Mobile PCIS: point-of-care information systems with portable terminals.

We have developed a Point-of-Care Information System (PCIS) that uses portable terminals and supports the entire loop of daily nursing work for the first time. Nursing work includes a great deal of indirect nursing work, such as documenting patient information, conferring with other health-care providers, and so on, as well as direct patient care. The time needed for this indirect work often exceeds the time actually spent directly caring for patients and needs to be reduced. Our system was developed with the goal of doing this to make nursing work more efficient. The system consists of personal digital assistants (PDAs) that nurses carry in the hospital wards and a server computer located in the nursing station. The system has three main functions: 1) Data Browsing provides patient information such as a brief history, vital-sign charts, and handwritten notes; 2) Schedule Planning helps nurses organize doctors' instructions and make To-do lists for the day; and 3) Care Management reminds nurses when they should execute the doctors' orders and provides tools for data entry. These three functions cover the entire loop of daily nursing work. The PDAs and the server computer can share up-to-date information by data transmission through telephone lines (low-power cellular phones can be used), infrared devices, or RS-232C cables. Results from a preliminary hospital evaluation showed that use of the system can reduce the time needed for nursing documentation by 60% (a 10% saving of a nurse's total working time), and that more than 80% of the nurses who used the system felt it would make nursing work more efficient.