Full Dissertation "Wireless PDA Applications in Healthcare"

Overview of Wireless PDA applications in Healthcare
1 INTRODUCTION
1.1 Background Motivation
“The future is wireless”, “intelligent technology communicating with each other”, all
these sentences sound familiar. “Clinical decision support systems to empower the
clinician to deliver a better healthcare quality” are ideas that throughout the Master’s
program were transmitted to the author.
After completing some assignments related to the use of disruptive technology and
Bluetooth technology in healthcare, the author felt that there is an enormous gap in the
amount of information that healthcare professionals have about this technology.
By having a special interest in mobile computing and wireless technology, the idea of
building a website dedicated to healthcare professionals was something that eventually
came to reality.
After doing an extensive research over the internet, the author wasn’t able to find one
single website which combined the basic information about the use of Personal Digital
Assistants, (PDA), Wireless Technology and Healthcare.
There are either websites which only sell PDA’s, other sell software only.
Some other websites feature Wireless technology for laptops only and are extremely
“techie”. There wasn’t any website which combines the basic knowledge that enables any
person to buy a PDA, in terms of basic functions, what to look, which operating system,
how much, etc.
Having a strong background in healthcare, the author felt that healthcare professionals
could benefit from this technology. Integrating the use of a PDA could lead to an increase
in personal productivity either at work, on the road or at home.
By compiling all this information into a website, the dissemination of information can
reach a much larger proportion of people than any other traditional method.
This report attempts to meet the demand of information about Wireless PDA Technology
serving the Healthcare community.
1.2 Main Aims
With this project, the author wishes to inform the healthcare community about the usage
of PDA mobile technology in Healthcare.
It is also an achievable aim to describe the Wireless Technology that can be used in
PDA’s.
The author also wishes to explain how the web information system was built and all the
technology used, including software for web-design, hosting protocols and the website
performance for a period of 24 months.
Finally, the author wishes to provide the reader with the web information system
evaluation, with a built in real time data analysis engine, kindly sponsored by
QuestionPro.
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1.3 Specific Goals
Some specific goals include:
Definition of what a PDA is and what it can be used for

Different available Operating Systems
Features regarding the PDA performance and usage
Describe Clinical Applications for Doctors and Nurses
Describe what Wireless Technology can be found in a PDA
Inform the process into which the specific Web Information System was built and
its Evaluation with a built in Online-Questionnaire.
1.4 Outline of Dissertation
The following chapter 2, explains the Methodology used over this Dissertation.
Chapter 3, gives an overview of PDA technology, comprising basic information
regarding the operating system, some important features to take in consideration and
some clinical applications available in the market.
Chapter 4, refers to the Wireless Technology regarding Bluetooth and Wireless Fidelity.
Here the reader can also find some of these applications in Healthcare.
Chapter 5 describes the implementation of this project as a form of a Website. The
process of creating and designing a website including the software and hardware needed
are explained in detail.
Also in this chapter, the Website evaluation, which comprises the design of an online
questionnaire directed to evaluate the user interaction and satisfaction while surfing in the
Website.
Chapter 6 concludes the dissertation with an extent to what goals and objectives were
achieved, what contributions this project made to the public, to the Healthcare
community, Health informatics and what further work and research can be done.
In order to make this reading experience more pleasant, there will be an introductory sub-
chapter in the beginning of each main Chapter, as well as a Summary which resumes the
Chapter and prepares the coming one.
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2 METHODOLOGY
2.1 Introduction
The project methodology was based in four separate areas.

The Literature Review, which enabled the author to understand the current up-to-date
information about the Wireless PDA Technology in Healthcare, visiting several websites
during the 18 month period of time. Several Online Journals, including the JAMIA
(Journal of American Medical Informatics Association).
Once the Review was being completed, the Questionnaire design came after. By using
Questionpro.com, the author came across to a large number of examples available in how
to rate and evaluate a website performance. Then, he implemented the built in
questionnaire in the website wireless-health.com so that visitors could fill in the
questionnaire. An automated response per every successful questionnaire was received as
well as a real time data analysis performed.
The conceptual map of the website was the next step. During the Healthcare
Technologies course, the author learnt how to design a website in order to complete one
assignment for a Telemedicine project. Combined with several hundred hours reading,
learning and experimenting, the author used several tools available in the market, such as
Macromedia Dreamweaver, Flash MX and others.
The website design included several specific areas in which the author would enable
every visitor to quickly access relevant information according to the clinical area of
expertise.
Finally, the evaluation of the overall performance was completed and rated with a
comprehensive statistical analysis of how many visitors, page views, duration of stay and
other important parameters during the 18 month period of time.
2.2 Literature Review
Literature review has been done using online journals and several Websites.
During the review, the author has not come across a single website that would compile
Hardware Reviews, Software Applications and Wireless Technology explained especially
dedicated to Doctors and Nurses.
There were several papers from the Journal of American Medical Informatics Association
which described some applications of Mobile and Wireless Technology in Healthcare.
Most of this information has been compiled through research studies in specific areas,
such as Diabetes Mellitus, Cardio-Thoracic departments and Outpatient clinics.
Not a single website was found using popular search engines, such as Google, Yahoo,
MSN. The Keywords used were:
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PDA, Clinical, Applications, Software, Bluetooth, Wi-Fi, Wireless Technology,

Healthcare, Doctors, Nurses, Medical, Nursing. A compilation of suggestive keywords
was also done, being the “PDA in Healthcare” the most complete one, returning better
results.
Desktop research has also been done through major clinical databases, using PubMed and
AMIA.
Web information found in popular websites is dedicated to general buyers, who are
looking for a Mobile Device and can browse through different manufacturers, operating
systems and price. Most of these websites were accessed during the period of 2003-2005
and become obsolete with outdated information, such as discontinued devices and
sometimes were the whole web infrastructure had disappeared.
There are however some websites dedicated to Doctors, Nurses, Radiographers and other
healthcare professionals. Most of these websites discuss specific applications in
specialities, such as Surgical, Cardiac, Orthopaedics, Critical Care, etc.
The downside is that once the user has found the best software application to use in the
daily clinical activity, there is no support to select the best hardware device and which
Wireless Technology.
The author wishes to enable every reader with a tool that will help to select the best
Mobile Device, the appropriated Wireless Technology and the best clinical application
piece of software available in the market.
2.3 Online Questionnaire
The objectives of the research study also incorporated the evaluation of the performance
of the website. Therefore, some relevant information would need to be asked. The output
report would incorporate graphics and statistical information that was learnt during the
Master’s.
The Questionnaire design incorporated 23 questions, regarding the website performance.
Please refer to Table 1. to learn more about the questions asked in the survey.
It was a completely voluntary questionnaire which was sent to students and teachers from
the MIM Centre, School of Informatics, City University.
Interestingly, most of the results were obtained from internet surfers, who found the
website and then kindly filled in the questionnaire.
The total number of completed responses was 74 and 123 people have started answering
it. The average time taken to complete was 6 minutes.
A full description was made available to users which informed them about the academic
purpose of the website. Data was confidential and users could see the results immediately
after filling in the overall questionnaire. This was only possible with the real time data
analysis engine built in by Questionpro.com.
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Fig. 1: Online Questionnaire Preview
2.3 Conceptual Map
This project’s map was planned according to the latest research developments that
combine an analogue and digital experience to the reader. In order to make it a
sensational experience, all the content available in this paper is also available in the
website.
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A user selection was customized according to Doctors and Nurses.

Each healthcare profissional should be able to find their own software application,
relevant to their clinical practice, as well as a PDA and type of wireless communications
options.
In order to properly measure the performance of the website, an online questionnaire was
designed, incorporating relevant questions to the user satisfaction when surfing a website.
This questionnaire would then feed a database of which the author was able to extract the
adequate statistical graphical information to insert in this paper’s tables.
As a final step, this project’s concept also includes future ideas for other readers wishing
to research this interesting area of Health Informatics and to enable the author with a
future possibility to undertake a PhD in Health Informatics.
Therefore, this conceptual map leaves room for further research and improvements in the
website experience as well as in this paper’s
contents.
Fig. 2: User Value Drivers for Wireless Technology in Healthcare
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2.4 Design
This paper’s design has incorporated an extensive research in how to enable a reader to
spend an hour entertained in reading the paper as well as visiting the website.
A colour-full picture, summary tables for the paper and dynamic animation, including
flash technology was used in order to make a greater overall experience.
The table of contents design was also carefully selected, with a rational sense of critical
importante and logical order of ideas.
2.5 Evaluation
Evaluating this project is made possible through the written quality of text and by the user
satisfaction from the website.
While the reader will create an idea about the quality of the paper, internet users have
already evaluated the website performance.
2.6 Summary
This paper’s methodology was created with the critical feeling of research and
contribution to the Health Informatics Community regarding the implementation of a
combined paper based project and one online web information system,
www.wireless-health.com.
The next chapter explains PDA technology, specially designed for Doctors and Nurses.
3 OVERVIEW OF PDA TECHNOLOGY
3.1 Introduction
This chapter will discuss the PDA technology available in our today’s markets, as well as
important features, containing Wireless technology, different Operating Systems
available, clinical software designed for Doctors and Nurses and an overall idea about
how to select the right PDA.
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3.2 Definition of PDA
(Personal Digital Assistant) is a handheld computer that serves as an organizer for

personal information. It generally includes at least a name and address database, to-do list
and note taker. PDAs may be combined with mobile phones and other wireless
technologies, providing a mobile office for people on the go.
In addition to including such applications as a word processor, spreadsheet, calendar, and
address book, PDAs are used as notepads, appointment schedulers, and wireless
communicators for sending and receiving data, faxes, and electronic-mail messages.
PDAs are pen based and use a stylus to tap selections on menus and to enter printed
characters. The unit may also include a small on-screen keyboard which is tapped with
the pen. Data are synchronized between the PDA and desktop computer via cable or
wireless connection.
Fig. 3: Example of Latest PDA
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3.3 Operating Systems
3.3.1. Pocket PC OS
According to Microsoft, the Pocket PC is "a handheld device that enables users to store
and retrieve e-mail, contacts, appointments, play multimedia files, games, exchange text
messages with MSN Messenger, browse the Web, and more." [1]
From a technical standpoint, "Pocket PC" is a standard from Microsoft that sets various
hardware and software requirements for mobile devices bearing the "Pocket PC" label.
For instance, any device which is to be classified as a Pocket PC must:
Run Microsoft's Windows CE (PocketPC version) operating system

