Good Works in the Palm of a Hand

Social services and disaster aid transformed by small computers

Registered nurse Cindy Johnson no longer lugs bulky medical files with her on the house calls

she makes to families with infants who are at risk of developing physical or mental disabilities.

Instead, Ms. Johnson records the babies’ weight, blood pressure, and other vital statistics, and looks up information from their records, on the Palm Pilot handheld device that the Visiting Nurses’ Association Home Health Systems, in Santa Ana, Calif., has given to Ms. Johnson and 75 other nurses.

Forms that used to take Ms. Johnson 45 minutes to an hour to complete now take her 30 to 35 minutes. And she saves additional time because she can electronically transfer the data to her employer from her home computer, eliminating a 40-mile drive to the office she made several times a week simply to drop off forms.

“I went into nursing because I wanted to take care of kids and because I wanted to be with people, not because I wanted to sit behind my desk and do all my paperwork,” she says.

Nonprofit organizations like the Visiting Nurses’ Association and many others are starting to look at handheld computers as more than devices for keeping track of addresses, phone numbers, and appointments. They are experimenting with them as a way for employees to carry large amounts of information with them when their jobs take them out of the office and to collect additional data while they’re there. Homelessness organizations are giving handheld computers to workers who need to quickly locate social-service programs for people who refuse to go to a shelter, while other charities are using the devices to record neighborhood trouble spots and collect demographic and other information in disaster-prone areas.

Nonprofit groups are taking advantage of the fact that handheld computers — sometimes called personal digital assistants, or PDA’s — are smaller, tougher, and less expensive than their laptop counterparts, selling for $100 to $600 each compared with at least $1,000 for a laptop computer. Information can be entered into the devices by touching a stylus to its screen or by using small keyboards that either come with or can be purchased for the handheld computer.

Manufacturers of handheld computers — companies like Compaq, Handspring, and Palm — have helped encourage charities and schools to find new uses for the devices through their corporate-donation programs. The companies together have donated several million dollars’ worth of hardware.

Fighting Urban Blight

Most of the charity programs that use handheld computers have started in the past year, but a few have been around longer.

The Center on Municipal Government Performance — part of the Fund for the City of New York — became one of the first nonprofit groups to test the devices through a program called ComNET.

Since December 1998, volunteers in the Computerized Neighborhood Environment Tracking program have been using handheld computers to track problems, such as abandoned vehicles, graffiti, dead trees, and broken streetlights, in eight New York City neighborhoods. A digital camera attached to the devices allows volunteers to photograph the problems they discover.

The software the volunteers use to gather the information also produces reports — including the digital photographs — that can be sent to the government agencies responsible for handling the various problems. Reports can also compare the results of surveys conducted at different times or in different neighborhoods.

Barbara J. Cohn, a vice president at the Fund for the City of New York, says that in the past community groups have conducted paper-based neighborhood evaluations, but the difficult process of tabulating the data made it a very frustrating process.

When people collect information using just pen and paper, “they get back to their office or someone’s living room, and they look at this stuff and they can’t understand their own handwriting or anybody else’s,” says Ms. Cohn. “Then it has to be collated. It’s tedious, and usually it just doesn’t get done.”

In a very different setting — rural villages in the hurricane-prone León region of Nicaragua — Save the Children is using handheld computers to gather local information. With a grant from Microsoft’s Disaster Assistance Technology program, the charity has developed software for handheld computers that its employees can use to collect data about a village, such as how many people live there and what kinds of health, food, and education services those people have. The charity is working to collect such information both before and after a natural disaster.

The small, durable devices are an ideal tool for employees to use in difficult terrain, says Heike Sommer, the charity’s grants manager for humanitarian response. “In most cases, they’re only taking out a backpack at most, so it’s not as cumbersome” as a laptop, she says. Handheld computers also require less power to operate than do laptop computers, so the batteries last longer, she notes.

In June, Save the Children tested the software to be used after a disaster in a hurricane simulation designed by the Disaster Management Center at the University of Wisconsin. The center gave residents in two remote Nicaraguan villages scripts to follow if they were questioned by the charity’s workers participating in the simulation. Posters on buildings told of structural damage, and children even met the workers outside the village to let them know that a bridge was washed out and they would have to walk the rest of the way into town.

Completing the assessments with the handheld computers took eight and a half hours — a task the charity estimates would have taken almost a week if they had been administered and compiled by hand.

In a real disaster, the time savings would make a big difference in the speed with which the charity could get aid to those in need. Another benefit of the computerized assessments, says Ms. Sommer, will be that data will be gathered in ways that are consistent and can be compared over time. “We didn’t have anything that was very standardized, so the information that we would get from emergency to emergency would be different,” she explains.

Now the charity will be better able to tell whether a problem, such as the prevalence of malaria in a village, was caused entirely or only partly by the disaster.

During the June simulation, Save the Children employees had to return to the charity’s office in León to electronically transfer the information that they collected into a central database. In future versions of the program, the charity hopes that employees will be able to transmit their data as soon as they collect it, using cellular or high-frequency radio connections.

Doug Laundry, one of two Microsoft consultants who worked on the Save the Children project, envisions software for handheld computers that will someday allow relief workers to annotate maps of the areas they are working in, noting, for example, that a bridge isn’t passable or that a mudslide has blocked a common escape route.

