Handheld computers in clinical practice

Editor—Handheld computers have a use in clinical medicine that was not included in the review by Al-Ubaydli¹: they can be adapted to provide patients with useful information and educational material.

We use colour images held on a personal digital assistant (PDA) during consultations to help patients learn more about their clinical diagnosis and understand the proposed management. We have a library of images, of the normal pelvis and various pathological conditions, that are easily accessible and can be annotated with information relevant to each patient. Any planned surgery can be explained in picture form.

Similarly, we use the same images postoperatively to describe what was found and done during surgery.

Figure 1.

Having designed a computer system that can record complete operations in real time (presented at the annual scientific Meeting of the British Society for Gynaecological Endoscopy, Dublin, May 2004), we now routinely capture images during or after surgery (from the recorded movie), downloading them on to the PDA. Rather than showing patients generic images on the postoperative ward round, we show pictures of their own operation. The response of our patients has been universally highly positive.

We have also transferred short, edited movies of surgical procedures to the PDA that can be shown as part of the preoperative counselling process. Few patients have any concept of what their surgery will entail, and we believe that such visual images are far superior to any verbal explanation.

In principle, as with still images, short clips of a patient's own surgery could be downloaded to the PDA.

Local guidelines must be followed when any visual recordings are made of patients. The General Medical Council guidelines state that permission or consent is not required from patients for endoscopic images or images of internal organs, provided that the recordings are effectively anonymised by removal of any identifying marks.