Come bundled with a specific suite of applications in ROM
Include a touchscreen
Include a directional pad or touchpad (case of HP iPAQ hx4700)
Include a set of hardware application buttons
Be based on a ARM version 4 compatible CPU, Intel XScale CPU, MIPS CPU or
SH3 CPU. (Pocket PC 2002, codenamed Merlin, works only with ARM-based
CPUs.)
Versions
Microsoft's current release is Windows Mobile 2003 Second Edition, which adds native
landscape support as well as other fixes and changes to those features already present in
the original release of WM2003. The first device to come with 2003SE was the Dell
Axim x30.
The previous operating system, Microsoft Windows Mobile 2003 for Pocket PC, consists
of the Windows CE.NET 4.2 operating system bundled with scaled-down versions of
many popular desktop applications, including Microsoft Outlook, Internet Explorer,
Word, Excel, Windows Media Player, and others. Past Pocket PC operating systems
include Pocket PC 2002 (launched October 2001) and Pocket PC 2000 (launched April
2000), both running Windows CE 3.0 underneath.
Windows Mobile 5, internally code-named Magneto, was officially released by Microsoft

on May 10, 2005. Based on Windows CE 5.1, Windows Mobile 5 incorporates features
such as Direct3D Mobile, integrated Bluetooth and WiFi stacks, and the ability to be
mounted as a USB Mass Storage device, bypassing ActiveSync. Pocket Word and Pocket
Excel have been renamed Word Mobile and Excel Mobile, respectively, and both
applications have gained more complete feature sets, including support for tables, ordered
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lists, and embedded graphics in Word Mobile, and support for charts in Excel Mobile.
PowerPoint Mobile, a new addition to the Office Mobile suite, supports the ability to
display and edit PowerPoint presentations on a Pocket PC. Windows Mobile 5 also
improves support for one-handed usage by inserting two, context-sensitive "soft" buttons
at the bottom of the screen which can be mapped to hardware buttons on any specific
device.
Windows Mobile 5 marks the convergence of the Phone Edition and Professional Edition
operating systems into one system that contains both phone and PDA capabilities. A
'Phone' application is now included in the OS, and all PIM applications have been
updated to interface with it. Windows Mobile 2005 is compatible with Microsoft's Smart
phone operating system and is capable of running Smart phone applications.
Pocket PCs running previous versions of the operating system generally stored user-
installed applications and data in RAM, which meant that if the battery was depleted the
device would lose all of its data. Windows Mobile 5 solves this problem by storing all
user data in the ROM, leaving the RAM to be used only for running applications, as it
would be on a desktop computer. As a result, Windows Mobile 5 Pocket PCs generally
have a greater amount of flash ROM, and a smaller amount of RAM, compared to earlier
devices.
3.3.2 Palm OS
Palm OS is an operating system made by PalmSource, Inc. for PDAs, manufactured by

various licensees. In May 2005, PalmSource sold the rights to the Palm name to
palmOne. As of August 2005, the new name for Palm OS (and PalmSource) has not been
announced.
Two major versions of Palm OS are currently under development: Palm OS Garnet (5.x),
and Palm OS Cobalt (6.x). The names were introduced in February 2004 in an attempt to
make it clear that 5.x development would not stop while 6.x development was
ongoing[1]. As of August 2005, all devices use Palm OS Garnet. Likely as a result of
Palm OS Cobalt's lack of adoption, PalmSource has shifted to developing Palm OS
Cobalt's APIs on top of a Linux kernel.
Palm OS licensees decides which applications are included on their Palm OS devices.
Licensees can also customize the applications. Below are some of the most common
PalmSource applications included with the Palm OS:
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Address Book/Contacts
The Palm's Address program stores personal information, keyed by any of several user-
definable categories. Entries are displayed and sorted in last name, first name order (this
can be changed only to Company, Last Name order). There are five slots for phone or e-
mail, each of which may be designated Work, Home, Fax, Other, E-mail, Main, Pager or
Mobile (the slot designations cannot be changed).
Calculator
CalculatorCalc turns the Palm into a standard 4-function pocket calculator with three
shades of purple and blue buttons contrasting with the two red clear buttons. It sports
square root and percent keys and has one memory.
It also has an option to display a running history of the calculations, much like the paper-
tape calculators that were once common.
Starting in Palm OS v. 5.4 Garnet, the calculator has a menu option to switch to an
advanced mode, which features several button layouts that pertain to specific jobs. These
modes include: Math, Trig, Finance, Logic, Statistics, Weight/Tmp, Length, Area, and
Volume.
Date Book/Calendar
Date BookDate Book shows a daily or weekly schedule, or a simple monthly view. The
daily schedule has one line per hour, between user-selected begin and end times. Clicking
on an empty line creates a new appointment. Empty lines are crowded out by actual
appointments, whose start and stop times are shown by default bracketed in the left
margin.
An appointment can be heralded by an alarm, any number of minutes, hours or days
before it begins. These alarms sound even when the unit is switched off.
Appointments can recur in a specified number of days, weeks, months or years -- and can
contain notes.
Expense
The Expense application allows a user to track common business expenses. No totals are
calculated on the Palm. The user must sync with a host computer and view the expense
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data in a worksheet (templates for Microsoft Excel are supplied). NOTE: Not included on
all Palm OS devices.
HotSync
HotSyncThe HotSync application provides integration with the user's PC. Usually
activated by a press of the physical HotSync button on the Palm's cradle (a dock station),
this application communicates with various conduits on the desktop PC to install
software, backup databases, or merge changes made on the PC or the handheld to both
devices.
In addition to the conduits provided by the licensee, developers can create their own
conduits for integration with other Palm OS applications and desktop products. For
example, a time tracking package could provide a conduit to communicate information
between Palm OS and Windows executables.
A Backup conduit included with the HotSync software backs up (and restores, if
necessary) most of the data on a Palm OS device. This allows users to hard reset their
Palm -- thus, clearing all of the data -- with few noticeable consequences. This also
allows users to migrate to new Palm devices of the same Palm OS version, a feature that
is helpful to those who lose or damage their device.
Some models of Palm keep their data storage in volatile memory and require constant
power to maintain their memory. Although these handhelds attempt to save the contents
of memory in low battery situations by not "turning on," leaving a "dead" handheld for an
extended period of time can cause this reserve power to be used up and the contents of
storage memory to be lost. Some later Palms use NVRAM or microdrive for storage.
Memo Pad/Memos
Memo PadThe Memo Pad can hold notes of up to 4,000 characters, keyed to user-
configurable categories. Memos are ordered in two ways: alphabetically, and manually
(which allows the user to choose the order of the memos). Memo Pad is for text, not for
drawings. For this reason, text in Memo Pad must be entered using the Graffiti alphabet.
Note Pad
Note PadDrawings go in Note Pad. You can squeeze up to 10 words per page, if your
writing is neat. Otherwise, it's better to put text in Memo Pad. There are three sizes of
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drawing crayon, plus an eraser and a background color change feature. It's possible to
draw a very simple map.
Note Pad appeared on most Palm OS PDAs starting with Palm OS 4.0; certain PDAs with
previous versions of Palm OS did not include this application.
To Do List/Tasks
To Do listAlso referred to as Task list.

