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Are irreputable health sites hurting your patients?
Web sites that offer questionable information about psychiatric illnesses and treatments can sway patients toward unproven, often worthless “remedies.” These sites may present themselves as patient resources but instead are promoting political or antipsychiatry agendas or selling unregulated, untested therapies.
Don’t let unscrupulous sites fool your patients. This article offers tools to help patients find evidence-based mental health information from objective, reputable sites.
Why counsel patients on web use?
Bad information can be harmful. I have lost many patients to follow-up because they discovered an unsubstantiated treatment complication or off-the-wall “remedy” on an antipsychiatry or antimedication site.
Years ago, I treated another mental health clinician. After she viewed an antimedication site, she was convinced that her bipolar disorder had “run its course” and stopped treatment, even though she had suffered a severe manic episode 1 year earlier. Another doctor treated her as if her bipolar disorder had been “cured.”
I resolved never to let patients troll the Internet for medical information without rudimentary guidance.
Most patients do not know how to analyze medical information. In medical school we learned—by implementing dictums of evidence-based medicine—where to find clinical information and how to assess its quality and objectivity. Most patients have not received such training.
Patients need our support. Most patients seeing a psychiatrist for the first time are anxious and fearful of what they might find out about themselves or their lives. Exploring their inner worlds is routine to us, but unsettling and disorienting to them. Unfiltered, uncensored Web sites prey upon new patients by offering a ready source of comfort.
Guiding new patients during this vulnerable time can cement the doctor-patient relationship and prevent faulty information from jeopardizing recovery. Patients who do not receive emotional support could turn to a Church of Scientology site—such as http://psychiatrysucks.com—or one of many other antipsychiatry sites to fill the void.
Encourage patients to describe their anxieties and trepidations toward their illnesses and medications. Help them explore questions about trust and hope, and anticipate and solicit questions resulting from their Internet exploration.
Setting web search guidelines
When new patients ask where to find information on their disorder or treatment, suggest the National Institutes of Health’s Web site, which offers a wealth of current information written in plain English, and links to databases, such as Medline and ongoing clinical trials.
Then give patients basic guidelines for broader Internet exploration. Warn them against sites that post personal attacks, exude a zealous tone, or present extreme positions or statements. Sites infused with fervor—positive or negative—should always warrant suspicion.
For more subtle concerns about quality of information, encourage patients to ask the following six questions—easily recalled with the acronym NO BASH (Table)—when visiting a mental health site:
Table
NO BASH: 6 questions to ask when perusing a health site
| 1. Is the site Networked? |
| 2. Is the information Objective? |
| 3. Is the content Balanced? |
| 4. Does the site’s author make Accusations? |
| 5. Is the site Selling something? |
| 6. Is the site ‘Hyperholy’? |
- IS THE SITE NETWORKED?
- IS THE INFORMATION OBJECTIVE?
- IS THE CONTENT BALANCED?
- DOES THE SITE’S AUTHOR MAKE ACCUSATIONS?
- IS THE SITE SELLING SOMETHING?
- IS THE SITE ‘HYPERHOLY’?
Other considerations
Also consider the site’s domain designation:
- sites with the .edu domain—operated by educational institutions—are most reliable
- .com designates a commercial site that is generally geared to selling goods or services and might or might not support psychiatric treatment
- .net and .org sites tend to be noncommercial, although some might be antipsychiatry.
Also steer patients to health care sites that display the HON Code seal of the Health On the Net Foundation (HON). HON, a nonprofit international organization that promotes development of useful, reliable online medical and health information, certifies health sites that meet its rigorous ethical standards (see Related resources).
- Health Care on the Net Foundation code of conduct (HON code) for medical and health Web sites. www.hon.ch/HONcode/Conduct.html.
Disclosure
Dr. Montgomery reports no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.
Web sites that offer questionable information about psychiatric illnesses and treatments can sway patients toward unproven, often worthless “remedies.” These sites may present themselves as patient resources but instead are promoting political or antipsychiatry agendas or selling unregulated, untested therapies.
