The Science Journal of the American Association for Respiratory Care

2000 OPEN FORUM Abstracts

PALM COMPUTER IMPROVES PRODUCTIVITY OF CARE PATH MANAGEMENT

Teresa A. Volsko RRT, Michael W. Konstan MD, Robert L. Chatburn RRT, FAARC Rainbow Babies and Children's Hospital and Case Western Reserve University, Cleveland, OH

The efficiency and quality of data collection are integral components of disease management programs. We investigated the use of a palm computer, the Palm IIIx, (Palm Computing, Inc., Santa Clara, CA) with a relational database for collecting clinical and outcome data for patients hospitalized for treatment of a pulmonary exacerbation of cystic fibrosis (CF), and who were managed on a clinical care path. We hypothesized that the use of the Palm IIIx for electronic data collection and transmission of linked data would reduce the amount of time and expense incurred when compared with our current paper based data collection and computer entry process.

Methods:
All patient and outcome data were previously collected on a paper copy of the forms created in our MS Access database. Our database contains 12 related tables that provide the framework from which a parent data collection form and 7 subforms were built. A total of 2,328 records were collected and stored in the database over a three month period (12/1/99 -- 3/1/00). The data recorded on the paper forms were manually entered into the mirror image electronic forms in the database. A representative sample of 10 patients (42 forms) was selected for determining data collection time. The time for the CF Care Manager to collect daily nutrition, lab, medication, nursing, respiratory, diagnostic testing, discharge criteria, and co-morbidity, data onto the paper forms and hand enter this information into the MS Access database was recorded. To enable electronic data entry via the Palm IIIx, the MS Access database was linked to Palm based data collection forms using Pendragon Forms (Pendragon Software Corp., Libertyville, IL). Palm based data collection forms were identical to the paper forms. The time in minutes for the same care manager to collect identical daily information on the Palm IIIx and transfer it to the MS Access database through a Hotsync maneuver was collected. Cost was calculated as the product of data collection time and care manager's hourly salary. Data were compared with unpaired t-test. Significance was established as p<0.05.

Results:
Data are displayed below:

Paper Palm p
Number of patients 10 10 -
Data collection time/patient/day in minutes 7.8 (1.55) 5.4 (0.51) < 0.001
Data collection cost/patient/day in dollars $2.59 (0.51) $1.82 (0.15) < 0.001
Values are mean (±SD)



Conclusions: Computerized data collection increased productivity for patients on the Cystic Fibrosis Care Path. Based on 4,802 patient days on the CF care path per year, we estimate a time savings of 360 hours per year (7.2 hrs/week) in the collection and transfer of daily clinical and outcomes data. This translates into an estimated annual cost savings of $7,207.00 at our institution.
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