Many family physicians spend significant time working outside the office, visiting nursing homes, hospitals and other facilities. For these times, there are excellent software programs for personal digital assistants (PDAs) that allow physicians to carry a subset of patient data beyond the office as well as input information gathered outside the office for future use.

For example, I use PDA software to track allergies, problems and medications taken by my patients at a nearby nursing home. These elderly patients’ medications can change between visits because they see many subspecialty doctors. With my PDA I am able to capture these changes and ensure my office records are up-to-date.

This article discusses some useful patient-tracking programs as well as a program that allows easy database creation on either Palm or Pocket PC devices.

Mini medical records

Tracking the care of patients in nursing homes, hospitals and other facilities is easier with a Palm or Pocket PC PDA and some easy-to-learn patient-tracking software. These programs enable you to carry a subset of your office records into the nursing home or other facility, where you can then input or modify information at the point of care. If you’re at a hospital, the same programs allow sophisticated input of laboratory and diagnostic data in addition to the basic information mentioned above.

The two programs described below are representative of patient-tracking programs and their capabilities.

PatientKeeper Personal. This was one of the first patient-tracking programs for the Palm platform and has been improving ever since. Although the company now sells an expanded array of products, PatientKeeper Personal is still sold as an inexpensive stand-alone patient-tracking program. It keeps track of patient demographics, problem lists, medications, lab and test orders and results, and tasks.

Highlights include the ability to print and back up patient data. Patient data can also be beamed from one Palm to another, thereby encouraging teamwork and reducing information workload.

Designed with hospital work in mind, this program would also be ideal to use while caring for patients in nursing homes or other facilities.

A trial version is available (see “Give them a try” for more information). It doesn’t expire, but many features in the trial version are either limited or disabled. The full version of PatientKeeper Personal costs about $40. The company also sells an expanded version that can link physicians with hospital systems; it is much more expensive, depending on which features are added.

Mobile MedData Charts. Although not quite as sophisticated as PatientKeeper Personal, Mobile MedData Charts does a nice job. It can track patient demographics, allergies, medications, problem lists, and lab tests and studies ordered and received, as well as other information. The pick lists of problems and medications can be customized. I use the stand-alone version on my Pocket PC.

A trial version of Mobile MedData Charts is available for Palm or Pocket PC (see “Give them a try”). The full stand-alone version costs about $100. A desktop version that can be integrated with hospital systems is $599.

Portable databases

Another way to manage critical data outside your practice is to set up a database on your PDA. The first step is identifying what information you wish you could take with you at a moment’s notice and access easily wherever you go. Here are a few examples of information that I store and manage on my PDA:

• Patients on warfarin with dates and lab results;

• Patients with important tests pending, such as mammograms;

• Patients with critical lab results that require follow up;

• Hospital billing information.

HanDBase (for Palm and Pocket PC) is the program I use to create these databases. It is one of the oldest and best-known database programs. Highlights include a desktop component with automatic database synchronization between the desktop and the PDA. You can either create your database on the computer and transfer it to the PDA, or create it on the PDA and transfer it to the computer.

Database creation is quick and intuitive. Many kinds of fields can be created, including text, dates, check boxes and drop-down boxes. Online training videos are available (see “Give them a try”). In addition, medical databases that were created by other HanDBase users are available on the company’s Web site for download, most of them for free.

Using HanDBase, I created a database that tracks patients in my practice taking warfarin. The database is a simple relational database with the main database containing patient information such as name, problem requiring warfarin, telephone number, last international normalized ratio (INR) and most recent dosage. One button in the main patient database links to another database that contains that patient’s serial INR values, warfarin dosages with dates and next lab due date. Alarms can be set based on date. The database can be sorted in any number of ways, including by patient name or by last INR date. Filters can be set to exclude data from view. For instance, a filter can be set to visualize only patients whose INR is due in the coming week. When I synchronize my PDA with my desktop computer, the information from the database on my PDA is transferred to the database on my desktop computer, simultaneously backing up my data and making it available on the desktop. HanDBase is relatively inexpensive. A free 30-day fully functional demonstration version is available.

Managing the load

The amount of information flowing through a family practice, and the number of patients and parameters to keep track of, has grown exponentially over the past five or 10 years. PDA databases and patient-tracking software offer a flexible and powerful way to handle this information. Carving out a small amount of time to learn these programs can pay great dividends in terms of patient care, safety and increased office efficiency.