For safety reasons alone, Michael Nochomovitz puts personal digital assistants (PDAs) that enable electronic prescribing at the top of his list of the most physician-friendly, high-tech gadgets on today’s market. The president and chief medical officer of University Hospitals Medical Practices (UHMP) in Cleveland says a PDA’s wireless hand-held technology allows doctors to access software that prints clear, legible prescriptions and electronically sends them to the pharmacy of their patients’ choice. Most e-prescription software also allows physicians to review insurance coverage, check for potentially harmful drug interactions, and screen for drug allergies recorded in patients’ charts.

And it’s inexpensive.

One e-prescription service provider, Allscripts, works on any Palm-based operating system, including the Palm T/X Handheld PDA, which retails for around $300. Although PDAs entered the market as wireless personal organizers, they now include Web browsers, e-mail functionality, and wireless networking enabled by Bluetooth technology.

“The use of PDAs for electronic prescribing is, I’d say, the most important advance in medical technology over the past couple of years,” says Nochomovitz. He notes that 40 offices in his medical group are participating in a national study sponsored by the federal government on e-prescribing. “Writing prescriptions by hand is more cumbersome, less convenient, and, frankly, less safe.”

Nochomovitz says the 330 physicians at UHMP write thousands of e-prescriptions each month using Hewlett-Packard’s iPAQ Pocket PC, a PDA that retails from $300 to $600. Other PDAs that enable affordable electronic prescribing include the Toshiba Pocket PC, Dell’s Axim Pocket PC, and the ACER n30se.

Computing on the go

The tablet PC has come a long way, too. John McCallister, director of information technology for Huntington Internal Medicine Group in West Virginia, says the highly portable technology has fast become an invaluable tool at hospitals and private practices across the country.

Tablet PCs, which also support e-prescribing, provide easy access to data, such as patient charts and test results, in the exam room or on the road. Using a stylus, doctors can update patient files, schedule appointments, and even illustrate procedures on the screen for patients. Tablets also give physicians the ability to connect to their desktop computers, servers, or EMRs. “We’re beginning to test scanning chart images so our physicians and patients can see them on the wireless tablet,” McCallister says, noting that the doctors in his practice already use the Motion Tablet PC to access patient files and send and receive e-mail.

Screen size, weight, and memory capacity dictate a tablet PC’s price. The Motion Tablet LE 1600 with a 12-inch screen starts at $1,999. The LS800 version, with its 8.4-inch screen, is $100 less. Hewlett-Packard also competes with its tc4400 tablet PC, which sells for $1,500; Gateway’s Convertible Notebook is priced at $999.

Self-serve technologies

From a cost-savings perspective, practice management consultant Elizabeth Woodcock in Atlanta gives her highest marks to patient kiosks — free-standing computers stationed in medical practice waiting rooms that allow patients to check themselves in and out of the office, submit copays, and electronically sign medical authorizations. Front-desk staff receive this information electronically and can use it to verify insurance eligibility before providing treatment. Kiosk technology has been readily available at airport terminals for several years, allowing passengers to avoid long lines by checking themselves in. The functionality that kiosks provide in medical practices may also take the form of wireless clipboards.

“This technology is a great return on investment, especially when it’s equipped with advanced features like insurance verification and collecting copays with credit cards,” says Woodcock. “It’s still very new, but we’re starting to see them at larger practices in urban markets.”

Vendors who supply kiosks include Galvanon in Maitland, Fla., which sells the MediKiosk. Clearwave Corp. in Marietta, Ga., charges roughly $3,000 per kiosk, plus a one-time $1,500 installation fee and a $200 monthly fee for access to Web-based applications; it also offers monthly leasing plans. Company spokeswoman Danielle Misko says practices that purchase their stand-alone kiosks typically see a $15,000-to-$25,000 return on investment within the first year. She adds that groups that integrate kiosks into their existing practice management systems can expect an average ROI of $30,000 to $40,000 per year.

More than a phone

Smart phones — relative newcomers to the mobile device market — are especially poised to revolutionize how doctors do business, says Rosemarie Nelson, a consultant for the Medical Group Management Association. This technology is designed to combine the functionality of PDAs with the voice capabilities of cell phones, allowing doctors to talk with colleagues, surf the Web, send e-mail, and browse clinical reference tools — all with a single, hand-held device. Many smart phones, including the Palm Treo, also act as digital cameras and text-messaging devices, and they offer Bluetooth technology that can enable wireless connections to other Bluetooth devices, such as headsets or car kits.