Don’t let unscrupulous sites fool your patients. This article offers tools to help patients find evidence-based mental health information from objective, reputable sites.
Why counsel patients on web use?
Bad information can be harmful. I have lost many patients to follow-up because they discovered an unsubstantiated treatment complication or off-the-wall “remedy” on an antipsychiatry or antimedication site.
Years ago, I treated another mental health clinician. After she viewed an antimedication site, she was convinced that her bipolar disorder had “run its course” and stopped treatment, even though she had suffered a severe manic episode 1 year earlier. Another doctor treated her as if her bipolar disorder had been “cured.”
I resolved never to let patients troll the Internet for medical information without rudimentary guidance.
Most patients do not know how to analyze medical information. In medical school we learned—by implementing dictums of evidence-based medicine—where to find clinical information and how to assess its quality and objectivity. Most patients have not received such training.
Patients need our support. Most patients seeing a psychiatrist for the first time are anxious and fearful of what they might find out about themselves or their lives. Exploring their inner worlds is routine to us, but unsettling and disorienting to them. Unfiltered, uncensored Web sites prey upon new patients by offering a ready source of comfort.
Guiding new patients during this vulnerable time can cement the doctor-patient relationship and prevent faulty information from jeopardizing recovery. Patients who do not receive emotional support could turn to a Church of Scientology site—such as http://psychiatrysucks.com—or one of many other antipsychiatry sites to fill the void.
Encourage patients to describe their anxieties and trepidations toward their illnesses and medications. Help them explore questions about trust and hope, and anticipate and solicit questions resulting from their Internet exploration.
Setting web search guidelines
When new patients ask where to find information on their disorder or treatment, suggest the National Institutes of Health’s Web site, which offers a wealth of current information written in plain English, and links to databases, such as Medline and ongoing clinical trials.
Then give patients basic guidelines for broader Internet exploration. Warn them against sites that post personal attacks, exude a zealous tone, or present extreme positions or statements. Sites infused with fervor—positive or negative—should always warrant suspicion.
For more subtle concerns about quality of information, encourage patients to ask the following six questions—easily recalled with the acronym NO BASH (Table)—when visiting a mental health site:
Table
NO BASH: 6 questions to ask when perusing a health site
| 1. Is the site Networked? |
| 2. Is the information Objective? |
| 3. Is the content Balanced? |
| 4. Does the site’s author make Accusations? |
| 5. Is the site Selling something? |
| 6. Is the site ‘Hyperholy’? |
- IS THE SITE NETWORKED?
- IS THE INFORMATION OBJECTIVE?
- IS THE CONTENT BALANCED?
- DOES THE SITE’S AUTHOR MAKE ACCUSATIONS?
- IS THE SITE SELLING SOMETHING?
- IS THE SITE ‘HYPERHOLY’?
Other considerations
Also consider the site’s domain designation:
- sites with the .edu domain—operated by educational institutions—are most reliable
- .com designates a commercial site that is generally geared to selling goods or services and might or might not support psychiatric treatment
- .net and .org sites tend to be noncommercial, although some might be antipsychiatry.
Also steer patients to health care sites that display the HON Code seal of the Health On the Net Foundation (HON). HON, a nonprofit international organization that promotes development of useful, reliable online medical and health information, certifies health sites that meet its rigorous ethical standards (see Related resources).
- Health Care on the Net Foundation code of conduct (HON code) for medical and health Web sites. www.hon.ch/HONcode/Conduct.html.
Disclosure
Dr. Montgomery reports no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.
Web sites that offer questionable information about psychiatric illnesses and treatments can sway patients toward unproven, often worthless “remedies.” These sites may present themselves as patient resources but instead are promoting political or antipsychiatry agendas or selling unregulated, untested therapies.
Don’t let unscrupulous sites fool your patients. This article offers tools to help patients find evidence-based mental health information from objective, reputable sites.
Why counsel patients on web use?
Bad information can be harmful. I have lost many patients to follow-up because they discovered an unsubstantiated treatment complication or off-the-wall “remedy” on an antipsychiatry or antimedication site.
