Mohammad Al-Ubaydli’s blog

The Doctor’s PDA and Smartphone Handbook: The task list

Posted in Medicine, My publications, Peer-reviewed papers, Technology by Dr Mohammad Al-Ubaydli on February 18, 2006

A good house officer is an organized house officer; and keeping track of the jobs to be done for each patient is arguably the most important skill for doctors beginning their career. Your handheld computer’s task list will not make you organized, but it will provide you with the tools you need to be organized.

Like the diary and address book, the task list’s importance means that most handheld computers include a button that takes you straight to the program. This is usually in the bottom right-hand corner, second from the right. Alternatively, on Palm Powered machines, tap on the HOME icon and then the icon labeled To Do List. On Pocket PCs, tap on the START icon and then Tasks.

The tasks are given in a list, with a tick box next to each task (Figures 1 and 2). Tap on a tick box if you have completed its task, and tap again to remove the tick from the box. Tapping on a task allows you to look at the task’s related text, priority and due date. The priority and due date are what you really need to manage your tasks for the day.

Creating a task

To add a task about setting up a chest computed tomography scan for a patient with hospital ID ABC123456:

  1. Tap on the New button on a Palm Powered device or the New menu item on a Pocket PC
  2. Write ‘CT scan ABC123456’
  3. 3. On a Pocket PC, tap the OK button.

It is important to make the text for each task short yet explanatory. As you look at the list of tasks during the day, you will mostly rely on this writing to give you the information you need at a glance.

Using the patient’s hospital ID rather than their full name is doubly important. First, tasks are not encrypted, so they are not secure enough to include identifying information about your patients. Second, as you fill out the computerized tomography request form later on, the ID is the most important detail you will need.

This works fine if you are already in the habit of attaching a sticky label from your patient’s notes onto your white coat. Combine this with the hospital number on your task list and you have a convenient system that still maintains confidentiality and complies with data protection rules.

Adding notes to a task

For some tasks, it is necessary to include extra information about the task. In the chest computerized tomography example, you might want to include a clinical summary of the patient and the question you want the radiologist to answer. Use the task’s notes to do this. On a Pocket PC:

  1. Tap on the task you want to edit
  2. Tap the Edit menu item
  3. Tap on the Notes tab
  4. Write the note
  5. Tap the OK button

On a Palm Powered device:

  1. Tap on the task you want to edit
  2. Tap on the Details… button
  3. Tap on the Note button
  4. Write your notes
  5. Tap the Done button.

Again, remember that the notes part of the tasks list is not encrypted, so you should not include any information that could identify your patients.

tasks.pocketpc.gif tasks.palm.gif
Figure 1 Pocket PC’s Tasks Figure 2 Palm Powered device’s To Do list

Priority and due dates

The key to being organized is to make sure that every task has a priority and a due date. Then you can begin your day’s efforts with the tasks that are most important or urgent. Once these are complete, you can focus your attention on the other tasks.

To change the priority and due date on a Pocket PC:

  1. Tap on the task to edit it
  2. Tap to the right of Priority:
  3. Select from Low, Normal and High. Normal is the default, while High priority tasks appear with a red exclamation mark in the tasks list
  4. Tap to the right of Due:
  5. Select the date by which the task needs to be completed.

On a Palm Powered device:

  1. Tap on the task to edit it
  2. Tap on the Details… button
  3. Select from 1 to 5 to the right of Priority: 1 is the default and is also the highest priority
  4. Tap to the right of Due:
  5. Select the date by which the task needs to be completed. You can quickly choose from Today, Tomorrow, One Week Later and No Date or you can tap on Choose Date… to get a calendar from which to choose another date.

Sorting and the satisfaction of purging

  1. Tap on Sort By in the top right corner
  2. Select Due Date instead.

By default, Palm Powered devices sort first by due date and second by priority. To change this:

  1. Tap on the Show… button
  2. Tap to the right of Sort by:
  3. Select Priority, Due Date to sort first by priority and second by due date
  4. It is worth also unticking the box to the left of Show Completed Items
  5. Tap the OK button.

To untick the Show Completed Items box is optional but very useful. The result is that whenever you tick a task to signal it has been completed, it will disappear from the list. To do the equivalent on a Pocket PC:

  1. Tap on the Show menu in the top left corner
  2. Tap on Active Tasks….

It is satisfying to see your list of tasks gradually getting shorter during the day as you go about your work.