vThis is a convenient place to create personal reminders and prioritize the things you
have to do.
Each To Do List item may also have: a priority, categories (to organize and view items in
logical groups), attached Note (to add more description and clarification of the task).
To Do List item can be sorted by: due date, priority or category.
Starting with the OS version 5.2.1 (which was released in the Tungsten T3, Tungsten E,
Zire 72) PalmOne, Inc. released their own version of this application, called Tasks, in
which alarms may be assigned to tasks, and can be made to repeat.
Third-party applications
There are many successful applications that can be installed on a Palm OS device. As of
August 2005, there are more than 20,000 third-party applications available for the Palm
OS platform, which have various licensing types, including open-source, freeware,
shareware, and traditional commercial applications.
3.3.3 Linux OS
The Linux OS is supported by three major Hardware manufacturers: AGENDA, ROYAL

and SHARP.
LINUX OS has the advantage of being totally customizable by software programmers.
You can in fact totally customize the keys and also develop your own application. Some
LINUX applications include embedded programs in other OS. The Sharp ZAURUS, the
latest model offers a fantastic processing speed with multiple features, including Compact
Flash type II slot AND an internal MMC/SD slot. These will allow you to use accessories
memory cards, modems and network cards (including wireless network cards)
simultaneously if you wish.
Due to its small coverage in terms of Worldwide markets and very few clinical
applications made available, the author will skip this OS and concentrate more in the two
most common Operating Systems described above: The Pocket PC and the Palm OS.
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3.4 SOME IMPORTANT FEATURES IN ALL PDAs
3.4.1 Processor Speed
Processor speed affects all aspects of any client software that runs on a PDA and is
therefore very pertinent to the usability of that software. Devices running Palm OS have
processor speeds between 33 and 400 MHz; those running Windows CE have processor
speeds between 133 and 600 MHz. The speed of image loading, simple pan and zoom
functions, and image information display is acceptable on most PDAs. However,
processor-intensive image manipulation can be carried out in real time only on the newer
Pocket PC and Palm PDAs. Image manipulation such as adjustment of window width and
level can be implemented in real time only on a device with a processor speed of 133
MHz or more. In addition, most newer processors have two-dimensional graphics
acceleration hardware that significantly increases the image display frame rate.
3.4.2 Installed Memory
The amount of built-in and expansion memory dictates how many images can be kept on
a PDA. Devices that run Palm OS have 2–64 Mbytes built in, with an expansion
capability of up to 512 Mbytes, whereas those that run the Windows CE operating system
have 16–128 Mbytes onboard with an expansion capability of up to 80 Gbytes. However,
unlike onboard flash RAM or synchronous dynamic RAM, expansion cards usually have
a greatly reduced data access speed. Furthermore, expansion cards use additional power
and thereby reduce battery life to an extent dependent on the card type. To increase
battery life, some expansion packs include an extra battery. Some PDAs now come with
two or more expansion card options, allowing at least some choice in the expansion cards
that can be used. The read speed also depends on the bus and processor speeds of the
PDA. PDAs with processor speeds under 133 MHz provide read speeds of only about 200
Kbytes/sec.
3.4.3 Screen
PDAs use an LCD (liquid-crystal display) screen. Unlike the LCD screens for desktop or
laptop computers, which are used solely as output devices, PDAs use their screens for
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output and input. The LCD screens of PDAs are smaller than laptop screens, but vary in
size. Almost all PDAs now offer color displays.
PDA displays have the following features:
Transflective TFT (thin-film transistor) LCD for indoor and outdoor use
Different pixel resolutions with higher resolutions for better quality
Color screen
Backlighting for reading in low light
Screen resolution refers to the clarity and detail with which text and images appear on the
PDA screen. Screens are are usually classified as high or low resolution. High-resolution
screens provide at least a 320 X 320 pixel display as compared to the 160x160 pixel
display of the low resolution screens. Higher resolution output provides a sharper image
and allows some devices (e.g. Sony) to display smaller fonts which permit much more
content to be viewed on the screen.
PDA screens are also differentiated by color capability. Monochrome screens are capable
of displaying black white and a few shades of gray, while color screens can display
around 65,000 colors or more. Monochrome devices are less expensive and are adequate
for viewing most text-based sources of information typically used in clinical practice.
Color screens also put heavier demands on the battery life of the PDA than monochrome
displays. Almost all color PDAs will stand up to a full day of intermittent use.
3.4.4 Input Methods
PDAs vary in how data and commands are input. Some devices use a stylus and touch
screen exclusively in combination with a handwriting recognition program. Using a
plastic stylus, the user can draw characters on the device's display or dedicated writing
area. Software inside the PDA converts the characters to letters and numbers. On Palm
devices, the software that recognizes these letters is called Graffiti. Graffiti requires that
each letter be recorded in a certain way, and must be used with a specialized alphabet.
For example, to write the letter "A," the user draws an upside-down V. The letter "F"
looks like an inverted L. To help Graffiti make more accurate guesses, the user must draw
letters on one part of the screen and numbers in another part.
Pocket PC PDAs offer three handwriting-recognition applications: Transcriber, Letter

Recognizer and Block Recognizer. Letter Recognizer and Block Recognizer are similar
to Graffiti and require specialized alphabets. By contrast, Transcriber recognizes the
"regular" handwriting, as long as it is written legibly. It is similar to the handwriting
recognition capabilities found on Tablet PCs.
A miniature onscreen keyboard is also available. It looks just like a regular keyboard,
except that the user taps on the letters with the stylus. In addition, many devices now
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include a small QWERTY keyboard. Some of these require the use of thumbs to type. It
can also be used a full-size keyboard by connecting it to the PDA via a Bluetooth or USB
port. Each model also has a few buttons and navigation dials to bring up applications and
scroll through files.
3.4.5 Expansion Support
With PDAs seemingly following in the footsteps of the personal computer, offering an
ever-increasing standard amount of data storage, why the need for expansion memory
cards?
For one, without an expansion slot a PDA would not be upgradeable, meaning
that if the memory storage needs grew to be more than the available space on the
PDA, we would need to go out and purchase a whole new device with more memory.
Aside from adding what amounts to a “second hard drive” to the PDA, expansion cards
offer other interesting uses, such as the ability to share information (such as photos) with
other types of electronic devices, including cameras, music and video players, and
printers. Also, expansion cards are perfect for storing large files that are used less
frequently than other main applications, for example a large dictionary, travel maps, or a
clinical database.
Given these interesting applications, it is not surprising that handheld manufacturers have
sought to bring to market new devices that offer expansion memory to their customers.
Handspring was the earliest with their Visor line, offering a proprietary expansion slot
called “Springboard” as a standard component for all of their devices. Beyond expansion
memory cards, the Springboard slot has become famous for supporting miniature
cameras, barcode scanners, and modems. TRG (now Handera) offered an expandable
model called the TRGPro, which was unique in that it embraced two industry standards,
Compact Flash (CF) and Secure Digital (SD). Sony soon followed with their first Palm
OS-based PDA, the Clie (pronounced CLEE-ay), which came standard with a slot that
supported their Memory Stick technology, making their PDA compatible with Sony’s
other consumer electronics products that (naturally) supported Memory Stick.
It is now possible to buy Expansion cards up to 5 GB of memory, which enables any user
with a powerful tool, leaving the desktop behind and carrying all the information needed.
Other expansion support includes Modem Support for analogue connections, GPS for the
Navigation System, FM Radio, Barcode Scanners, Digital Cameras and Display adaptors.
3.4.6 Battery Support
PDAs are powered by batteries. Some models use alkaline (AAA) batteries, while others
use rechargeable batteries (lithium, nickel-cadmium or nickel-metal hydride). The battery
life depends on what kind of PDA and how it is used. Here are some examples that can
drain batteries:
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Operating system -PocketPC requires more power by virtue of its increased

memory requirements
More memory
Wireless connections, such as Wi-Fi and Bluetooth
Backlighting on the display
Battery life can vary from hours to months, depending upon the PDA model and its
features. Most PDAs have power management systems in place to extend the battery life.
Even if the batteries are so low that the user can no longer turn the machine on, there's
usually enough power to keep the RAM refreshed.
If the batteries do run out or if the user removes them, most devices have an internal
backup battery that provides short-term power (typically 30 minutes or less) until a
replacement is installed. If all power sources are depleted, PDAs lose all of the data in
RAM. This makes backing up or synchronizing the PDA extremely important.
In addition to battery power, many PDAs come with AC adapters to run off household
electric current. A car adapter is also generally available as an accessory.
3.4.7 Wireless Capability
PDA’s can be enabled with GSM technology, allowing a phone operation built in the
PDA. GSM technology can be used to make phone calls, send SMS and access WAP
websites.
General Packet Radio Service (GPRS) is a mobile data service available to users of GSM
mobile phones. It is often described as "2.5G", that is, a technology between the second
(2G) and third (3G) generations of mobile telephony. It provides moderate speed data
transfer, by using unused TDMA (Time Division Multiple Access) channels in the GSM
network. Originally there was some thought to extend GPRS to cover other standards, but
instead those networks are being converted to use the GSM standard, so that is the only
kind of network where GPRS is in use.
Infrared (IR) radiation is electromagnetic radiation of a wavelength longer than visible
light, but shorter than microwave radiation. The name means "below red" (from the Latin
infra, "below"), red being the color of visible light of longest wavelength. Infrared
radiation spans three orders of magnitude and has wavelengths between 700 nm and 1
mm.
IR data transmission is also employed in short-range communication among computer
peripherals and personal digital assistants. These devices usually conform to standards
published by IrDA, the Infrared Data Association. Remote controls and IrDA devices use
infrared light-emitting diodes (LEDs) to emit infrared radiation which is focused by a
plastic lens into a narrow beam. The beam is modulated, i.e. switched on and off, to
encode the data. IR does not penetrate walls and so does not interfere with other devices
in adjoining rooms.
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GPS Technology, usually called GPS, is a satellite navigation system used for
determining one's precise location and providing a highly accurate time reference almost
anywhere on Earth or in Earth orbit. It uses an intermediate circular orbit (ICO) satellite
constellation of at least 24 satellites.
The GPS system was designed by and is controlled by the United States Department of
Defense and can be used by anyone, free of charge. The GPS system is divided into three
segments: space, control and user. The space segment comprises the GPS satellite
constellation. The control segment comprises ground stations around the world that are
responsible for monitoring the flight paths of the GPS satellites, synchronizing the
satellites' onboard atomic clocks, and uploading data for transmission by the satellites.
The user segment consists of GPS receivers used for both military and civilian
applications. A GPS receiver decodes time signal transmissions from multiple satellites
and calculates its position by trilateration.
Other technology includes Bluetooth and Wi-Fi, which are explained in great detail over
the next chapter.
Fig. 4: Some of the devices used for wireless communications
3.5 Clinical Applications
3.5.1 Clinical Applications for Doctors
Realizing the potential of wireless technology in healthcare, the industry has developed a
number of applications, both clinical and administrative, to improve patient safety and the
health care delivery process. Applications can be categorized into clinical and
administrative. The two most widely used applications at the present time are described
below:
E-Prescription and Drug and formulary databases
The objective of these applications is to reduce medication errors by generating legible