Years ago, I treated another mental health clinician. After she viewed an antimedication site, she was convinced that her bipolar disorder had “run its course” and stopped treatment, even though she had suffered a severe manic episode 1 year earlier. Another doctor treated her as if her bipolar disorder had been “cured.”
I resolved never to let patients troll the Internet for medical information without rudimentary guidance.
Most patients do not know how to analyze medical information. In medical school we learned—by implementing dictums of evidence-based medicine—where to find clinical information and how to assess its quality and objectivity. Most patients have not received such training.
Patients need our support. Most patients seeing a psychiatrist for the first time are anxious and fearful of what they might find out about themselves or their lives. Exploring their inner worlds is routine to us, but unsettling and disorienting to them. Unfiltered, uncensored Web sites prey upon new patients by offering a ready source of comfort.
Guiding new patients during this vulnerable time can cement the doctor-patient relationship and prevent faulty information from jeopardizing recovery. Patients who do not receive emotional support could turn to a Church of Scientology site—such as http://psychiatrysucks.com—or one of many other antipsychiatry sites to fill the void.
Encourage patients to describe their anxieties and trepidations toward their illnesses and medications. Help them explore questions about trust and hope, and anticipate and solicit questions resulting from their Internet exploration.
Setting web search guidelines
When new patients ask where to find information on their disorder or treatment, suggest the National Institutes of Health’s Web site, which offers a wealth of current information written in plain English, and links to databases, such as Medline and ongoing clinical trials.
Then give patients basic guidelines for broader Internet exploration. Warn them against sites that post personal attacks, exude a zealous tone, or present extreme positions or statements. Sites infused with fervor—positive or negative—should always warrant suspicion.
For more subtle concerns about quality of information, encourage patients to ask the following six questions—easily recalled with the acronym NO BASH (Table)—when visiting a mental health site:
Table
NO BASH: 6 questions to ask when perusing a health site
| 1. Is the site Networked? |
| 2. Is the information Objective? |
| 3. Is the content Balanced? |
| 4. Does the site’s author make Accusations? |
| 5. Is the site Selling something? |
| 6. Is the site ‘Hyperholy’? |
- IS THE SITE NETWORKED?
- IS THE INFORMATION OBJECTIVE?
- IS THE CONTENT BALANCED?
- DOES THE SITE’S AUTHOR MAKE ACCUSATIONS?
- IS THE SITE SELLING SOMETHING?
- IS THE SITE ‘HYPERHOLY’?
Other considerations
Also consider the site’s domain designation:
- sites with the .edu domain—operated by educational institutions—are most reliable
- .com designates a commercial site that is generally geared to selling goods or services and might or might not support psychiatric treatment
- .net and .org sites tend to be noncommercial, although some might be antipsychiatry.
Also steer patients to health care sites that display the HON Code seal of the Health On the Net Foundation (HON). HON, a nonprofit international organization that promotes development of useful, reliable online medical and health information, certifies health sites that meet its rigorous ethical standards (see Related resources).
- Health Care on the Net Foundation code of conduct (HON code) for medical and health Web sites. www.hon.ch/HONcode/Conduct.html.
Disclosure
Dr. Montgomery reports no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.
Smartphones: Ask 4 questions before you buy
‘Smartphones,’ hybrid cell phones and personal digital assistants (PDAs), are increasingly helping psychiatrists stay in touch on the road or manage multi-site practices.
This article reviews the capabilities of most smartphone models (Table) and offers practical advice to help you choose the right device for your practice.
What you can do with a smartphone
Make phone calls. Most smartphones integrate high-end wireless phone features such as selective call screening, Bluetooth wireless device compatibility, moderate-resolution cameras, and voice recognition for hands-free dialing. Call quality varies by device but is generally above average as cell phones go.
Smartphones cost between $100 and $500 depending on model (the more cutting-edge the smartphone, the higher the price) and whether a service activation discount is offered. A service provider’s area and coverage uniformity usually affects call quality.
Some service plans include data service (ie, e-mail) with phone service, whereas others charge an extra monthly fee depending on volume of data to be transmitted.