For other groups, handheld computers are proving just as useful for their ability to retrieve information as to collect it.

Pathways Community Network, a collaboration of social-services organizations and local governments in metropolitan Atlanta, has started the Wireless Outreach Worker Initiative to make it easier for social workers to tap into information about their clients’ histories and the services that are available to help them. The Web-based Pathways Compass system allows organizations to share information about their programs with one another and to gain access to clients’ records.

Until now, the system has only been accessible when social workers see people who come into their offices, and hasn’t been much help when employees talk to people who live on the streets and are reluctant to come to the social-services offices.

Since May, social workers have been able to gain access to the Pathways database system using cell phones that can connect to the Internet. And starting next month, such workers will start using handheld computers to get into the system. Users will also be able to enter information about clients into the system via the wireless devices.

William Matson, Pathways executive director, says such access is crucial because the window of opportunity after a homeless person accepts an offer of assistance is brief. “If you run to a pay phone, get a busy signal, or it takes you a few minutes to connect,” he says, “when you turn around, that person’s gone.”

Slow Internet connections have posed problems for outreach workers using the cell phones, as has the difficulty of using a numeric keypad to enter information. To enter the letter “c,” for example, a cell-phone user has to hit the “2″ button three times.

Human Interaction

While charities say handheld computers hold great potential, some of the early users say they are not without their drawbacks.

The HIV Prevention Project, a needle-exchange program run by the San Francisco AIDS Foundation, uses handheld computers to record participants gender and ethnicity, as well as the number of syringes each one exchanges, saving the charity 10 hours a week. But an unexpected result of the switch from paper forms has been that it’s harder for the volunteers who run the exchanges to maintain eye contact with the people seeking help.

“You can write without looking, but you can’t really record the data without looking at the Palm Pilot for at least a few seconds,” says John Mullen, logistics coordinator for the project. “Since the interactions are so brief, if you spend more time looking down at the Palm Pilot than at the person, it doesn’t have as warm a feeling.”

Mr. Mullen says that now that volunteers are aware of the problem they are making a more conscious effort to greet each program participant when he or she arrives and to make eye contact as much as possible.

Glare from direct sunlight hitting the screens of the handheld computers has also been a problem, since some of the exchange sites are outdoors. Charity volunteers have tried adjusting the screen specifications to daytime and outdoor settings, but so far not much has helped.

One of the project’s employees has come up with a solution, however, to the potential problem that the devices could be damaged if they slip out of a user’s grasp. Volunteers can now attach the handheld computers to a chain that hooks on to a belt loop so that the PDA wouldn’t hit the ground if it were dropped.

Resource Guides

Two resource guides have been published recently to offer charities advice on working with handheld computers.

Last month Npower NY, a nonprofit organization that provides technology assistance to other charities, published “Mobile Technology in the Non-Profit World” (http://www.npowerny.org/pdfs_shared/MobileReport.pdf), a report that offers tips on selecting handheld computers, Web-enabled telephones, and other new technologies.

Jayne Cravens, online volunteering specialist at United Nations Volunteers in Bonn, Germany, has compiled an online resource (http://www.unites.org/html/resource/unites/unites0.htm) that reports on how charities are using handheld computers.

While she is impressed by the creative uses that organizations are finding for handheld computers, Ms. Cravens worries that charities may fall into some of the same pitfalls that organizations have run into with other new technologies. She fears that charities may be tempted to incorporate PDA’s just for the sake of introducing new technology, rather than carefully thinking about how handheld computers will enhance what they’re doing.

She advises nonprofit organizations to think about who will troubleshoot problems with both the hardware and the software and who will train staff members and volunteers to use the handheld computers before they run out and buy the machines.

Jeneane Brian, president of Visiting Nurses’ Association Home Health Systems, thinks that it’s important for charities to keep in mind handheld computers’ strengths and weaknesses as they design their programs.

Users will become frustrated, she says, if you ask them to enter large blocks of text — like someone’s medical history — using a computer stylus or tiny keyboard.

“You have to use it for what it’s good for and not try to make it into a portable computer,” she explains. “You have to respect that the PDA is a data instrument that collects fields of data that are short and sweet.”

COMPANIES THAT DONATE HANDHELD COMPUTERS TO CHARITIES

Compaq Computer Corporation
Corporate Community Relations
20555 State Highway 249
MS 050204
Houston, Tex. 77070-2698
fax: (281) 514-7024
cpq.contributions@compaq.com
http://www.compaq.com/corporate/community/program.html
Compaq’s corporate-giving program focuses on arts and culture, education, the environment, and health and social services.

Handspring Foundation
189 Bernardo Avenue
Mountain View, Calif. 94043
http://www.handspring.com/company/foundation
The Handspring Foundation makes product donations to nonprofit organizations that focus on arts and culture, education, the environment, health and social services, housing, and international aid.

Palm Education Pioneer Grant Program
SRI International
333 Ravenswood Avenue
Menlo Park, Calif. 94025
PEPhel@palmgrants.sri.com
http://www.palmgrants.sri.com
Palm’s product-donation program for nonprofit organizations is not currently accepting applications, but the company’s school-donation program announced its second round of grants in June.