prescriptions with drugs that are in the formulary of the patient’s health plan. The
physician has access to real time patient information at the point of care and can not only
18
reference the drug database and the formulary while writing a prescription but is also
alerted if there is a drug interaction in the patients medication profile, thereby preventing
any medication errors. In addition, the physician can print the prescription right
from her wireless device or send it electronically via the Internet directly to the patient’s
pharmacy. Since this is a typed and structured prescription, it reduces the pharmacy
errors due to illegible handwriting. In addition, since the physician now selects a drug
from the health plan formulary, that is available in real time, chances of selecting an off
formulary medication is highly reduced, thus reducing the call backs from the pharmacies
to ask for alternate drugs.
Patient Tracking Utilities
With this application, the physician can capture and sort patient information quickly and
easily during rounds. Some basic patient information, admission diagnoses, patient
histories, daily progress notes, and lab results can be recorded. There is also the
possibility of tracking medications being taken by patients at home and in the hospital, as
well as set alarms for reminders.
Fig. 5: Potential benefits of Wireless applications in Healthcare
3.5.2 Clinical Applications for Nurses
Nursing PDA applications can also be classified under two major areas.
Calculators with databases and drug guides built in and reference e-books which can be
used as clinical decision support systems in the Point-of-care, (POC).
19
Here the author reviews the drug guides and the reference electronic books.
Drug Guides
Applications include a detailed up-to-date and practical resource for the Palm OS and
Pocket PC operating systems.
These databases generally include trade and generic drugs, drug classifications,
monographs and commonly used combination of drugs, including the dosage amount of
the active generic ingredient. Special dosing considerations for special patients, such as
renal, hepatic, elderly, paediatric, neonatal are included in the applications enabling the
nurse with a valuable tool. Minimizing the time spent in consulting books or databases
and increasing the time spent with the patient is one major advantage.
Fig. 6: Decision power from the use of data
Reference Electronic Books
Several E-books can be found dedicated to various Nursing specialities.

Antibiotic guides, Clinical formulas, Lab Tests, ECG analysis are all common
applications that Nurses can use to empower their clinical practice.
20
3.6 Summary
In this chapter, the author reviewed extensively all the major components of a PDA, its
various Operating Systems and some available Clinical Applications for Healthcare
Professionals. Over the next chapter, a detailed review about the Wireless Technology
available in PDA’s is performed, specifically the Bluetooth and the Wi-Fi.
4 WIRELESS TECHNOLOGIES
4.1 Introduction
“The health care industry -- traditionally known as a laggard in the IT arena -- is now
emerging as a leader in adopting mobile and wireless technology. In an October 2004
study of wireless adoption in various vertical industries, market research firm IDC found
that more than 80% of 34 health care organizations polled said they have deployed
wireless LANs or plan to deploy one in the next 12 months. And according to the 2005
Healthcare Information and Management Systems Society Leadership Survey, which was
published in February, 79% of 253 health care executives responding to an online
questionnaire said they will use wireless information systems this year while 54% said
they will use handheld devices.”
Extracted from ComputerWorld, May 2005
In this chapter, the author reviews Bluetooth and Wireless Fidelity Technology,
commonly used in Healthcare settings.
Starting with the Industry definition and standards, the author also identifies where this
wireless technology is currently being used in Healthcare.
4.2 Bluetooth Technology
Fig. 7: Bluetooth Official Logo
4.2.1 Definition of Bluetooth Technology
21
Bluetooth is a standard for a small, cheap radio chip to be plugged into computers,
printers, mobile phones, etc.
Bluetooth Wireless technology was an idea that first came out in 1994 by Ericsson
Mobile Communications as a way to connect laptops and cell phones at a low cost rate.
The name of "Bluetooth" came from late 10th century Danish Viking and King, Harald
Blåtand (translated as "Harald Bluetooth" in English). He ruled a large part of what is
now Denmark and Norway. During his rule, he resolved many conflicts between his two
nations because of his ability to have them interact with each other.
A Bluetooth chip is designed to replace cables by taking the information normally carried
by the cable, and transmitting it at a special frequency to a receiver Bluetooth chip, which
will then give the information received to the computer.
Bluetooth technology revolutionizes the personal connectivity market by providing
freedom from wired connections - enabling links between mobile computers, mobile
phones, portable handheld devices, and connectivity to the Internet. Bluetooth technology
redefines the very way we experience connectivity.
Some exciting possibilities exist in the field of medical device communications and
networking. Bluetooth clearly provides an advantage for highly mobile battery-powered
devices, and it opens up the possibility for these devices to connect to a LAN or wide-
area network. Input, output, and storage can be removed from individual devices and
centralized to increase flexibility and reduce the devices' cost, size, and power. Devices
also can talk to each other within a patient-area network, which will make them less
prone to medical errors.
Bluetooth wireless technology will enable medical devices to connect more easily with
each other and to information access points provided by LANs. Bluetooth's low power,
low cost, and few configuration requirements will be traded off against 802.11b's higher
speed and easy enterprise integration. The use model and environment for each individual
application will determine the best choice for wireless data technology.
Some of common clinical devices are PDA’s, pulse oxymeters, blood glucose meters and
scales.
From the clinician’s use, sound speech recognition headsets and phone synchronization to
Microsoft Outlook are common applications of the Bluetooth Technology.
4.2.2 Bluetooth Applications in Healthcare
Bluetooth has been successfully adopted in Healthcare mostly by doctors.

Doctors have used Bluetooth as a Physician Medical Assistant, planning appointments,
maintaining contacts and other PDA tasks, synchronizing the PDA with their desktops
over the air.
In a more detailed clinical use, Standard database access, including Rx for dosages,
interactions, symptoms, disease libraries, described in the previous chapter as clinical
applications.
22
The access to electronic patient records complete with the patient’s history, test results,
decision support tools and expert systems guidance.
Headsets connected to voice recognition systems have been successfully used by General
Practitioners in outpatient clinics and private practices.
As for Medical Devices, Bluetooth has enabled information management without cabling.
For ambulatory patients their mobility has also been increased, using medical devices,
such as SPO2 sensors, ECGs, Blood Sugar machines, feeding databases directly by
mobile phones, which are then remotely accessed by Doctors and Nurses.
Bar code scanning has also been used in Healthcare, in which a portable scanner is
attached to a PDA, reading the patient’s bracelet and checking his identity. The clinical
error is decreased, helping to coordinate the device information against the patient’s
electronic health record.
Fig. 8: Barcode Scanning with Bluetooth Technology
23
4.3 Wireless Fidelity Technology
Fig.9: Wi-Fi Official Logo
4.3.1 Definition of Wireless Fidelity
Wi-Fi stands for Wireless Fidelity. It is also known as the 802.11.b protocol. This name
was given by the IEEE, which is the Institute of Electrical and Electronics Engineers. The
first part of the protocol, the 802 is generally used in networking language. In fact, 802.3
represents the 10 Mbps Ethernet Protocol. The 802.11 represents an open standard, in
which any manufacturer can build receivers using this protocol.
In order to have a label printed in a wireless device, first a thorough test must be
completed to prevent incompatibilities with other manufacturers. After that, it can hold
the Wi-Fi Logo, which is now common in most of the Wireless Networking devices, such
as laptops, USB adapters, PC Cards, Routers, Access Points, etc.
These Wi-Fi enabled devices (laptops or PDA's) can send and receive data wirelessly
from any location equipped with Wi-Fi access. Through access points, installed within a
Wi-Fi location, transmit an RF signal to Wi-Fi enabled devices that are within range of
the access point, which is about 300 feet. The speed of the transmission is governed by
the speed of the pipeline fed into the access point. The maximum speed achieved has
been 54 Mbps. This is called the 802.11.g protocol.
Most of the devices found in the market hold the standard 802.11.b, which means that
data can be transferred up to 11Mbps between devices.
It’s possible to select from the 802.11g protocol if the reader is building an entire wireless
network from scratch in home or small office. The increased throughput will make file-
sharing and printer-sharing much easier.
Use 802.11b if it’s needed to spend as little money as possible to build a LAN from
scratch. These devices are less expensive due to the slower throughput. Since most DSL
lines top out at 1.5 Mb/s, the reader won't experience any slowness reaching the internet
due to the wireless network.
4.3.2 Wireless Fidelity Applications in Healthcare
"In 2004, we estimate the total medical Wi-Fi market to be $495 million in the United
States. That includes Wi-Fi equipment, Wi-Fi networking and systems integration, and
also mentoring, control and optimization. Going out to 2010, we estimate it will be about
24
$2 billion. The study projects that wireless networking and related service revenues in the
healthcare arena will be a $7 billion business in the United States by 2010. "
Extracted from Wi-Fi Planet, August 2004.
Fig. 10: Wireless PDA for Clinical Applications
In their quest to streamline operations, optimize communications and improve patient