Send and receive e-mail. Smartphones include fully featured e-mail clients. While away from the office, you can save immeasurable time communicating with staff and colleagues via text instead of paging and waiting for callbacks.
“Pop-ups” let you quickly view and respond to e-mails without disrupting workflow. You can automatically send messages such as “will call you after this meeting” and “please call my receptionist for a meeting time” without having to type them.
Smartphones can be set to check e-mail at intervals. Many wireless service providers offer “push e-mail,” which is broadcast to your device as soon as the e-mail server receives it, but you don’t need this service if you are satisfied with receiving e-mail every 15 minutes or longer.
Search the Web. Smartphones are equipped with browsers, so you can enter key words and quickly retrieve online abstracts while away from the office. For psychiatrists practicing at multiple sites or without immediate Internet access, this point-of-care search capability can be priceless.
Organize your schedule. Datebook/calendar, address book, memo, and task list functions are cross-linked with telephony. You can make a phone call directly from an address book listing, dial by tapping on a number included in an e-mail message, and automatically add a contact to your address book after a call. You can insert contact numbers and tasks into the calendar and set reminder alarms and alerts as needed.
Task lists consolidate daily to-do lists, and reminders keep missed tasks top of mind the next day. On more-advanced models, appointment calendars can be updated wirelessly several times daily, so you can add appointments or meetings while away from the office without having to call in for a scheduling update.
Create/edit multimedia files. Recording, editing, and playing back videos, photos, audio recordings (dictation and MP3s), and even feature-length movies are becoming common handheld features.
More-advanced smartphones that are compatible with Palm OS and Pocket PC let you open and edit Microsoft Office documents, edit and play back PowerPoint presentations through a monitor or LCD projector, or create or modify Microsoft Word or Excel documents on a mobile platform. This mobile software is included with some phones and can be purchased with others.
Beat ‘belt clutter.’ Some smartphones consolidate cell phone, pager, PDA, dictation recorder, appointment book, and wristwatch functions. By taking the place of these devices, a smartphone can reduce pocket and belt clutter, a common problem among doctors.
Drawbacks
Screen size. The smartphone’s screen size and slow downloading impede its use as a stand-alone Internet browser. Smartphone screens can be similar in size to a PDA screen (4 inches diagonally) or relatively small (2 inches-by-2 inches), although resolution is usually high. Viewing full-size Web pages can be challenging, though most phones offer an option to adapt them for small-screen viewing.
Internet surfing. Broadband data transfer rates are only now appearing with service providers in different areas. Broadband will make smartphone Web surfing and data transfers much faster. By and large, however, Internet surfing is limited to analog modem speeds, so you’ll be waiting a while for Web pages to appear on your screen.
Security. Most smartphones use Bluetooth short-range radio to connect with headsets and computers. Hackers have exploited this technology in public places, so phones left open to Bluetooth ‘discovery’ by other phones can be breached.
This can spell trouble if you store medical records on your smartphone. If an unauthorized person accesses these records, you would be violating HIPAA privacy regulations because you are responsible for protecting patient information.
You can activate a password protection system using various encryption algorithms on your smartphone to guard against theft. You can also selectively encrypt some files, though having to repeatedly enter passwords to access the secure files slows daily use.
Choosing a smartphone
Your new smartphone will be your practice “companion,” so you want to get this choice right. As you shop for a smartphone, ask yourself:
- Which medical reference software do I plan to use? As with PDAs, smartphones work on the Palm OS/Windows Mobile/Pocket PC operating systems. Although most major medical reference titles—such as Lexi-Comp and Epocrates—come in Palm OS and Windows Mobile/Pocket PC versions, others are compatible with only one operating system.
- Can I read the screen display? Although text usually can be enlarged or shrunk, screen size determines how much you can see at a glance. Make sure you’re comfortable with the display before you purchase.
- Can I work the keyboard? Most smartphones integrate a small QWERTY keyboard for sending e-mail. Each smartphone keyboard has a different feel; make sure you can type comfortably and accurately.
