Many family physicians will not manually update PDA software: an observational study

In a prospective study to explore connections between clinical information delivery and information retrieval, 41 Canadian family physicians searched an electronic knowledge resource (EKR) as needed for practice. Research software, called the Information Assessment Method (IAM), prompted family physicians to report on the situational relevance, perceived cognitive impact and application of their retrieved information hits. Both the IAM and the EKR needed periodic updating to properly address our research questions. To determine the frequency of software updating when manual or semi-automatic approaches are used by family physicians. Each family physician received a handheld computer (PDA) that ran the Windows Mobile 6 operating system. For technical reasons, both the IAM and the EKR were accessed offline on PDA. To update the EKR and the IAM, family physicians were asked to synchronize their PDA to their PC. Updating the IAM was a manual process, whereas updating the EKR was semi-automatic. We found: (1) about 25% of family physicians never or rarely updated PDA software on their own, (2) a large number of software updates were never installed and (3) the semi-automatic method was associated with a small increase in the proportion of installed software updates (58.9% versus 48.6% for the manual method). When a wireless internet connection is not used to update PDA software, sociotechnical issues complicate mobile data collection and data transfer.