News: Metaworks

Pocket Doctor

by Virginia Beaton

March 12, 2002, The Chronicle-Herald

DR. DENNIS BOWIE calls his Palm hand-held computer his "peripheral brain.
 
"I came to the hospital without it one day and I felt lost," jokes Bowie, a respirologist at Queen Elizabeth II Health Sciences Centre in Halifax.
 
Bowie and his colleagues in the respirology clinic are all avid users of Palm technology and, in particular, a series of health-care applications developed for Palm Canada by Metaworks Inc., a Halifax software company.
 
"We create applications to help doctors with their daily routines," says Christopher Hachey, Metaworks' executive vice-president.
 
Hachey said the firm began working on the applications about a year and a half ago.
 
"It was a fluke," he remembers, saying their other projects ranged from data collection and management for a large food broker to a MetaGuide for the Atlantic Film Festival.
 
"Now it's become part of our core business."
 
Doctors are taking up hand-held computers in ever-increasing numbers, says Hachey. Quoting a study by the Canadian Medical Association, he says "something like 25 per cent of doctors under age 35 have used one."
 
He said it's estimated the shortage of family doctors and other physicians will become more acute over the next decade. The rest will be under heavy pressure and he predicts they'll be grateful for wireless technology like Palm which, he believes, will help streamline and speed up the workload, adding "it's consistent, speedy and cost-effective."
 
Instead of a time-consuming search through reference books for data on prescription drugs or other medical treatment, information retrieval is instantaneous with the Palm, plus the appropriate Metaworks application.
 
"The biggest asset of the hand-held technology is the time," says Hachey, adding the various applications can do anything from calculating blood-gas values to carrying entire patient histories.
 
"The power of the tool is that it's a computer in your hand."
 
Metaworks uses Mantis, its original product, to create a selection of calculators, analysis engines and reference tools as applications for health professionals.
 
The applications include Apache II Version 2.0, a scoring method measuring the severity of an illness in very sick patients; Top Flow Version 1.0, which allows quick calculation of cardiac outputs for a range of cardiac indexes using the patient's height and weight; and Respirology Version 1.0, a data collection tool that helps select patients for research study.
 
Metaworks is also working on a medical dictionary and a pharmaceutical company has asked it to develop a drug interaction application. "There are so many new drugs now, it's difficult to keep up with them," Hachey observes.
 
He credits the Medical Society of Nova Scotia and its information-technology director, Steve Anderson, for being forward-looking in the society's approach to the new technology.
 
"We have a partnership with them," Hachey says. "We can ask 3,000 doctors what their needs are. It's a great test market."
 
Doctors use hand-helds for many purposes, but there are several topics about which they frequently make inquiries, Hachey says.
 
"Number one, they're requesting information on diseases. Following that is product information and next is treatment."
 
At first some doctors were skeptical, Hachey admits. "When I first went to see the people in the respirology department at the QEII, three out of 20 were using hand-helds."
 
Gradually that changed as they saw the advantages, he says. "On my second visit half the people were using them and by the third time, they all had them."
 
Bowie is one of those doctors. He believes Palms help staff efficiently communicate medical information about patients on the ward. It saves time scribbling notes and directions and eliminates paperwork, he says.
 
"I used to carry file cards and I still do," says Bowie, pulling a small stack of three-by-five cards out of his pocket.
 
"But with the Palm, I can carry so much more information."
 
One important function has been that with Palms, respirology staff can quickly collect data to help them select patients for clinical trials.
 
"So if we're doing drug trials, I automatically put it in and it loads to a program on the computer," says Bowie.
 
It's also easier now to assess the chance of risky drug interactions. "For instance, people who have had lung transplants are taking lots of drugs. We have to check their prescriptions to make sure there will not be any cross-reactions."
 
Before, Bowie would use a hefty reference book called the Compendium of Pharmaceuticals and Specialties. Now he gets the required data quickly and efficiently through his Palm.
 
The Palm even reminds Bowie to make phone calls at certain times ("I can set it with an alarm to go off") or check a patient's progress.
 
Since he began using the Palm, Bowie has gone from being what he calls "a neophyte" at wireless technology to being a daily user "but I'm probably using only half the capacity that I could," he speculates.
 
"I carry it with me all day and don't put it down until I go to sleep at night. . . . I carry it on weekends, to a hockey game even."
 
Bowie predicts the trend toward using wireless technology will increase, both for doctors in private practice and at hospitals.
 
"I'd say that in 10 years' time, every doctor will have one in his or her pocket."