At Your Fingertips

Editor's Note: ADVANCE is proud to introduce a new column designed to provide information and reviews of PDA programs and other software used in daily practice. If you are interested in becoming a reviewer panelist or providing software for review, contact Jill Rollet at jrollet@merion.com.

Pediatrics Software Integrates PDA and Internet

CogniQ Pediatrics - Platinum. Howard Bauchner, Robert Vinci, Melanie Kim, David Tatro, PharmD. 2003, $149.95, Facts & Comparisons and PocketMedicine.com. For Palm OS (6.5 MB) and Pocket PC (6.4 MB) personal digital assistants. Unbound Medicine, www.unboundmedicine.com.

Reviewed by Colleen Hughes, NP, a pediatric nurse practitioner at Premier Pediatrics in Lakewood, Ohio.

CogniQ Pediatrics is a system that integrates handheld devices with the Internet. The platinum version of this software features four databases: A to Z Drug Facts, Drug Interaction Facts, MEDLINE Journals and Pocket Pediatrics.

A to Z Drug Facts is a basic drug guide. Features found here but not consistently available in similar packages include lab interactions, assessment and interventions, and patient education. Insurance formularies and cost information are not included. The database does not indicate whether a drug is available over the counter or whether it's a controlled substance.

Drug Interaction Facts allows the user to select any number of medications and check for interactions. It discusses the onset and reasons for anticipated reactions and interaction management. It also indicates whether interactions are well documented in the literature. The user can also request more information online, and a list of additional references will appear the next time a hot sync operation is completed.

The Medline Journals channel is a unique feature of the CogniQ package. Current journal tables of contents and abstracts, which are delivered to the handheld device monthly. A list of journals is pre-selected for the user, but the list can easily be customized. Some of the articles show only the abstract or citation, but others offer the full-text option online. Some full articles are available only with a journal subscription, site pass or single-article fee. There is also an option to find related articles. CogniQ provides a Folder Manager so users can save articles to a library.

The final component is Pocket Pediatrics, which discusses hundreds of common pediatric illnesses. It includes history and physical parameters, tests, differential diagnoses, management and follow-up care. Again the user can request additional information from online sources, which will be added at the next hot sync. The data provided in Pocket Pediatrics is detailed, yet easily understandable. It offers a nice review for someone who is already familiar with a particular disease process and a starting point for those not yet encountered. When the desired entry does not yield results, you have the option to go to CogniQ's question-and-answer feature and perform a Medline query.

CogniQ Pediatrics is a comprehensive program that can serve as the only software on your handheld device, or it can supplement other programs. It is an excellent resource and would be especially helpful to students and new nurse practitioners.

Patient Tracking Software for the Mobile Age

ePatient for Palm OS. 2003, $139.99, IatroSoft Corporation. For Palm OS (3MB) personal digital assistants. www.iatrosoft.com.

Reviewed by Colleen M. Grebus, NP, a family nurse practitioner at Primary Care of Milford in Milford, N. H.

The ePatient database is designed to manage patient information on a mobile platform your Palm OS device (the ePatient PocketPC is not yet available). The software has built-in security with password protection. It features ePrescribing capabilities, customizable drop-down templates for quick selection of clinical data, and several clinical references.

This software will accommodate charting by exception or full-text documentation for all patient encounters including new visits, procedures, histories and physicals. The charting by exception feature allows the user to create profiles for common diagnoses and then quickly edit for specific patients. Users can also track vital signs, build medication profiles, and order and track labs, cultures and diagnostic tests.

ePatient includes a formula calculator that is helpful but perhaps more applicable to an inpatient than outpatient setting. The included clinical references from MICRODEX Thomson Healthcare include a PDR Concise, AltMedex Points, ToxPoints, DrugPoints, My Rx and an English-Spanish Translator.

After some difficulties with installation, I was very impressed with this software. Screens are uncluttered and intuitive. Pull-down menus contain words or phrases that allow the user to choose data to be entered for the patient encounter. Unfortunately, menus close immediately after each single selection, which might frustrate users who would prefer to choose several items from these lists before they close.

The templates in the downloaded software are limited but easily expanded. The task list feature allowed me to keep an ongoing list of unfinished items for patients. I could view all tasks or only those tasks for a specific patient.

The clinical references are good, but the format requires constantly selecting an item that then opens another list. This is not as user friendly as most of the popular drug and clinical references. Toggle buttons don't allow scrolling down the screen, and the onscreen side bar is hard to use for scrolling slowly - it moves too quickly, causing me to overshoot the information I'm looking for.

Despite these difficulties, the information in the software's databases is accurate and complete. I didn't try the ePatient Messenger that allows a user to send or receive patient notes from another ePatient user. These notes are sent to the specific user after hot sync. I believe this feature would be compliant with the new HIPAA standards because patient information would be shared with only a selected affiliated ePatient user.