- Which form feels most comfortable? Smartphones range from candy-bar shaped and flip phones, to slider and clamshell models.
In the end, the answers to these questions—plus a hefty dose of visceral appeal—should influence your choice. Smartphones are constantly evolving, so you’re better off taking the plunge rather than waiting for the ultimate smartphone.
Table
Smartphone models: Sample listing
| Model | Key features/cost |
|---|---|
 | - Microsoft Windows Mobile 5.0 |
| - Slim form factor | |
| - Cutting-edge design | |
| - Price unknown | |
| - Available this Spring | |
 | - Palm OS (650) |
| - Ergonomic design | |
| - Largest library of medical reference software available | |
| - Touch screen 320×320 pixels | |
| - $219-$548 | |
 | - Windows Mobile 5.0 |
| - Ergonomic design | |
| - Touch screen 240×240 pixels | |
| - $399-$499 | |
 | - Microsoft Windows Mobile for Pocket PC Phone Edition 2003 SE |
| - Runs full Microsoft Office Mobile suite | |
| - Slide-out keyboard and touch screen input | |
| - $429-$499 | |
 | - RIM Blackberry OS |
| - EDGE enabled for fast Web browsing | |
| - Push e-mail (no latency) | |
| - $0-$299 | |
 | - Microsoft Windows Mobile 5.0 Pocket PC Phone Edition |
| - Integrated GPS receiver with navigation software | |
| - Runs full Microsoft Office Mobile suite | |
| - Wi-Fi- and EDGE-enabled for fast Web browsing | |
| - Push e-mail | |
| - Pricing unknown | |
| - Available late spring | |
| Source: www.cnet.com | |
Related resources
Brighthand Consulting. Reviews and other information on smartphones, other handhelds. www.brighthand.com.
Cnet.com. Listing of 90 smartphone models by manufacturer, carrier, other criteria. http://reviews.cnet.com/4566-6452_7-0.html?tag=coco.
Engadget. Reviews of smartphone models. http://www.engadget.com/search/?q=smartphones.
Disclosure
Dr. Montgomery reports no financial relationship with any manufacturer whose products are mentioned in this article or with manufacturers of competing products.
‘Smartphones,’ hybrid cell phones and personal digital assistants (PDAs), are increasingly helping psychiatrists stay in touch on the road or manage multi-site practices.
This article reviews the capabilities of most smartphone models (Table) and offers practical advice to help you choose the right device for your practice.
What you can do with a smartphone
Make phone calls. Most smartphones integrate high-end wireless phone features such as selective call screening, Bluetooth wireless device compatibility, moderate-resolution cameras, and voice recognition for hands-free dialing. Call quality varies by device but is generally above average as cell phones go.
Smartphones cost between $100 and $500 depending on model (the more cutting-edge the smartphone, the higher the price) and whether a service activation discount is offered. A service provider’s area and coverage uniformity usually affects call quality.
Some service plans include data service (ie, e-mail) with phone service, whereas others charge an extra monthly fee depending on volume of data to be transmitted.
Send and receive e-mail. Smartphones include fully featured e-mail clients. While away from the office, you can save immeasurable time communicating with staff and colleagues via text instead of paging and waiting for callbacks.
“Pop-ups” let you quickly view and respond to e-mails without disrupting workflow. You can automatically send messages such as “will call you after this meeting” and “please call my receptionist for a meeting time” without having to type them.
Smartphones can be set to check e-mail at intervals. Many wireless service providers offer “push e-mail,” which is broadcast to your device as soon as the e-mail server receives it, but you don’t need this service if you are satisfied with receiving e-mail every 15 minutes or longer.
Search the Web. Smartphones are equipped with browsers, so you can enter key words and quickly retrieve online abstracts while away from the office. For psychiatrists practicing at multiple sites or without immediate Internet access, this point-of-care search capability can be priceless.
Organize your schedule. Datebook/calendar, address book, memo, and task list functions are cross-linked with telephony. You can make a phone call directly from an address book listing, dial by tapping on a number included in an e-mail message, and automatically add a contact to your address book after a call. You can insert contact numbers and tasks into the calendar and set reminder alarms and alerts as needed.