care and satisfaction, many hospitals and other healthcare providers are discovering the
benefits of wireless technology and mobile computing solutions.
Wireless technology, which uses safe radio frequencies (RF) to connect a variety of
equipment that can be located from ten metres to a few kilometres apart, without having
to use a wireline infrastructure, is becoming increasingly prevalent in modern health care
facilities.
For example, wireless Voice over IP (VoIP) telephones can overcome the barriers of a
one-way pager system, which is vulnerable to delays while a paged physician or medical
staff member searches for a landline and is sometimes further hampered by voice mail or
busy signals. It is also significantly less disruptive and more conducive to a healing
environment than a 24/7 overhead pager.
Wireless data solutions can give clinicians and health care professionals real-time,
anytime, anywhere access to all of their patients’ critical data.
One of the major reasons for the rapid growth of wireless technology is the last few years
has been the acceptance of 802.11b as an almost universal standard for wireless local area
networks. This has lead to increased interoperability between devices from different
manufacturers. However this standard offers data transfer rates of a maximum of 11Mbps
and its frequency is being congested by other technologies like Bluetooth.
25
IEEE, developer of the 802.11b standard has developed a newer standard called 802.11a,
which offers data transfer rates of up to 54 Mbps and operates in the 5GHZ frequency
spectrum. With such high data transmission rates and standardization, the industry is set
to migrate from 802.11b to 802.11a in the next coming years.
Competing Standards
The predominant standard today that is accepted by majority of the vendors in the
industry is 802.11b, developed by IEEE. This standard operates in the 2.4 GHZ frequency
spectrum and provides a maximum bandwidth of 11 Mbps. Two competing standards are
HomeRF and HiperLAN/1 in the 2.4 GHZ frequency and HyperLAN/2 in the 5GHZ
frequency. HomeRF and HiperLAN/1 are 2.4 GHZ technologies and hence competition
to 802.11b, while HyperLAN/2 is a 5 GHZ standard competing with the future 802.11a
standard from IEEE an upgrade form 802.11b which will provide extremely high
bandwidths of 54 Mbps.
Cost Factors
The cost of implementing a WLAN includes several elements, which includes cost of the
network infrastructure, the access points, the devices along with the access cards, the
clinical software application and ongoing maintenance and support costs. Infrastructure
costs depend on the number of access points installed, which in turn depends on the
coverage of the access points. Access points cost anywhere from £100 -£1000 depending
on the coverage of the access points. The cost of the devices vary with
the type of device being used, ranging from £200 for a PDA to £2000 for table
computers. The cost of the clinical applications would depend on whether it is a
standalone application or an integrated application covering many clinical functions.
Another cost consideration would be the costs associated with technology migration.
802.11b will soon be outdated by the much faster 802.11a technology. Vendors would
need to consider the reuse of customers existing equipments and provide backward
compatibility with older technologies.
In general, the cost of setting up and maintaining a wireless LAN is lower than that of a
wired LAN for two reasons. First, with WLAN, the cost of cables and the labor costs of
installing and repairing the network are eliminated. Second, because modification to the
WLAN, like moving and adding access points is extremely simple, it reduces costs of
user downtime and administrative costs.
4.4 Summary
26
Over this chapter, the author has extensively reviewed the Wireless Technology used in
Healthcare.
Bluetooth and Wi-Fi are now being widely used in Hospital, Nursing Homes, Health
Clinics and Healthcare Visitors.
With so many devices and so many different applications, some of the biggest challenges
facing the application developers, are integrating these applications with each other and
with the legacy information systems in the hospitals. Only when all patient related
information, labs, radiology, billing, medical history will be available seamlessly and
securely from a single device, will the clinical community successfully adopt the
applications.
Next chapter discusses the website design, infrastructure, hosting, ranking and
evaluation. Software tools that were used are also described in great detail.
5 PROJECT IMPLEMENTATION
5.1 Introduction
In order to the fast dissemination of the content researched and compiled by the author, a
website was created. Dedicated to healthcare professionals, this website, called
www.wireless-health.com was first registered in 2003. This chapter explains the process
in which the author registered, designed, implemented and evaluated the website. Later
on in the chapter, the author also explains the design process of the online questionnaire.
Fig. 11: Flash Introduction of the Wireless-health.com website
27
5.2 Website Process
5.2.1 Planning
People are the key to successful Web projects. Although the people who will use the site
will determine whether the project is a success, ironically, those very users are the people
least likely to be present and involved when the site is designed and built.
Keeping these lines in mind, the author needed to trace some objective goals:
Inform the Clinical Community about Wireless Technologies in Healthcare

Be an information Portal for Clinicians about the use of PDA Technology in
Healthcare
Constitute a resource to evaluate a Master’s Degree Dissertation by an online
questionnaire.
Getting to know the audience targeted for this website was not difficult. Doctors, Nurses
and Health Informaticians were the primary target. Their knowledge and interest about
mobile technologies is usually very limited. Therefore all the information would need to
be easily found and intuitive.
Once this idea of the website's mission and general structure was defined, the assessment
of the content started. Building an inventory or database of existing and needed content
enabled the author to review the existing content resources and to make a detailed outline
of his needs.
5.2.2 Developing a Site Specification
The site specification is the planning concise statement of core goals, values, and intent,
to provide the ultimate policy direction for everything that comes next. A well-written
site specification is a powerful daily tool for judging the effectiveness of a development
effort. It provided the author with a compass to keep the development process focused on
the ultimate purposes of the site. As such, it quickly become a daily reference point to
settle disputes, to judge the potential utility of new ideas as they arise, to measure
progress, and to keep the development focused on the ultimate goals.
A good site specification should define the content scope, budget, schedule, and technical
aspects of the Web site. Site specifications are very short and to the point, and are often
just outlines or bullet lists of the major design or technical features planned. The finished
28
site specification should contain the goals statement from the planning phase, as well as
the structural details of the site.
Goals and strategies
What is the mission of the project?

How will creating a Web site support the Dissertation?
What are the two or three most important goals for the site?
Who is the primary audience for the Web site?
What does the author want the audience to think or do after having visited the
site?
What Web-related strategies will be used to achieve those goals?
How will be measured the success of the site?
How will it be adequately maintained, once finished?
Production Issues
How many pages will the site contain? What is the maximum acceptable count
under this budget?
What special technical or functional requirements are needed?
What is the budget for the site?
What is the production schedule for the site, including intermediate milestones
and dates?
Who are the people on the development team and what are their responsibilities?
5.2.3 The Site Development Process
Every web project generally follows six major stages:
1. Site definition and planning

2. Information architecture
3. Site design
4. Site construction
5. Site marketing
6. Tracking, evaluation, and maintenance
5.2.4 Site Definition and Planning
29
This initial stage is where the author defined his goals and objectives for the website and
begins to collect and analyze the information needed to justify the budget and resourced
required. This is also the time to define the scope of the site content, the interactive
functionality and technology support required, and the depth and breadth of information
resources that will be needed to fill out the site and meet the reader's expectations.
Site production checklist
Developers within corporations or other large enterprises can often count on substantial
in-house technology support when creating new Web sites. In the author’s case, it was
needed to contract with various technology and design vendors to assemble everything
needed in order to create a substantial content site.
Technology:
The following Browsers and Operating Systems are supported by the website:
Windows, Macintosh, UNIX, Linux

Netscape Navigator, Internet Explorer; minimum version supported
The network bandwidth of the average visitor would be ADSL or ISDN.
Advanced features and Dynamic HTML (HyperText Markup Language)

JavaScript or vbscript required
Java applets required
Style sheets required
Third-party browser plug-ins required
The way readers reach the support team:

