Handheld computers for data entry: high tech has its problems too

Clinical nurses involved in a randomised controlled trial collected patient information on a hand held computer in parallel with a paper-based data form. Both sets of data were entered into an access database and the hand held computer data compared to the paper-based data for discrepancies.Error rates from the handheld computers were 67.5 error per 1000 fields, compared to the accepted error rate of 10 per 10,000 field for paper-based double data entry. Error rates were highest in field containing a default value.While popular with staff, unacceptable high error rates occurred with hand held computers. Training and ongoing monitoring are needed if hand held computers are to be used for clinical data collection.The use of handheld computers has been increasing steadily in medicine over the last decade. As a data entry tool, handheld computers have a number of advantages over paper-based data collection including reduced paperwork, transcription errors, time and cost [1,2]. In some clinical settings it has been estimated that the use of a handheld computer can save nurses nearly two hours per day [3]. Handheld computers have been adapted into a variety of research and clinical settings and available software allows integration into many database types. However, studies have not documented the accuracy of data collection using handheld computers. There is an underlying assumption they are better than a paper-based system.We recently completed a longitudinal prospective randomised controlled trial of 461 palliative patients [4] followed from referral to a specialised palliative care service until death. This trial generated more than 2 million paper-based data entry points. Prior to instituting handheld computers for data collection and entry, we assessed user accuracy. Our aim was to use handheld computers to reduce trial nurse's workload.An Ethics Committee-approved comparison study was undertaken with 6 trial forms. Staff undertook training on Compaq Pocket PCs mode