Mass medication distribution for disease outbreak: comparison of personal digital assistant and paper-based decision support

In a disease outbreak, medication must be rapidly yet safely distributed to a population. Are there significant differences in efficiency (time) and error rates in drug dissemination to a population using algorithm-driven paper and personal digital assistant (PDA) methodology? In this study, conducted at the University of Hawaii, mock citizens were sent through points of dispensing with volunteer clerks processing them during two sessions (alternating modes for Session 2). No significant differences were found in time or number of errors with PDA vs. paper. However, the mode and order of testing affected time. Clerks doing the paper method second were slower than those doing paper first (significant at p < 0.0001 level). The PDA was consistent in time whether clerks used it first or second. This may indicate the presence of a fatigue factor from using the paper method and may indicate that during an outbreak, when clerks are tired, using an algorithm-driven PDA may help sustain efficiency.