By Email messages from readers
Chat rooms, forums and phone support
Web server support
There is no In-house Web server. It is outsourced to an Internet Service Provider, located

in the United States, Texas.
The unique domain name available, consists of wireless-health.com.
There are 100 MB of Disk space and 2GB of site traffic limitation.
30
The hosting company guarantees a Twenty-four-hour, seven-days-a-week support and

maintenance.
The website Statistics on users and site traffic is continuously monitored.
The Server log analysis is outsourced. Guaranteed 99.9% up-time.
The search engine submission for the authors content was automatically inserted using
the web hosting ISP.
5.2.5 Information Architecture
At this stage the need for detailed content and organization of the Web site is mandatory.
All existing content, description of what new content is required, and definition of the
organizational structure of the site is now prepared. Once a content architecture has been
sketched out, small prototypes of parts of the site to test are built. Site prototypes are
useful for two reasons. First, they are the best way to test site navigation and develop the
user interface. The prototypes should incorporate enough pages to assess accurately what
it's like to move from menus to content pages. Second, creating a prototype allows the
graphic designers to develop relations between how the site looks and how the navigation
interface supports the information design.
Some Typical results or contract deliverables at the end of this stage could include:
Detailed site design specification

Detailed description of site content
Site maps, thumbnails, outlines, table of contents
Detailed technical support specification
Browser technology supported
Connection speed supported
Web server and server resources
Proposals to create programming or technology to support specific features of the
site
A schedule for implementing the site design and construction
5.2.6 Site Design
At this stage the project acquired its look and feel, as the page grid, page design, and
overall graphic design standards are created. Now the illustrations, photography, and
other graphic or audiovisual content for the site need to be created. Research, writing,
organizing, assembling, and editing the site's text content was also performed at this
stage. The goal is to produce all the content components and functional programming and
have them ready for the final production stage: the construction of the actual Web site
pages.
31
Products deliverable at this stage included:
Text, edited and proofread

Graphic design specifications for all page types
Finished interface graphics for page templates
Header and footer graphics, logos, buttons, backgrounds
Detailed page comps or finished examples of key pages
Interface design and master page grid templates completed
Finished HTML template pages
Illustrations
Photography
JavaScript scripts, Java applets designed
Search engine designed and tested
Templates
The development of templates was also completed at this stage. From a template, it can
be easier to start a page that already has the basic navigation and site graphics in place.
Popular Web site development software packages such as Macromedia's Dreamweaver
offer powerful templates and standard reusable libraries of site graphics and HTML made
it easy to create new pages and maintain the website.
Accessibility
Providing equal access to Web pages is institutional policy. It is critical therefore, that all
of the web pages are validated and the content of the website is rechecked throughout the
development process to ensure that all pages are accessible to all users.
5.2.7 Site Construction
Only at this mature stage of the project are the bulk of the site's Web pages constructed
and filled out with content. By waiting until this detailed site architecture, mature content
components, and a polished page design specification the author minimized the content
churning, redundant development efforts, and wasted energy that inevitably result from
rushing to create pages too soon.
Products delivered on this stage were:
32
Finished HTML for all Web pages, all page content in place
Finished navigation link structure
All database components in place and linked to site pages
All graphic design, illustration, and photography in place
Final proofreading of all site content
Detailed testing of database and programming functionality
Testing and verification of database reporting features
Testing of site reader support procedures, answering email, etc.
Archives of all site content components, HTML code, programming code, and
any other site development materials
5.2.8 Site Marketing
The Wireless-Health.com website was marketed using strategic partnerships with other
online websites, as well as submission in the Google Ad Words during 18 months.
The website has also been promoted next to friends and colleagues that kindly input some
support and ideas throughout the project.
5.2.9 Tracking, Evaluation and Maintenance
A large abundance of information about visitor was recorded with the web server
software. By analyzing the server logs for the website, the author developed quantitative
data on the success of the website. The logs will tell what pages were the most popular
and what brands and versions of Web browser people used to view the site. Server logs
also gave information on the geographic location of site readers. The usefulness of site
logs will depend on what is asked from the server and the people who maintain the
server. Detailed logs are the key to quantifying the success of a Web site.
A number of popular software packages are designed to produce easily readable site
traffic reports, complete with data graphics and charts to aid in data analysis. As a service
to customers, site hosting companies often offer reports from popular site analysis
programs like WebTrends, often free of charge.
Please find below three tables with some simple statistics about the number of visitors
since 2003 up to now.
33
Fig. 12: Analysis of visitors during 2003
34
35
Maintaining the website
Once the website has been completed and the production “goes live”, the aesthetical and
functional aspects of the website need constant attention. The coordination of new
content, maintaining the graphics and editorial standards, assuring that the programming
and linkages of all pages remain intact and functional are all important tasks to follow.
Backups and site archives
The site author made sure that the Wireless-health.com is regularly backed up into a
secure server to ensure that a catastrophic hardware failure in the web server does not
wipe out all the website data.
36
5.3. Questionnaire Design
The questionnaire was designed in order to provide an evaluation of the website

perfomance. A good design can encourage participants to answer the author questions
fully and accurately, and provide information which can be analyzed to generate real
knowledge. The questionnaire comprised of 24 questions about the visitor and his – her
impression while browsing the website.
5.3.1 Data Acquisition
The data was gathered between 2003 and 2005, through the online questionnaire,
connected to the website by a built-in link. Users were invited to answer to the
questionnaire, after accepting and reading a legal disclaimer both in the website as well as
in the questionnaire.
5.3.2 Data Processing
All the questionnaire answers were recorded and with the built-in analysis engine
provided by Questionpro, once the questionnaire was completed, the user could see
immediately his results and other results as well. This real time data system provided the
author a good estimate of how the website was performing and whether some changes
were needed.
5.3.3 Results
Please refer to Figure 15, (below) for the fully comprehensive report.
Executive Summary
Overall Survey Statistics
Completed Responses : 74
Started Responses : 124
Average time taken to complete : 6 minute(s)
Survey Statistics
Completed Responses 74
Started 124
37
Drop Outs (After Starting) 50
Survey Views 406
What is your gender?
Frequency Analysis
# Answer Frequency Percentage
Male 45 60.81%
Female 29 39.19%
Total 74 100%
Statistical Calculations
Mean 1.392 Mean Percentile 80.41%
[1.280 - 1.504]
Confidence Interval @ 95%
n = 74
Standard Deviation 0.492
Standard Error 0.057
What is your age?
Frequency Analysis
under 13 0 0.00%
13-17 2 2.70%
18-34 33 44.59%
35-49 31 41.89%
50-64 8 10.81%
65 or older 0 0.00%
Total 74 100%
Confidence Interval @ 95% [3.445 - 3.772]
38
n = 74
Where are you located?
Frequency Analysis
Africa 0 0.00%
Antarctica 0 0.00%
Asia 2 2.67%
Oceania (Australia, New

3 4.00%
Zealand, etc.)
Europe 46 61.33%
USA 18 24.00%
Canada 3 4.00%
Central America 0 0.00%
Other 3 4.00%
Total 75 100%
[5.155 - 5.619]
n = 75
What is your primary language (i.e., the one you speak most of the time)?
Frequency Analysis
Chinese 1 1.35%
39
Spanish 1 1.35%
English 55 74.32%
French 0 0.00%
German 1 1.35%
Dutch 0 0.00%
Japanese 0 0.00%
Portuguese 11 14.86%
Swedish 0 0.00%
Italian 0 0.00%
Other 5 6.76%
Total 74 100%
[3.683 - 4.857]
n = 74
What is your level of education?
Frequency Analysis
Some High School 2 2.70%
High School Graduate 2 2.70%
Some College 7 9.46%
College Graduate 16 21.62%
Some Postgraduate 16 21.62%
Postgraduate 28 37.84%
Other 3 4.05%
40
Total 74 100%
[4.558 - 5.172]
n = 74
What is your current occupation?
Frequency Analysis
Student 12 16.22%
Doctor 10 13.51%
Nurse 28 37.84%
Health Informatician 5 6.76%
Clerk 1 1.35%
Manager 2 2.70%
Salesman 3 4.05%
Other Healthcare
2 2.70%
Professional
Unemployed 2 2.70%
Other 9 12.16%
Total 74 100%
[3.364 - 4.690]
n = 74
41
How comfortable do you feel using computers, in general?
Frequency Analysis
Very comfortable 51 68.92%
Somewhat comfortable 18 24.32%
Neither comfortable nor

4 5.41%
uncomfortable
Somewhat uncomfortable 0 0.00%
Very uncomfortable 1 1.35%
Other 0 0.00%
Total 74 100%
[1.241 - 1.569]
n = 74
In a typical week, how many hours do you spend online?
Frequency Analysis
0 to 5 10 13.51%
6 to 10 13 17.57%
11 to 20 23 31.08%
21 to 30 7 9.46%
31 to 40 10 13.51%
More than 40 11 14.86%
Total 74 100%
42
[2.998 - 3.732]
n = 74
Primarily from what kind of computer system do you access the internet?
Frequency Analysis
Windows PC
49 66.22%
system(Desktop)
Windows(Notebook) 20 27.03%
Tablet PC 3 4.05%
Macintosh system(Desktop) 2 2.70%
Macintosh
0 0.00%
system(Notebook)
Unix system 0 0.00%
PDA(Palm OS) 0 0.00%
PDA(Pocket PC) 0 0.00%
PDA(Linux OS) 0 0.00%
Total 74 100%
[1.272 - 1.593]
n = 74
How did you hear about the Website?
43
Frequency Analysis
Found by using a search

18 20.45%
engine
Invitation from email 25 28.41%
Newsletter/Literature 9 10.23%
Was told URL by an

