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P&S Journal

P&S Journal: Fall 1996, Vol.16, No.3
Clinical Advances
Hand-Held Computers Help Track, Treat TB

After a three-month test run, a new system that allows nurses visiting the homes of tuberculosis patients to transmit information to CPMC via a hand-held computer and wireless modem has been deemed a success. The goal of the system, a computer linking CPMC, the New York City Department of Health, and the Visiting Nurse Services of New York City, is to better monitor the treatment of tuberculosis patients.

Since December 1995 eight nurses from the VNS have used the computer and modem when visiting the homes of all patients, including TB patients referred to the VNS by CPMC. The system reduces paperwork for the nurses by having them enter patient data only once on the computer screen as opposed to filling in multiple forms by hand or taking notes and filling in forms later. The computer uses a pen-based system instead of a keyboard for entering data. "The nurses used to spend a large part of their day writing the same patient's name and address on five different forms," says Dr. George Hripcsak, assistant professor of medical informatics. "This way they can print out five forms based on one entry of data."

Nurses also can access all records of a patient's treatment at CPMC, including the names of the doctors and social workers who worked with the patient and the name of the admissions person who referred the patient to VNS. At the other end of the connection, CPMC doctors can review the data entered by the nurses anytime they review patient records. The computerized system also automatically reports new TB cases seen by CPMC doctors to the Department of Health.

So far, the wireless computers are winning favorable reviews from the nurses. "I would be reluctant to give the computer back," reported one in an evaluation at the end of the demonstration project. "I need it for the names of the doctors, the social workers, the clinic numbers," said another. The only complaints were about the weight of the computer-3.5 pounds with the wireless modem installed.

The VNS now plans to equip 200 nurses with computers: Half will have a computer with a wireless modem system (using a different modem that weighs less than the one tested); the other half will have the hand-held computer but use a regular modem to upload all the information collected at the end of the day. The VNS hopes to equip all its nurses with computers in the next two to three years.

Dr. Hripcsak is now investigating the uses and benefits of "wiring" CPMC doctors. A pilot study started in July equipped eight doctors with a palmtop computer and wireless modem. No specific application has been set for the computer system; the pilot study will help determine which uses are most helpful for the doctors.

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