PDAs beat pagers for doctor response times, says study

A study published in the open-access journal BMC Medical Informatics and Decision Making has revealed that surgeons at a London hospital whose pagers were replaced with PDAs combined with mobile phones responded to calls more quickly, improving communication between clinicians.

A team of surgeons at St Mary’s Hospital, Paddington, had their pagers replaced with Palm Tungsten W PDAs, with GPRS on the Vodafone network, for three alternate weeks out of six. Several reference textbooks were also loaded onto the devices, including the British National Formulary, as well as medical calculators.

"The use of combined PDA-mobile phone devices in our pilot study suggests that this technology might reduce the time doctors take to respond to a call," said the study authors. "This is not surprising as the PDA with a mobile phone is a bi-directional device and enables faster communication between the caller and the doctor."

During the study, when doctors were contacted on their pager or PDA, response times were logged. If the surgeon took more than five minutes to respond to a call, it was considered ‘failed’. In every case, when the surgeons had PDAs they replied to messages more quickly than when they had pagers.

Omer Aziz, clinical research fellow at the department of Surgical Oncology and Technology at the hospital and co-ordinator of the study, told E-Health Insider: "Doctors traditionally communicate only through two way systems. In the past this used to be by letter, now if someone is paged they call back and you talk to them.

"Pagers are not ideal because the person being paged has to find a free phone to call back on, which can sometimes take too long. Most people won’t wait more than five minutes for a response."

The pilot also measured how smoothly the new technology was taken up by the surgeons. Despite only two clinicians in the pilot having experience of using PDAs, questionnaires throughout and at the end of the study showed a high percentage of users believing it made communication easier. Most of the staff surveyed also thought it useful to have access to electronic-based journals and reference textbooks.

Aziz said that the technology had to help surgeons do their job more quickly. "There is no point giving someone a PDA and telling them use it when it is easier for them not to use it.

"This needs to be a trust-based approach to provide useful applications on the PDA. We found that once doctors find this saves them time, and that they can do their work from anywhere in the hospital, they learn to use them very quickly."

Aziz is planning for a wider trial into the use of PDAs within hospitals, in order to make their case for further adoption of the technology: "Ultimately what we hope a larger trial will show is benefit to clinicians, ease of work, improved communication, fewer errors, and finally better patient care."

He added: "This type of initiative is likely to be easily reproducible in NHS trusts across the country, and may be one of the most important IT updates ever made in the NHS."

Since the study took place last year, Aziz and his team are currently in the process of securing funding to provide every doctors in the hospital with a PDA and to install a supporting network (either wireless LAN, or based over GPRS or 3G). Aziz added that junior doctors in the hospital would find PDAs useful in organising their time and helping their education.

The Palm Tungsten PDAs, which have come off the market since the completion of the study, were donated by Palm Europe.

Links

Handheld computers and the 21st century surgical team: a pilot study [PDF, 107K]
St Mary’s Hospital