A lab application nearly ready for release
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The market potential of wireless access to laboratory data is significant, a fact that has not escaped the attention of software and information system vendors. A handful of companies have emerged in the last few years that are working to develop and market applications that meet this need. Most of the attention to date has focused on charge-capture and prescription-writing applications, mainly because a strong case can be made for a favorable return-on-investment picture for these functions.
"We view mobility in health care as a journey with tremendous promise and some important near-term considerations," says Stephen Hau, founder and VP platform of PatientKeeper, Boston. The company claims some 50,000 physician users, primarily of its PatientKeeper Personal application.
Founded almost five years ago, PatientKeeper has launched three main applications aimed at making it possible for clinicians to use their PDAs for clinical and administrative purposes: a charge-capture application called ChargeKeeper, a lab-results-viewing application called LabKeeper, and a standalone application called PatientKeeper Personal. All applications are part of the open PatientKeeper platform. The company’s LabKeeper application, co-developed with Cerner, now in alpha testing at several health care sites, is scheduled for release this summer.
PatientKeeper is, as Hau puts it, "transport- and form factor-agnostic. We support 802.11 wireless LAN, Bluetooth, network cradle, and infrared. We also support Windows CEand Palm OSdevices," he explains. A key underlying concept can be thought of as "sometimes connected" or "wireless bandwidth on demand." This means "if you have an 802.11 or Bluetooth infrastructure in place and your PDA is wireless enabled, it will take advantage of wireless," says Hau. "But when wireless is unavailable, your PDA queues the information until it has the ability to re-connect to the network—either by wireless or by wireline mode."
This makes sense, Hau adds, because, exciting as wireless is, the requisite infrastructure is not yet installed in many institutions. And even when it is, there are dead zones—for example, radiology with lead shielding, elevators—the wireless signal doesn’t reach. "You can’t assume that the user will always enjoy a real-time wireless connection," Hau says. "If you make the ’always wireless’ assumption and the user is ever disconnected, then he’s just carrying a dumb brick. That’s a situation we don’t think the user should be in."
Like other PatientKeeper software, LabKeeper is more properly thought of as a mobile, not just a wireless, application. At a minimum, using it requires syncing—that is, installing the device in a network cradle connected directly to the network. "When you sync, LabKeeper pulls down all the relevant information for your new patients and their lab results," Hau says. "If you’re submitting a new request, it’s queued up, and the next time you sync it’s transmitted and new information is pulled back."
The company has opened its development tools to third parties, a well-established strategy in the software world, one adopted by Microsoft and Palm, among others. The strategy encourages third parties to develop applications for the company providing the development tools.
About security Hau says: "We have access control. Depending on the institution, a password is required, every time the user logs on, every four hours, every 24 hours, and so forth—if you don’t enter the correct password, you don’t get the information." PatientKeeper is augmenting that security with enhanced encryption, audit trails, and nonrepudiation measures, which means the system monitors not just what the physician has access to but what he or she has viewed.