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Holy PDAs! It’s Point-of-Care to the Rescue
Spend time at a hospital these days, and you’ll notice physicians sporting utility belts rivalling those in Batman comics. With over 80% of US medical students and 50% of US practitioners regularly using handheld devices, demand for high-quality, up-to-the-minute healthcare information delivered via PDAs and other mobile devices is growing rapidly.
Elsevier’s approach to the challenge of providing clinicians with the latest, most reliable information to work into their patient care plan rests on several integrated initiatives. Elsevier’s Chief Technology Officer David Marques explained, "Content becomes much more valuable when it’s optimized for a specific use and framed within the context of a user's goal. By enabling our customers to extract the pieces of content that matter to them at a particular moment and providing them with the flexibly to combine them, we offer maximum value.”
In the last ten years, Evidence-Based Medicine (EBM¹) has emerged as one of the most significant trends in health care and education. For healthcare students and professionals alike, the problem has always been how to take the neat theory of EBM and apply it to the messy, hectic world of clinical practice.
FIRST Consult ( www.firstconsult.com) is Elsevier’s Web- and PDA-based system that enables users to access and digest, within a couple of mouse clicks, exact snippets of clinical information. Highly specific content is accompanied by summaries and citations to supporting literature, a feature that really does take EBM out of the textbook and into real life².
Holly Harden, Liaison Librarian, Johns Hopkins School of Medicine, commented, "In a point-of-care environment, it's essential for clinicians to have access to the latest evidence-based information. FIRST Consult provides them with a very comprehensive tool for clinical decision making, offering immediate diagnosis and treatment protocols from qualitative and critically appraised sources within moments. It mirrors our commitment - to offer the most advanced tools available, providing a higher level of training for students and ultimately greater quality care for patients."
Achieving this goal does not simply involve repurposing existing content. An editorial board of leaders in primary care and specialty medicine works with medical writers and reviewers to update FIRST Consult every week, ensuring accuracy and currency. To facilitate usability, a highly templated structure helps physicians learn where to find what they need fast.
Demand for wireless delivery is strong with the number of “wired” hospitals increasing all the time. Elsevier reports that FIRST Consult wireless delivery will be offered from May 2004, and that it is compliant with the latest Wi-Fi technologies.
Underlying development of Elsevier’s point-of-care content is POCKET Consult, a highly advanced versatile platform for handheld content delivery. POCKET Consult (launching this May) is a fully integrated one-stop site allowing healthcare professionals to access and manage Elsevier’s handheld content in the health sciences. Via this new service, users will receive free access to news and drug alerts from MD Consult; a suite of medical calculators; and the latest tables of content and abstracts from Elsevier journals. It will also be possible to order and download Elsevier handheld titles via PDA using POCKET Consult’s online store.
For subscribers to services such as MD Consult and FIRST Consult, POCKET Consult will include Mosby’s Drug Consult, delivering 950 updated drug monographs and an all-new drug interaction tool, Mosby’s IX. Cross-linking capabilities will allow users to look up drug information instantly by selecting drug names in other Elsevier handheld titles.
Beginning with the release of Cecil Textbook of Medicine in December 2003, POCKET Consult’s groundbreaking technology is also being integrated into Elsevier E-ditions™, allowing users to select and download content to handheld devices to create customized references. Each time users hotsync their PDAs, content, drug information and news is automatically updated. “With the rapid growth in PDA usage amongst medical practitioners, residents and students,” observed Fiona Foley, Executive Vice President, Elsevier Global Medicine. “It’s a natural evolution that users are demanding rapid access to key clinical and educational content at point of need. POCKET Consult gives our customers one-stop delivery of a wealth of handheld information in an easy-to-use and flexible format.”
PDAs are part of the day-to-day medical environment and Elsevier recently announced plans to upgrade most of their current handheld products, such as FIRST Consult Handheld and MDC Mobile to include POCKET Consult technology. Physicians are superheroes to their patients. Like Batman and Robin’s, let’s hope doctor’s utility belts are fully loaded with all the ammunition needed. 
1. Sackett, D.L., Rosenberg, W.M.C., Muir Gray, J.A., et al. (1996). Evidence based medicine: What it is and what it isn't [Editorial]. British Medical Journal, 312, 71-72.
2. White, B. (2004, February). Making evidence-based medicine doable in everyday practice. Family Practice Management, 11(2), 51-58.
