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Using Wireless Handheld Computers to Seek Information at the Point of Care: An Evaluation by Clinicians

^a Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, DHHS, Bethesda, MD
^b John A. Burns School of Medicine, University of Hawaii, Honolulu, HI.

^_* Correspondence: Dina Demner-Fushmen, Lister Hill National Center for Biomedical Communications, National Library of Information, 8600 Rockville Pike, Bethesda, MD 20894 (Email: ddemner{at}mail.nih.gov).

Received for publication: 03/06/07; accepted for publication: 07/14/07.

Objective: To evaluate: (1) the effectiveness of wireless handheld computers for online information retrieval in clinical settings; (2) the role of MEDLINE® in answering clinical questions raised at the point of care.

Design: A prospective single-cohort study: accompanying medical teams on teaching rounds, five internal medicine residents used and evaluated MD on Tap, an application for handheld computers, to seek answers in real time to clinical questions arising at the point of care.

Measurements: All transactions were stored by an intermediate server. Evaluators recorded clinical scenarios and questions, identified MEDLINE citations that answered the questions, and submitted daily and summative reports of their experience. A senior medical librarian corroborated the relevance of the selected citation to each scenario and question.

Results: Evaluators answered 68% of 363 background and foreground clinical questions during rounding sessions using a variety of MD on Tap features in an average session length of less than four minutes. The evaluator, the number and quality of query terms, the total number of citations found for a query, and the use of auto-spellcheck significantly contributed to the probability of query success.

Conclusion: Handheld computers with Internet access are useful tools for healthcare providers to access MEDLINE in real time. MEDLINE citations can answer specific clinical questions when several medical terms are used to form a query. The MD on Tap application is an effective interface to MEDLINE in clinical settings, allowing clinicians to quickly find relevant citations.