Task lists consolidate daily to-do lists, and reminders keep missed tasks top of mind the next day. On more-advanced models, appointment calendars can be updated wirelessly several times daily, so you can add appointments or meetings while away from the office without having to call in for a scheduling update.
Create/edit multimedia files. Recording, editing, and playing back videos, photos, audio recordings (dictation and MP3s), and even feature-length movies are becoming common handheld features.
More-advanced smartphones that are compatible with Palm OS and Pocket PC let you open and edit Microsoft Office documents, edit and play back PowerPoint presentations through a monitor or LCD projector, or create or modify Microsoft Word or Excel documents on a mobile platform. This mobile software is included with some phones and can be purchased with others.
Beat ‘belt clutter.’ Some smartphones consolidate cell phone, pager, PDA, dictation recorder, appointment book, and wristwatch functions. By taking the place of these devices, a smartphone can reduce pocket and belt clutter, a common problem among doctors.
Drawbacks
Screen size. The smartphone’s screen size and slow downloading impede its use as a stand-alone Internet browser. Smartphone screens can be similar in size to a PDA screen (4 inches diagonally) or relatively small (2 inches-by-2 inches), although resolution is usually high. Viewing full-size Web pages can be challenging, though most phones offer an option to adapt them for small-screen viewing.
Internet surfing. Broadband data transfer rates are only now appearing with service providers in different areas. Broadband will make smartphone Web surfing and data transfers much faster. By and large, however, Internet surfing is limited to analog modem speeds, so you’ll be waiting a while for Web pages to appear on your screen.
Security. Most smartphones use Bluetooth short-range radio to connect with headsets and computers. Hackers have exploited this technology in public places, so phones left open to Bluetooth ‘discovery’ by other phones can be breached.
This can spell trouble if you store medical records on your smartphone. If an unauthorized person accesses these records, you would be violating HIPAA privacy regulations because you are responsible for protecting patient information.
You can activate a password protection system using various encryption algorithms on your smartphone to guard against theft. You can also selectively encrypt some files, though having to repeatedly enter passwords to access the secure files slows daily use.
Choosing a smartphone
Your new smartphone will be your practice “companion,” so you want to get this choice right. As you shop for a smartphone, ask yourself:
- Which medical reference software do I plan to use? As with PDAs, smartphones work on the Palm OS/Windows Mobile/Pocket PC operating systems. Although most major medical reference titles—such as Lexi-Comp and Epocrates—come in Palm OS and Windows Mobile/Pocket PC versions, others are compatible with only one operating system.
- Can I read the screen display? Although text usually can be enlarged or shrunk, screen size determines how much you can see at a glance. Make sure you’re comfortable with the display before you purchase.
- Can I work the keyboard? Most smartphones integrate a small QWERTY keyboard for sending e-mail. Each smartphone keyboard has a different feel; make sure you can type comfortably and accurately.
- Which form feels most comfortable? Smartphones range from candy-bar shaped and flip phones, to slider and clamshell models.
In the end, the answers to these questions—plus a hefty dose of visceral appeal—should influence your choice. Smartphones are constantly evolving, so you’re better off taking the plunge rather than waiting for the ultimate smartphone.
Table
Smartphone models: Sample listing
| Model | Key features/cost |
|---|---|
| - Microsoft Windows Mobile 5.0 |
| - Slim form factor | |
| - Cutting-edge design | |
| - Price unknown | |
| - Available this Spring | |
| - Palm OS (650) |
| - Ergonomic design | |
| - Largest library of medical reference software available | |
| - Touch screen 320×320 pixels | |
| - $219-$548 | |
| - Windows Mobile 5.0 |
| - Ergonomic design | |
| - Touch screen 240×240 pixels | |
| - $399-$499 | |
| - Microsoft Windows Mobile for Pocket PC Phone Edition 2003 SE |
| - Runs full Microsoft Office Mobile suite | |
| - Slide-out keyboard and touch screen input | |
| - $429-$499 | |
| - RIM Blackberry OS |
| - EDGE enabled for fast Web browsing | |
| - Push e-mail (no latency) | |
| - $0-$299 | |
| - Microsoft Windows Mobile 5.0 Pocket PC Phone Edition |
| - Integrated GPS receiver with navigation software | |
| - Runs full Microsoft Office Mobile suite | |
| - Wi-Fi- and EDGE-enabled for fast Web browsing | |
| - Push e-mail | |
| - Pricing unknown | |
| - Available late spring | |
| Source: www.cnet.com | |
Related resources
Brighthand Consulting. Reviews and other information on smartphones, other handhelds. www.brighthand.com.