23 26.14%
Associate/Friend
Followed Link from another

9 10.23%
Web page
Other (Please Specify) 4 4.55%
Total 88 100%
[2.599 - 3.219]
n = 88
So we can match the right information with the needs of our visitors to the site, please tell us why you visit
our site?
Frequency Analysis
Looking for general

29 14.29%
information
Looking for rules/regulations 5 2.46%
44
Looking for forms 3 1.48%
Looking for facility

1 0.49%
information
Looking for regulatory

4 1.97%
information
Looking for upgrade

7 3.45%
Information
Looking for Qualified

Professional/Consultant 25 12.32%
Information
Looking for news (Meetings,

Seminars, Calendar, Public 10 4.93%
Hearings etc)
Looking for Contacts

5 2.46%
Information
Research for Work 21 10.34%
Research for School 15 7.39%
Download files 3 1.48%
Professional Development 26 12.81%
Looking for update on earlier

3 1.48%
information
I have been invited 38 18.72%
I belong to the newsletter 7 3.45%
Other 1 0.49%
Total 203 100%
[8.708 - 10.051]
n = 203
How likely are you to:
Mean Distibution Matrix
45
# Question Frequency Mean
1 Return to this Web site? 74 1.568
2 Add this Web site to your favourites? 74 1.878
3 Join our Web Forum? 74 2.230
4 Use our Chat Room? 74 2.676
5 Sign up our Newsletter? 74 2.014
6 Sign our Guest Book? 74 2.257
7 Set it as your homepage? 70 3.171
Average 2.256
Return to this Web site?
Frequency Analysis
Very Likely 45 60.81%
Somewhat Likely 20 27.03%
Somewhat Unlikely 5 6.76%
Not At All Likely 4 5.41%
Total 74 100%
[1.375 - 1.760]
n = 74
Add this Web site to your favourites?
Frequency Analysis
46
Total 74 100%
[1.646 - 2.111]
n = 74
Join our Web Forum?
Frequency Analysis
Total 74 100%
[1.967 - 2.493]
n = 74
Use our Chat Room?
Frequency Analysis
47
Total 74 100%
[2.422 - 2.929]
n = 74
Sign up our Newsletter?
Frequency Analysis
Total 74 100%
[1.759 - 2.268]
n = 74
Sign our Guest Book?
Frequency Analysis
48
Total 74 100%
[1.990 - 2.524]
n = 74
Set it as your homepage?
Frequency Analysis
Very Likely 5 7.14%
Total 70 100%
[2.968 - 3.375]
n = 70
Approximately how many pages did you go to during this visit?
49
Frequency Analysis
1 to 3 12 16.22%
3 to 5 16 21.62%
5 to 8 21 28.38%
More than 10 25 33.78%
Total 74 100%
[2.550 - 3.045]
n = 74
From what you have seen and your experience with other sites, please rate the following features of the web
pages:
1 Visual appearance/layout: 74 3.919
2 Content: 74 4.068
3 Writing style: 74 3.905
Average 3.964
Visual appearance/layout:
Frequency Analysis
Poor 3 4.05%
Fair 7 9.46%
Good 15 20.27%
50
Very Good 17 22.97%
Excellent 32 43.24%
Total 74 100%
[3.650 - 4.188]
n = 74
Content:
Frequency Analysis
Poor 1 1.35%
Fair 6 8.11%
Good 13 17.57%
Very Good 21 28.38%
Excellent 33 44.59%
Total 74 100%
[3.831 - 4.304]
n = 74
Writing style:
Frequency Analysis
51
Poor 1 1.35%
Fair 8 10.81%
Good 17 22.97%
Very Good 19 25.68%
Excellent 29 39.19%
Total 74 100%
[3.658 - 4.153]
n = 74
How much effort did your search require before you found what you were looking for?
(Did it take a long time? Did you have to try several times?)
Frequency Analysis
A lot less than I expected 22 30.14%
Less than I expected 20 27.40%
About what I expected 27 36.99%
More than I expected 3 4.11%
A lot more than I expected 1 1.37%
Total 73 100%
[1.970 - 2.414]
n = 73
52
Please rate our Web Interactive Menus:
1 Home 74 3.703
2 Basics 74 3.743
3 Clinical 74 3.689
4 FAQ 74 3.716
5 Links 74 3.811
6 Survey 74 3.730
Average 3.732
Home
Frequency Analysis
Poor 3 4.05%
Fair 7 9.46%
Good 21 28.38%
Very Good 21 28.38%
Excellent 22 29.73%
Total 74 100%
[3.448 - 3.958]
n = 74
Basics
Frequency Analysis
53
Poor 2 2.70%
Fair 9 12.16%
Good 18 24.32%
Very Good 22 29.73%
Excellent 23 31.08%
Total 74 100%
[3.490 - 3.996]
n = 74
Clinical
Frequency Analysis
Poor 4 5.41%
Fair 7 9.46%
Good 20 27.03%
Very Good 20 27.03%
Excellent 23 31.08%
Total 74 100%
[3.423 - 3.956]
n = 74
54
FAQ
Frequency Analysis
Poor 4 5.41%
Fair 7 9.46%
Good 19 25.68%
Very Good 20 27.03%
Excellent 24 32.43%
Total 74 100%
[3.448 - 3.984]
n = 74
Links
Frequency Analysis
Poor 3 4.05%
Fair 7 9.46%
Good 18 24.32%
Very Good 19 25.68%
Excellent 27 36.49%
Total 74 100%
[3.548 - 4.074]
n = 74
55
Survey
Frequency Analysis
Poor 4 5.41%
Fair 8 10.81%
Good 18 24.32%
Very Good 18 24.32%
Excellent 26 35.14%
Total 74 100%
[3.454 - 4.005]
n = 74
Q26
1 What was your previous knowledge about Bluetooth Technology? 69 2.841
2 What was your previous knowledge about Wi-Fi Technology? 69 2.493
3 What was your previous knowledge about PDA Technology? 69 3.333
Average 2.889
Q26
What was your previous knowledge about Bluetooth Technology?
56
Frequency Analysis
Never heard about it before 4 5.80%
Heard but never understood 22 31.88%
Have seen it before 24 34.78%
Have worked with it before 19 27.54%
Total 69 100%
[2.628 - 3.053]
n = 69
Q26
What was your previous knowledge about Wi-Fi Technology?
Frequency Analysis
Total 69 100%
[2.213 - 2.772]
n = 69
Q26
57
What was your previous knowledge about PDA Technology?
Frequency Analysis
Total 69 100%
[3.149 - 3.517]
n = 69
Q26
After browsing through the website, can you explain what

1 69 3.435
Bluetooth is?
After browsing through the website, can you explain what

2 69 3.333
Wi-Fi is?
After browsing through the website, can you explain what a

3 69 3.710
PDA is?
Average 3.493
Q26
After browsing through the website, can you explain what Bluetooth is?
Frequency Analysis
58
I didnt understand it 0 0.00%
I still need some more time

4 5.80%
researching
I can explain the basics 31 44.93%
I know what it is and can

34 49.28%
explain it well
Total 69 100%
[3.292 - 3.578]
n = 69
Q26
After browsing through the website, can you explain what Wi-Fi is?
Frequency Analysis

7 10.14%
researching

32 46.38%
explain it well
Total 69 100%
[3.163 - 3.503]
n = 69
Q26
59
After browsing through the website, can you explain what a PDA is?
Frequency Analysis

3 4.35%
researching

52 75.36%
explain it well
Total 69 100%
[3.582 - 3.839]
n = 69
Would you like to be added to our Web news mailing list? Web news notifies subscribers of periodic updates
to our Web site and other news and events. We do not share our list of subscribers.
Frequency Analysis
Yes 44 59.46%
No 30 40.54%
Total 74 100%
[1.293 - 1.518]
n = 74
Q35
60
While reading through the website, did you find a suitable application for your clinical needs?
Frequency Analysis
Yes 54 78.26%
No 15 21.74%
Total 69 100%
[1.119 - 1.315]
n = 69
Would you recommend Wireless-Health.com website to others?
Frequency Analysis
Definitely 46 62.16%
Probably 17 22.97%
Might Or Might Not 5 6.76%
Probably Not 4 5.41%
Definitely Not 0 0.00%
Never Visited 2 2.70%
Total 74 100%
[1.408 - 1.916]
n = 74
61
Q36
How difficult was it for you to deal with this questionnaire?
Frequency Analysis
Very dificult 0 0.00%
Difficult 0 0.00%
Neutral 10 13.51%
Easy 21 28.38%
Very easy 42 56.76%
Other 1 1.35%
Total 74 100%
[4.290 - 4.629]
n = 74
Online Surveys Powered By QuestionPro Survey Software