Categories

As with the address book, categories are useful. Good categories to create include the names of the wards of your patients and the names of the consultants for whom you work. On a Pocket PC:

  1. Tap on the task to edit
  2. Tap the Edit menu item
  3. Tap to the right of Categories:
  4. Tick the box next to each category you want
  5. If you do not find the category you need, tap on the Add/Delete tab and add the name of your new category
  6. Tap the OK button.

On a Palm Powered device:

  1. Tap on the task to edit
  2. Tap on the Details… button
  3. Tap to the right of Category:
  4. Select the category you want
  5. If you do not find the category you need, tap on Edit Categories… and add the name of your new category
  6. Tap the OK button.

Categories are particularly helpful for beaming.

Beaming

To beam a task on a Pocket PC:

  1. Tap and hold on the task
  2. Select Beam Task… from the menu that appears.

On a Palm Powered device:

  1. Tap on the task
  2. Tap on the MENU icon
  3. Tap on Beam Item from the Record menu.

To beam all the tasks within a category on a Pocket PC:

  1. Select the category from the list of categories in the top left-hand corner
  2. Tap and hold on the first task in the category
  3. Drag down to the last task in the category. You can tell when all of the tasks in the category are selected because they will switch to white writing over a blue background
  4. Select Beam Task… from the Tools menu.

On a Palm Powered device:

  1. Select the category from the list of categories in the top right corner
  2. Tap on the MENU icon
  3. Tap on Beam Category from the Record menu.

Advanced uses

Two types of additional software are available. The first type is useful because it allows you to link a task to a person. For example, you can link each of your referral tasks to the consultant the patient needs to see. When you meet the consultant, their name in the address book will list all the referral tasks for that consultant. You can discuss all the relevant patients with that consultant. Examples of software in this group include Agendus [www.iambic.com] for Palm Powered machines and Agenda Fusion [www.developerone.com] for Pocket PCs.

The second type of software allows hierarchical tasks. For example, the main task for a patient might be setting up a referral to a neurologist, but this would depend on the completion of two other tasks: scheduling a computerized tomography scan of the patient’s head and putting the radiology report in the notes for the neurologist to use. It is best to set up one task with the title `refer to neurologist’ and give it three subsidiary tasks: `CT head’, `add CT head report to notes’ and `write referral letter’. Hierarchical software, such as ThoughtManager [www.handshigh.com] for Palm Powered devices and TreNotes for Pocket PCs [www.fannsoftware.com], allows correct sequencing for the subsidiary tasks and tracks the progress of each of these.

Sadly, no software allows linking to both addresses and hierarchical tasks, so you will have to choose which feature matters to you most. If you are already using Agendus or Agenda Fusion, it is best to stick to it for your tasks. If you end up using ThoughtManager for its note-taking skills, you should use it for your tasks as well. Otherwise, you should try both types of software, as they include free trial versions that will allow you to decide which best suits your habits.

Footnotes

This is the third in a series of extracts from a forthcoming book by A Al-Ubaydli and C Paton. The website [www.rsmpress.co.uk/bkpda.htm] includes video tutorials to accompany this text.

Clinical vignette of a junior doctor’s shift

Tuesday mornings were Dr Charcot’s busiest, as they began with her consultant’s ward round. During the round, she would keep track of every job for the patients on her handheld computer’s task list. From each patient’s notes, she attached a sticker to her coat pocket. For each task, she included the patient’s hospital number. For the more complex tasks, she added a note with extra information.

Dr Charcot categorized the tasks by the ward on which the patient was present. She also included the priority and due date for each task.

After the round, Dr Charcot carried out the most urgent and highest priority tasks before going for lunch. After lunch, she could go through the other tasks at her leisure. It was satisfying to see her list get shorter as she ticked off each task as completed.

The stickers on Dr Charcot’s coat provided her with each patient’s identifying information. Combined with the patient number on each task, she could keep track of who needed what without compromising patient confidentiality on her handheld computer.

At the end of Dr Charcot’s shift, she would beam the categories with tasks that she had not yet completed to the night shift’s junior doctor. The next morning, she would confirm that the junior doctor had completed all the tasks overnight. As Dr Charcot left the hospital, she made use of the `shopping’ task list category. She ticked off every item as she went down the supermarket’s aisles. Soon it would be time to relax over dinner.

Citation: Paton C, Al-Ubaydli M. The Doctor’s PDA and Smartphone Handbook Databases. J R Soc Med. 2006 Feb;99(1):73-6.

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