PDAs Are as Indispensable as Stethoscopes at UB as Medical School Mandates Them for All Students

BUFFALO, N.Y. -- Move over, Stedman's. Make way, Netter's. At the University at Buffalo School of Medicine and Biomedical Sciences, all medical students have added something new -- and high-tech -- to their list of must-have school supplies: a personal digital assistant, more commonly known as a PDA.

The school last year began requiring all first-year students to report for class with one of the palm-sized, computer-compatible organizers. This fall, students in all four classes are expected to own one.

"In this age, having information, and the technology to obtain that information, at your fingertips is becoming standard practice," observes Margaret W. Paroski, M.D. '80, interim dean of the School of Medicine and Biomedical Sciences and vice president for health affairs at UB.

"Rapid access to information at the bedside makes a big difference in the quality of patient care. Clearly, PDAs offer significant advantages in medicine, and we wanted our students to be at the forefront of this technology."

The PDA mandate comes at a time when rapidly growing numbers of health-care professionals are using the devices to access patient data, lab results, medical reference resources and drug guidelines, all at the point of care. Students are following suit, purchasing the sleek little devices to replace handwritten "cheat sheets," dog-eared reference guides and other conventional, and sometimes cumbersome, learning materials.

"This tool is just too powerful not to be completely embedded in how medicine is practiced," says Raymond P. Dannenhoffer, M.A. '82, Ph.D. '87, associate dean for support services and director of medical computing. He estimates that only 15 to 20 percent of medical schools nationwide have created an infrastructure to formally support students' use of the PDA.

"We're not training medical students to practice today's medicine; we're training medical students to be able to practice the medicine of five and 10 years from now," Dannenhoffer adds. "If

anyone thinks that in five or 10 years some kind of handheld reference device is not going to be an absolutely irreplaceable part of how medicine is practiced, they're just missing something."

While some at the medical school quickly recognized the PDA as a powerful learning and teaching tool, it wasn't immediately clear how the handheld device could be successfully incorporated into the curriculum. That task fell to Michael S. Blumenson, B.A. '88, MBA '98, senior LAN analyst and the school's manager of wireless applications.

To Blumenson, supporting student use of the PDA entails much more than recommending a particular model and letting new users fumble through its applications on the fly.

Instead, the school is doing everything from hosting training sessions -- referred to humorously as the "PDA M*A*S*H unit"-- to creating electronic calendars for course and school events and software that connects third-year students with their clerkship directors during rotations.

Jason C. Hoffmann, who purchased a PDA before his third year of medical school, estimates that at least 75 percent of his fourth-year classmates own a PDA.

"You used to see students carrying around these huge reference books and pocket guides that didn't really fit in their pockets. Or they would have to run to the library and look everything up. But this is so compact and so much easier than a book that it's unbelievable. I'm looking forward to using mine more and more."

Throughout his third-year rotations, Hoffmann estimates that he relied on his PDA anywhere from five to 30 times a day, referring primarily to ePocrates Rx, the clinical drug reference program that contains medical information on more than 1,600 medications, including dosing, contraindications and drug interactions. During his pediatrics rotation, Hoffmann purchased the 5-Minute Pediatric Consult, a software version of the fast-access reference of conditions seen in infants, children and adolescents.

In addition to software they buy or download for free, students also are benefiting from pedagogical programs that UB has tailor-made for their needs. The teamwork of Blumenson and medical computing programmer Mark Schneggenburger has resulted in the UBMobileMed application. One facet of this program helps students during their clinical rotations. Known as the Patient Encounter, it allows them to jot down patient information on their PDA and send the electronic reports to their clerkship director via the Internet.

"With the Patient Encounter, medical students quickly capture the essence of the patient they're seeing," explains Blumenson, who adds that all the information revealed complies with the privacy requirements of the Health Insurance Portability and Accountability Act. "They can record ethnicity, gender, what hospital they're working at and the attending they're working with; they also capture what diagnoses they're exposed to and what procedures they're observing, assisting or performing."

The traditional method of sending and receiving information on a PDA requires a cradle attached to a personal computer. Using infrared technology, however, UB students, residents and faculty can transmit that information directly to the medical school without relying on either piece of hardware.

"The implications are significant," Blumenson says. "We are giving remote students the 'conduit' to send almost real-time data to the school. Likewise, the school can send important updates to the remote student and know that enhancements and schedule changes will be seen and read in a timely fashion."