Cnet.com. Listing of 90 smartphone models by manufacturer, carrier, other criteria. http://reviews.cnet.com/4566-6452_7-0.html?tag=coco.
Engadget. Reviews of smartphone models. http://www.engadget.com/search/?q=smartphones.
Disclosure
Dr. Montgomery reports no financial relationship with any manufacturer whose products are mentioned in this article or with manufacturers of competing products.
‘Smartphones,’ hybrid cell phones and personal digital assistants (PDAs), are increasingly helping psychiatrists stay in touch on the road or manage multi-site practices.
This article reviews the capabilities of most smartphone models (Table) and offers practical advice to help you choose the right device for your practice.
What you can do with a smartphone
Make phone calls. Most smartphones integrate high-end wireless phone features such as selective call screening, Bluetooth wireless device compatibility, moderate-resolution cameras, and voice recognition for hands-free dialing. Call quality varies by device but is generally above average as cell phones go.
Smartphones cost between $100 and $500 depending on model (the more cutting-edge the smartphone, the higher the price) and whether a service activation discount is offered. A service provider’s area and coverage uniformity usually affects call quality.
Some service plans include data service (ie, e-mail) with phone service, whereas others charge an extra monthly fee depending on volume of data to be transmitted.
Send and receive e-mail. Smartphones include fully featured e-mail clients. While away from the office, you can save immeasurable time communicating with staff and colleagues via text instead of paging and waiting for callbacks.
“Pop-ups” let you quickly view and respond to e-mails without disrupting workflow. You can automatically send messages such as “will call you after this meeting” and “please call my receptionist for a meeting time” without having to type them.
Smartphones can be set to check e-mail at intervals. Many wireless service providers offer “push e-mail,” which is broadcast to your device as soon as the e-mail server receives it, but you don’t need this service if you are satisfied with receiving e-mail every 15 minutes or longer.
Search the Web. Smartphones are equipped with browsers, so you can enter key words and quickly retrieve online abstracts while away from the office. For psychiatrists practicing at multiple sites or without immediate Internet access, this point-of-care search capability can be priceless.
Organize your schedule. Datebook/calendar, address book, memo, and task list functions are cross-linked with telephony. You can make a phone call directly from an address book listing, dial by tapping on a number included in an e-mail message, and automatically add a contact to your address book after a call. You can insert contact numbers and tasks into the calendar and set reminder alarms and alerts as needed.
Task lists consolidate daily to-do lists, and reminders keep missed tasks top of mind the next day. On more-advanced models, appointment calendars can be updated wirelessly several times daily, so you can add appointments or meetings while away from the office without having to call in for a scheduling update.
Create/edit multimedia files. Recording, editing, and playing back videos, photos, audio recordings (dictation and MP3s), and even feature-length movies are becoming common handheld features.
More-advanced smartphones that are compatible with Palm OS and Pocket PC let you open and edit Microsoft Office documents, edit and play back PowerPoint presentations through a monitor or LCD projector, or create or modify Microsoft Word or Excel documents on a mobile platform. This mobile software is included with some phones and can be purchased with others.
Beat ‘belt clutter.’ Some smartphones consolidate cell phone, pager, PDA, dictation recorder, appointment book, and wristwatch functions. By taking the place of these devices, a smartphone can reduce pocket and belt clutter, a common problem among doctors.
