Palm Pilot Use in Medicine

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Hans van der Slikke, MD: “It’s September of 2001, and we’re in Paris at the 2nd Controversies Conference. Next to me is John Mattox from Phoenix, Arizona. Welcome, John.”

John Mattox, MD: “Thank you very much, it’s a pleasure to be here.”

Hans van der Slikke, MD: “It was a pleasure talking in the lobby about your program where you use Palm Pilots to educate our residents. How did this idea start?”

John Mattox, MD: “When the technology was introduced and reflecting on the missions to prepare students and residents to practice medicine, I saw an enormous potential to bring in this personal digital assistant, and we chose the Palm about four years ago. At that time we were impressed that some of the residents were very knowledgeable and some had no experience and no comfort with it so the first year we chose a very simple goal just to have people put in telephone numbers, critical telephone numbers, each year. I’m working with an individual, Dr. Smith, who I consider an expert in this area. We have enlarged our goals and now we’re recording statistics. We use those to encourage the residents to reference journals, and we have prescribing software on them so that they can look at drug interactions. We’re working on communicating with them with e-mail and the Intranet within our system, and we think that in terms of prescribing, billing, and keeping track of their daily schedules this is going to have enormous potential for the future.”

Hans van der Slikke, MD: “Did you provide the Palms yourself?”

John Mattox, MD: “Yes, we made the decision that if we were going to bring the technology to the residents that we had to give them not only the instrument because there is some expense involved but we also had to provide them with the support. So I personally had one of the clerical people in my program trained so that she is onsite everyday to work with the residents in case they have a question or a problem.”

Hans van der Slikke, MD: “How are the first reactions?”

John Mattox, MD: “As we had talked earlier, standardization is always a major issue - how do you keep up with the technology and what programs should you include or exclude? Some of the residents were very advanced, and I said I cannot support you contacting your stockbroker or your mother-in-law but if you want to learn more about medicine let’s agree among the faculty and the residents what the most critical things are and then with that agreement we bring in one or two of those each year. We’re in the fourth year of the project by the way, and I would say that on a scale of one to ten in terms of level of use and sophistication of the programs involved we’re probably at a six or seven now.”

Hans van der Slikke, MD: “What were the most hot topics for you that you started with?”

John Mattox, MD: “We started with phone numbers and the contact not only of people in the department but outside the department, the different clinics, and things that are so critical to an active training program.”

Hans van der Slikke, MD: “So just some basic skills and use the Palm in itself.”

John Mattox, MD: “Yes, and not try to frustrate them or make them experts in everything all at one time. I do think that is a very important element for success because if you bring in all the technology at a single time you’ll probably reach two-thirds of your residents but a third of them will be frightened and won’t use it. As an added incentive, I give them the opportunity to purchase the Palm at the end of their training program for a much reduced rate. So they can not only get comfortable with it during their training but they can take that with them into their practice.”

Hans van der Slikke, MD: “Which were the first models you built in for using this Palm?”

John Mattox, MD: “Right now I think this limitation is going away but how much memory is in the PDA and that is sort of a limitation. This year, specifically, Dr. Smith and I agreed on two programs and one is for the residents to document their training experiences and the number of procedures that they have done. Ortho-McNeil Pharmaceuticals has provided us with some software to record the number of statistics and then to also have availability of referencing journals so we have two of our most prestigious journals – ‘Obstetrics and Gynecology’ and ‘The American Journal of Obstetrics and Gynecology’ built into the system so they can look at those abstracts even though they’re a month or two behind. If I can just get them to look at those abstracts I feel like I’ve gotten something done.”

Hans van der Slikke, MD: “Thank you very much for this interview. I want to congratulate you on this very nice program, and thank you again. I wish you luck and success.”

John Mattox, MD: “Thank you, it’s been my pleasure.”