American College of Physicians: Internal Medicine — Doctors for Adults ®

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Internists can put the power of PIER in their pocket

From the October ACP Observer, copyright © 2003 by the American College of Physicians.

ACP's decision-support tool is about to make the jump to handheld computers, giving internists more evidence-based information in the exam room or at the bedside.

For more than a year, thousands of College members have been using the Physicians' Information and Education Resource (PIER). By logging onto the Web, internists can tap into treatment guidelines on more than 200 diseases and conditions without paging through textbooks or journals.

By this winter, however, internists will be able to get much of that same information from their handheld computers. PIER's handheld version has been redesigned for the small screen, allowing physicians to reach into their pockets to review evidence-based clinical recommendations.

There's more good news: You'll be able to use the handheld version of PIER with wireless devices that can access the Internet, as well as those that use the software "offline" and must be "hot-synced" with a desktop device connected to the Web.

Here's an overview of the pocket-size version of PIER and its features:

  • Disease modules. To make the handheld version of PIER fast enough to function as a point-of-care tool, the College has scaled down some of the features found on the desktop version.

    The desktop version of PIER, available online contains disease modules that feature evidence-based recommendations to manage specific diseases and conditions. It also includes the Lexi-Comp drug resource database and modules on screening and prevention, specific procedures, complementary and alternative medicine, and legal and ethical issues.

    The handheld version of PIER, by comparison, features the 200-plus disease modules and the Lexi-Comp drug resource. It does not include other PIER modules on complementary and alternative medicine, legal and ethical issues, etc.

    "The disease modules are the most clinically applicable for the handheld version," explained PIER's Editor-in-Chief, David R. Goldmann, FACP. "We know they will be used at the bedside and during office visits."

    Dr. Goldmann said that the new version should be ideal for physicians rounding in the hospital or working in exam rooms where computers aren't available. The handheld version of PIER can also help physicians deal with emergency situations or make tough clinical calls without having to leave a patient to use a desktop computer.

  • New format. Current PIER users will notice that the handheld version looks slightly different on the smaller screen. To make PIER more portable, many of PIER's tables have been reformatted. As a result, you won't have to scroll through lengthy tables on your PDA's small screen.

    While portability comes with one tradeoff—less depth—College officials say that the desktop and handheld versions of PIER each offer unique strengths.

    "For quick, day-to-day questions, you can refer to the handheld version's clinical recommendations," said Michael Strange, the College's Acting Vice President of the Medical Knowledge and Education Division. "If you need more information about the evidence behind those recommendations, you can bounce back to the desktop version."

  • Offline access. Besides posting a "wireless" version of PIER that can be accessed on the Web using a PDA, the College has created a handheld version of PIER that users can download onto their desktop computer and then load onto their handheld device. Downloadable versions will be available for many different types of handheld computers, including Palm OS and Pocket PC-based devices.

    While the Web version of PIER for handhelds will be updated daily, "offline" users will have to "hot-sync" their PDA to a desktop computer that is connected to the Web. Offline users will be able to update their version of PIER as often as they like.

    To get a feel for how the offline version of PIER will work, you can download a sample package of 10 disease modules online. (You will need a member password to download the sample package.)

    The handheld and Web versions of PIER will cost ACP members $99 ($199 for nonmembers). More information, including instructions on how to order the PDA version of PIER via the Web, will appear on the PIER Web site.

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