of Mobile/Medical Reference Suppliers Specialties  Cardiology  Dentistry  Dermatology  Emergency Medicine  Endocrinology  Gastroenterology and Hepatology  Hematology  Infectious Disease  Internal Medicine  Nephrology  Neurology  OBGYN  Orthopeadics  Pediatrics  Pulmonary Medicine  Rheumatology  Sports Medicine  Toxology  Nursing …many more… Representative Titles Davis’s Drug Guide Drug Interaction Facts - iFacts Taber’s Cyclopedic Medical Dictionary Nurse’s Manual of Lab & Diagnostic Tests Diseases & Disorders: A Nurse’s Manual Taylor’s Clinical Nursing Skills Nurse’s Quick Check: Diseases Nursing Drug Handbook Mosby’s 2007 Drug Reference Nursing Drug Handbook Lippincott’s Review For NCLEX-RN Stedman’s Concise Dictionary Nursing Procedures … many more …

32. 32 Latest Platforms…

33. 33 How About You? Will YOU be part of the Mobile Healthcare Explosion?

34. 34 Quick Demo

35. 35 Quick Demo On Skyscape’s Emulator and Q&A’s

36. 36 Allison Weich, Skyscape allison@skyscape.com 617.460.4670 Thank You!