"I am the director of a large urgent care that functions as a free standing emergency department. I first was introduced to PDA's in medicine by two of my Physician Assistants. One was a "computer geek" and the other was just a new graduate; I thought those things were only toys and not really valuable for use in medicine. However, they showed me some programs where they could look up drug information faster than I could with my monthly prescribing reference. Their information was more accurate than relying on my own memory. I bought a PDA and downloaded Dr. Drugs, The 5 Minute Clinical Consult, and The Washington Manual. I found that I began to use them quite frequently and soon needed a drug interaction reference, and so downloaded iFacts. Then I needed an infectious disease reference but was out of memory so I bought a memory expansion chip, transferred my previous references to the chip and downloaded BartlettID. Along came the terrorists and we had an anthrax scare with several cases presenting to my urgent care. In answer to the problem came .911 and I was able to advise our local sheriff's department based on the information which I had recently downloaded in that program. I am the physician director of a local county EMS system, and I was also able to teach a class on Bioterrorism out of information from that program, giving the most recent guidelines from the CDC and the Medical Letter.

Three years ago, a patient came into my practice with Behcet's Syndrome. I had never heard of it and spent many hours trying to get as much information as I could from the Internet on the disease. Some of that information was anecdotal, and some was totally misdirected. I thought Behcet's was so rare that I would never see another case in my life. Recently another patient with similar symptoms came into my office. I looked up Behcet's syndrome in the 5 Minute Clinical Consult and was able to get the essential information to make the diagnosis at the bedside and a web reference which led me to the International Behcet's Society, and a contact physician who had seen 100's of cases of Behcet's in the Middle East. Now I have 3 Behcet's patients in my practice, and have become the Behcet's expert in my little city.

My need for rapid access to information has grown, and I now have a total of 8 large clinical references loaded onto my PDA, including all of the above plus Archimedes and the Sanford Guide. I have loaded a digital photo reference onto my PDA and have downloaded anatomical pictures for my own reference and patient teaching. I use some reference from my PDA on almost every third patient with rapid access to information at the bedside, looking up drug dosages and interactions, diagnostic and treatment information, teaching and printing up information for patients to take home. I sometimes do locum tenens work at remote sites, and carry an entire library in my pocket. Recently, I deleted some critical files in a download and so made one of my most used programs inaccessible on the PDA. For two days until I could get it fixed, I was in a panic...I had to look up the information in my old paperback monthly prescribing reference, and it took me forever! (And it wasn't quite as fun!) I had to haul that paperback with me to every room to see the patients because I had gotten used to having information at my finger tips.

I believe that I practice better, more efficient medicine now because of the Skyscape and other programs that I have loaded onto my PDA. I am so convinced of that fact that I have recommended them to several other physicians and my EMS personnel. The future of medicine is accurate information, and he who has the most rapid access to it is a better physician, nurse or any other health care provider."

Kevin Jensen, MD 
Director of Sierra View Medical Center