New technology and Internet connectivity are powering today's handheld computers to write and transmit electronic prescriptions, schedule appointments, track patients, code visits, order lab results and make referrals. Now, with the support of venture capitalists and Wall Street, a spate of start-up companies are flooding the handheld market.
Last month, for example, Durham, N.C.-based MDeverywhere, which offers physicians a handheld computer for charge capture and information transfer, announced that it raised $11 million in venture capital.
Some wonder whether technology-leery physicians will warm to such high-tech practices and whether they'll be able to support such a diverse handheld market.
But Chicago internist David Litoff, M.D., himself a handheld computer user, says today's palm devices are useful tools and are at least worthy of consideration.
"Without the Internet, then all the handheld computers were basically expensive toys. I would show my computer to people and they'd say, 'That's neat.' But when you add Internet connectivity to that, it becomes a very powerful and attractive tool," he says.
Litoff has been using an Apple Newton computer to track patients, make referrals and code visits for years. Because he was an early user of handheld technology, he had to cobble together a hodgepodge of programs to meet his needs and currently uses Palmedic, a patient tracking software, and Archimedes, a medical calculator that helps him compute medical formulas. But his handheld is not integrated with his office's practice management software, a feature offered by some newer models.
"If your handheld device is tied into your practice management system through a wireless network, then you can use it as an input device, either to capture charges, order lab results or use it to refer a patient to a specialist," he says. "I see the handheld machine replacing a lot of the paper forms that doctors have to fill out every day."
Cambridge, Mass.-based Virtmed hopes to eliminate the pen and index card billing system many physicians currently use. Virtmed, which is currently beta testing its product in a Boston teaching hospital, offers physicians a handheld coding and charge capture system that can interface with practice management systems.
Virtmed estimates that physicians currently lose about 2% of their billing cards or forms, and another 10% of charges are lost because physicians don't document them. Virtmed estimates that a total of 10% of billing can be recaptured using its system.
Lloyd Hey, M.D., founder and chairman of MDeverywhere, says using the company's charge capture system can up the average number of diagnoses per encounter from 1.1 to 2.8 and save physicians about $10 per encounter. The savings come from preventing lost revenue and eliminating what Hey calls "rework," or having someone retype the billing information into the practice management system and field calls from payers to confirm billing information.
The 150 physicians using MDeverywhere pay a transaction fee, typically about $1, for each charge. MDeverywhere recently announced that it signed six additional sites, including the University of South Florida. The sites will act as sponsors for the physicians and pay all charges. Virtmed charges physicians on a monthly basis. Many handheld companies offer free computers to physicians or free downloads of programs if they already own a Palm Pilot.
Caren Taylor, an e-healthcare analyst with San Francisco-based E*Offering, says the companies are wise to target charge capture.
"If you're going to have a handheld device, the killer application that will first get physicians to use it is going to be charge capture--something that really targets the bottom line," she says.
A number of companies hope that physicians view e-prescribing as a killer application: The handheld prescribing market is one of the most crowded in the e-healthcare arena. Libertyville, Ill.-based Allscripts, Mountain View, Calif.-based ePhysician, San Mateo, Calif.-based iScribe and Fort Lauderdale, Fla.-based ParkStone Medical Information Systems all offer physicians electronic prescription writing tools. San Carlos, Calif.-based ePocrates offers a handheld clinical drug information guide, with Internet connectivity and updates on drug recalls.
Nearly all of the e-prescribing companies, as well as the charge capture companies, plan on adding capabilities, whether it be payer and pharmacy connectivity or clinical reference.
Daren Marhula, an analyst with U.S. Bancorp Piper Jaffray in Minneapolis, says layering of services also will be accompanied by mergers and buyouts within the handheld arena.
"Very few of these palm companies are going to exist as stand-alone entities. Many are going to be gobbled up by the larger players."