Drawbacks
Screen size. The smartphone’s screen size and slow downloading impede its use as a stand-alone Internet browser. Smartphone screens can be similar in size to a PDA screen (4 inches diagonally) or relatively small (2 inches-by-2 inches), although resolution is usually high. Viewing full-size Web pages can be challenging, though most phones offer an option to adapt them for small-screen viewing.
Internet surfing. Broadband data transfer rates are only now appearing with service providers in different areas. Broadband will make smartphone Web surfing and data transfers much faster. By and large, however, Internet surfing is limited to analog modem speeds, so you’ll be waiting a while for Web pages to appear on your screen.
Security. Most smartphones use Bluetooth short-range radio to connect with headsets and computers. Hackers have exploited this technology in public places, so phones left open to Bluetooth ‘discovery’ by other phones can be breached.
This can spell trouble if you store medical records on your smartphone. If an unauthorized person accesses these records, you would be violating HIPAA privacy regulations because you are responsible for protecting patient information.
You can activate a password protection system using various encryption algorithms on your smartphone to guard against theft. You can also selectively encrypt some files, though having to repeatedly enter passwords to access the secure files slows daily use.
Choosing a smartphone
Your new smartphone will be your practice “companion,” so you want to get this choice right. As you shop for a smartphone, ask yourself:
- Which medical reference software do I plan to use? As with PDAs, smartphones work on the Palm OS/Windows Mobile/Pocket PC operating systems. Although most major medical reference titles—such as Lexi-Comp and Epocrates—come in Palm OS and Windows Mobile/Pocket PC versions, others are compatible with only one operating system.
- Can I read the screen display? Although text usually can be enlarged or shrunk, screen size determines how much you can see at a glance. Make sure you’re comfortable with the display before you purchase.
- Can I work the keyboard? Most smartphones integrate a small QWERTY keyboard for sending e-mail. Each smartphone keyboard has a different feel; make sure you can type comfortably and accurately.
- Which form feels most comfortable? Smartphones range from candy-bar shaped and flip phones, to slider and clamshell models.
In the end, the answers to these questions—plus a hefty dose of visceral appeal—should influence your choice. Smartphones are constantly evolving, so you’re better off taking the plunge rather than waiting for the ultimate smartphone.
Table
Smartphone models: Sample listing
| Model | Key features/cost |
|---|---|
| - Microsoft Windows Mobile 5.0 |
| - Slim form factor | |
| - Cutting-edge design | |
| - Price unknown | |
| - Available this Spring | |
| - Palm OS (650) |
| - Ergonomic design | |
| - Largest library of medical reference software available | |
| - Touch screen 320×320 pixels | |
| - $219-$548 | |
| - Windows Mobile 5.0 |
| - Ergonomic design | |
| - Touch screen 240×240 pixels | |
| - $399-$499 | |
| - Microsoft Windows Mobile for Pocket PC Phone Edition 2003 SE |
| - Runs full Microsoft Office Mobile suite | |
| - Slide-out keyboard and touch screen input | |
| - $429-$499 | |
| - RIM Blackberry OS |
| - EDGE enabled for fast Web browsing | |
| - Push e-mail (no latency) | |
| - $0-$299 | |
| - Microsoft Windows Mobile 5.0 Pocket PC Phone Edition |
| - Integrated GPS receiver with navigation software | |
| - Runs full Microsoft Office Mobile suite | |
| - Wi-Fi- and EDGE-enabled for fast Web browsing | |
| - Push e-mail | |
| - Pricing unknown | |
| - Available late spring | |
| Source: www.cnet.com | |
Related resources
Brighthand Consulting. Reviews and other information on smartphones, other handhelds. www.brighthand.com.
Cnet.com. Listing of 90 smartphone models by manufacturer, carrier, other criteria. http://reviews.cnet.com/4566-6452_7-0.html?tag=coco.
Engadget. Reviews of smartphone models. http://www.engadget.com/search/?q=smartphones.
Disclosure
Dr. Montgomery reports no financial relationship with any manufacturer whose products are mentioned in this article or with manufacturers of competing products.