Fig. 15 Questionnaire Results powered by QuestionPro
5.4. Summary
In this chapter, the author explained how the website was implemented, which
technology was used and also informed the readers about how the questionnaire was
designed, implemented and evaluated.
By the answers obtained, one can easily realize that the website is easily accessible; the
information given was relevant and new to most users. It is also relevant to state that
European English Speaking Nurses and Doctors were predominant in the survey.
The questionnaire was fully answered by 74 people and 124 started but did not finish it.
62
6 CONCLUSION AND RECOMMENDATIONS
With this assignment, the author extensively reviewed PDA technology in Healthcare,
Wireless applications in Healthcare and the process of building a structured web
information system.
Wireless technology fits in so well with the mobile healthcare workflow, that one would
be tempted to conclude that it is definitely headed towards success in the healthcare
industry. But we need to realize that organizational and cultural issues, more than the
technology itself, have always been a bigger challenge in implementing technology in the
healthcare industry. There are several case studies describing the successful
implementation of wireless technology in clinics and hospitals nationwide, but the
financial impact and impact on patient care and safety remains to be studied. Hardly any
studies measured the outcomes of the use of wireless technology in the healthcare. There
is also lack of studies measuring the Return on Investment (ROI) of implementing
wireless solutions in healthcare. The few that exist have been conducted by the vendors
of the wireless technology themselves and are likely to be biased on the positive side for
obvious reasons. The same is also true for the many case studies available in the literature
and on the web, most of which are conducted by the vendors. Thus more studies need to
be conducted and more evidence needs to be gathered about the impact of wireless
systems in healthcare.
Recommendations for future research include continuous up-to-date information in the

web information system, potential transformation into an electronic commerce solution
and the dissemination of the use of Mobile Technology in Healthcare through associative
organizations. The author also wishes to pursue into a PhD in the very near future,
increasing his research intensity in this very special field of Health Informatics.
REFERENCES
In order to complete this assignment, several hundreds of hours were spent researching
the web. Using Google search engine and Scholar Google, the author identified several
references, which are described below:
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63
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4) http://cgwebermd.tripod.com/Clinical-med/, last accessed on July 2005
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18) http://pbrain.hypermart.net/index.html, last accessed on August 2005
19) http://pocketpa.imrac.com/, last accessed on August 2005
20) http://statbanner.com/, last accessed on August 2005
21) http://statcoder.com/, last accessed on August 2005
22) http://www.aafp.org/fpm/icd9.html, last accessed on August 2005

23) http://www.acm.org/conferences/sac/sac2000/Proceed/FinalPapers/MC-19/,
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24) http://www.activecenter.com/, last accessed on August 2005
25) http://www.activecenter.com/, last accessed on August 2005
26) http://www.acutecare.com/palmpilot.htm, last accessed on August 2005
27) http://www.aetherpalm.com/, last accessed on August 2005
28) http://www.analysys.com/, last accessed on August 2005
29) http://www.bachmannsoftware.com/ExpansionMemory.pdf, last accessed on
August 2005
30) http://www.cebm.utoronto.ca/palm/ebmcalc/, last accessed on August 2005
31) http://www.cedarcovetech.com/, last accessed on August 2005
32) http://www.collectivemed.com/, last accessed on August 2005
33) http://www.ddhsoftware.com/medical.html, last accessed on August 2005
34) http://www.docucare.net/, last accessed on August 2005
35) http://www.ebm2go.com/, last accessed on August 2005
36) http://www.e-mds.com/, last accessed on August 2005
37) http://www.e-medtools.com/, last accessed on August 2005
38) http://www.encountertechnology.com/, last accessed on August 2005
39) http://www.ephysician.com/, last accessed on August 2005
40) http://www.epocrates.com/vhttp://www.fadavis.com/marketing/handheld.ht
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41) http://www.fastknowledge.com/nurseware/index2.htm, last accessed on
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42) http://www.fcg.com/, last accessed on August 2005
64
43) http://www.freewebs.com/webhelpdoctors/index.htm, last accessed on

September 2005
44) http://www.gcq.ucla.edu/ last accessed on September 2005

45) http://www.geocities.com/fhirning/eDrugsSoftware.html last accessed on
September 2005
46) http://www.grule.com/OasisPalm.htm last accessed on September 2005
47) http://www.handekeeper.com/ last accessed on September 2005
48) http://www.handera.com/ last accessed on September 2005
49) http://www.handheldmed.com/ last accessed on September 2005
50) http://www.handspring.com/ last accessed on September 2005
51) http://www.harrisinteractive.com/news/allnewsbydate.asp?NewsID=345 last
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52) http://www.healinghandheld.com/ last accessed on September 2005
53) http://www.healthypalmpilot.com/ last accessed on September 2005
54) http://www.hopkins-abxguide.org/ last accessed on September 2005
55) http://www.infopoems.com/ last accessed on September 2005
56) http://www.intermec.com/ last accessed on September 2005
57) http://www.internetweek.com/transform/transform032700-1.htm last
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58) http://www.invivodata.com/ last accessed on September 2005
59) http://www.jimthompson.net/palmpda/ last accessed on September 2005
60) http://www.kidometer.com/ last accessed on September 2005
61) http://www.kingguide.com/ last accessed on September 2005
62) http://www.kyocera-wireless.com/kysmart/kysmart_series.htm last accessed
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63) http://www.lexi.com/ last accessed on September 2005
64) http://www.liebertonline.com last accessed on September 2005
65) http://www.mcnjournal.com last accessed on September 2005
66) http://www.mdeverywhere.com/ last accessed on September 2005
67) http://www.medcomsys.com/, last accessed on September 2005
68) http://www.medical-data-solutions.com/, last accessed on September 2005
69) http://www.medicalsoftwareforpdas.com/, last accessed on September 2005
70) http://www.medicaltoolbox.com/, last accessed on September 2005
71) http://www.medicalwizards.com/, last accessed on September 2005
72) http://www.medicine.dal.ca/palm/, last accessed on September 2005
73) http://www.med-media.com/, last accessed on September 2005
74) http://www.med-notes.com/, last accessed on September 2005
75) http://www.medpda.net/, last accessed on September 2005
76) http://www.medrevu.com/products/pda.asp, last accessed on September 2005
77) http://www.medspda.com/, last accessed on September 2005
78) http://www.meistermed.com/, last accessed on September 2005
79) http://www.mobiledesigntech.com/, last accessed on September 2005
80) http://www.novasync.com/, last accessed on September 2005
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67

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Overview of Wireless PDA applications in Healthcare

1.1 Background Motivation

1.2 Main Aims

1.3 Specific Goals

Some specific goals include:

Definition of what a PDA is and what it can be used for

1.4 Outline of Dissertation

The project methodology was based in four separate areas.

2.2 Literature Review

PDA, Clinical, Applications, Software, Bluetooth, Wi-Fi, Wireless Technology,

2.3 Online Questionnaire

Fig. 1: Online Questionnaire Preview

2.3 Conceptual Map

A user selection was customized according to Doctors and Nurses.

Fig. 2: User Value Drivers for Wireless Technology in Healthcare

3 OVERVIEW OF PDA TECHNOLOGY

3.2 Definition of PDA

(Personal Digital Assistant) is a handheld computer that serves as an organizer for

Fig. 3: Example of Latest PDA

3.3 Operating Systems

For instance, any device which is to be classified as a Pocket PC must:

Run Microsoft's Windows CE (PocketPC version) operating system

Windows Mobile 5, internally code-named Magneto, was officially released by Microsoft

Palm OS is an operating system made by PalmSource, Inc. for PDAs, manufactured by

To Do listAlso referred to as Task list.

The Linux OS is supported by three major Hardware manufacturers: AGENDA, ROYAL

3.4 SOME IMPORTANT FEATURES IN ALL PDAs

3.4.1 Processor Speed

3.4.2 Installed Memory

PDA displays have the following features:

3.4.4 Input Methods

Pocket PC PDAs offer three handwriting-recognition applications: Transcriber, Letter

3.4.5 Expansion Support

3.4.6 Battery Support

Operating system -PocketPC requires more power by virtue of its increased

3.4.7 Wireless Capability

Fig. 4: Some of the devices used for wireless communications

3.5 Clinical Applications

3.5.1 Clinical Applications for Doctors

E-Prescription and Drug and formulary databases

The objective of these applications is to reduce medication errors by generating legible

Patient Tracking Utilities

Fig. 5: Potential benefits of Wireless applications in Healthcare

3.5.2 Clinical Applications for Nurses

Fig. 6: Decision power from the use of data

Reference Electronic Books

Several E-books can be found dedicated to various Nursing specialities.

4.2 Bluetooth Technology

Fig. 7: Bluetooth Official Logo

4.2.1 Definition of Bluetooth Technology

4.2.2 Bluetooth Applications in Healthcare

Bluetooth has been successfully adopted in Healthcare mostly by doctors.

Fig. 8: Barcode Scanning with Bluetooth Technology

4.3 Wireless Fidelity Technology

Fig.9: Wi-Fi Official Logo

4.3.1 Definition of Wireless Fidelity

4.3.2 Wireless Fidelity Applications in Healthcare

Fig. 10: Wireless PDA for Clinical Applications

In their quest to streamline operations, optimize communications and improve patient

Fig. 11: Flash Introduction of the Wireless-health.com website

5.2 Website Process

Inform the Clinical Community about Wireless Technologies in Healthcare

5.2.2 Developing a Site Specification

Goals and strategies

Full Dissertation "Wireless PDA Applications in Healthcare"

Full Dissertation "Wireless PDA Applications in Healthcare"