Using personal digital assistants and patient care algorithms to improve access to cardiac care best practices.

In order to facilitate knowledge transfer between specialists and generalists and between experts and novices, and to promote interdisciplinary communication, there is a need to provide methods and tools for doing so. This interdisciplinary research team developed and evaluated a decision support tool (DST) on a personal digital assistant (PDA) for cardiac tele-triage/tele-consultation when the presenting problem was chest pain. The combined human factors methods of cognitive work analysis during the requirements-gathering phase and ecological interface design during the design phase were used to develop the DST. A pilot clinical trial was conducted at a quaternary cardiac care hospital over a 3-month period. During this time, the DST was used by the nine nursing coordinators who provide tele-triage/tele-consultation 24/7. This clinical trial validated the design and demonstrated its usefulness to advanced cardiac care nurses, its potential for use by nurses less experienced in cardiac care, and for its potential use in an interdisciplinary team environment.