Keeping tabs on new doctors

The doctors in the St. Louis University Family Practice Residency program, operated in cooperation with the Air Force, need to keep track of the procedures performed by resident doctors who are working to earn their stripes as full-fledged doctors.

Previously, residents would scribble details about pro.cedures they performed on index cards, which then would be passed on to a data-entry person who keyed the information into a PC application.

But hospital officials weren't satisfied with the system because of the potential for lost records and the cost of data entry. The solution was to issue Palm Inc. handheld devices to all 50 of the hospital's residents in October 1999, said Dr. Scott Strayer.

Because there was no off-the-shelf procedure-tracking application available, hospital staff members wrote their own software. "It is the most advanced procedure-tracking program you can possibly do," Strayer said.

Because doctors don't have spare time to spend keying in data using the devices' sometimes cumbersome handwriting-recognition feature, the in-house application gives users a menu of common procedures from which to choose.

"The only information they have to enter is the patient's name and medical record number," Strayer said. "It takes 30 to 40 seconds to put in a procedure, and no time to put it in the database later."

Doctors put their handheld devices into a synchronization cradle to upload recorded information into the main database. "That is where we get our return on investment," Strayer said.

Hospital staff members are adding a function that will enable the attending physician to enter grading information as well so the resident can be evaluated for proficiency in each procedure.

Color displays and wireless networking, two hot options for handheld computers in general, aren't relevant for the hospital's application, Strayer said. A color display might make it easier to select procedures, but the information isn't time-sensitive, so a delay in entering it into the database doesn't affect its usefulness, he said. The database "is OK for weekly, or even monthly updating."

Hospital officials plan to issue Palm devices to all staff members and give them access to a central scheduling application. This will let users know who is on call and how to reach them. The telephone system currently provides that information, but it is overburdened and an upgrade would be expensive.

"We can avert buying a several-million-dollar phone system by spending several thousand dollars on Palm [devices]," Strayer said.