Annals of Long Term Care

Author Affiliations: Dr. Kobylarz is Associate Professor, Center for Healthy Aging at Parker Stonegate Department of Family Medicine, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ; Ms. Clark is Director of Medical Informatics, Department of Family Medicine and Rural Health, Florida State University College of Medicine, Tallahassee; and Dr. Brummel-Smith is Charlotte Edwards Maguire, MD, Chair, and Professor, Department of Geriatrics, Florida State University College of Medicine.

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Introduction

The use of clinical informatics is an essential 21st-century skill of physicians and other providers, and yet no articles describe the use of Personal Digital Assistants (PDAs). In geriatrics, PDAs have become a commonly used clinical tool and are increasingly used in medical student, resident, pharmacy, nursing education, and faculty development.1-6 All of these are available for both the Palm operating system (OS) and Windows Mobile platform. Pocket PCs, Blackberry, and Mac iPhone versions are under development for many of the listed resources.

The purpose of this article is to provide a brief review of several PDA medical references that would enable healthcare providers to provide high-quality care to older adults. The geriatric issues of chronic illness, declining functional and mental status, as well as complications of polypharmacy, are of major concern, and the vast amount of new research being done is constantly changing guidelines, medications, and assessment strategies for managing geriatric conditions. The PDA can be a vital tool to be used at the point of care for quality, accuracy, and life-long learning, whether it is in a hospital, nursing home, office, or in the patient’s home. The advent of high-quality PDAs/cell phones also eliminates the need for carrying any extra equipment, while providing a wealth of interactive tools, as well as volumes of information at your fingertips.

PDA Resources

Geriatrics At Your Fingertips (GAYF)

The American Geriatrics Society (AGS) created Geriatrics At Your Fingertips (GAYF) in 1998 as a small booklet. The website was created in 2002, and the first PDA version of GAYF was released in 2004.7 A quick reference resource, GAYF contains basic disease information and care guidelines for a number of geriatric conditions, such as dementia. It contains drug dosages, including the starting dose for geriatric patients, and normal laboratory values for geriatric patients, which differ from those for younger patients. Assessment algorithms for certain illnesses such as depression and dementia are provided. There are many useful tables comparing medications and treatment options, images, calculators, and algorithms. It contains an index, content, and tools page, making it simple to find answers to your geriatric questions.

GAYF provides easy access to clinical tools. Some examples include the Geriatric Depression Scale for depression screening, the Mini-Cog for screening dementia, and the activities of daily living and instrumental activities of daily living scales for function.

The resource had been free until this year. It remains free to all trainees (medical students and residents) who join the AGS.

The 2007-2008 PDA version is available at:
http://www.geriatricsatyourfingertips.org.

Epocrates

Epocrates is one of the most popular PDA products among practicing healthcare professionals today. Epocrates Rx has been a free download for years, which partially explains its popularity. The beauty of Epocrates has always been the quality of the design of the product interface. The interface is so intuitive that little instruction is needed to become comfortable with the product.

Epocrates Rx covers the basic prescription drug information, including indications, dosing, contraindications, adverse reactions, and costs.