When the Tablet PC is Overkill
Today I made a visit to the doctor that restored my hearing. I never thought I would say this about a doctor’s office, but this one is one of my favorite places to visit. It would be reason enough that this place will always be remembered as the miracle hearing restoration place, but on top of that it is a medical practice that is outfitted with Tablet PCs. Tablets can serve such offices with panache, yet it is rare to see so many of the devices in such an office. After two visits and an extended conversation with the doctor running the practice, I now know why such offices are rare. They’re not needed as a rule.
There are three distinct sections to this practice, and each is using a different Tablet PC. The first section in the practice is where the audiologists use HP 2710p convertible tablets, one of my all-time favorites. They are as thin as can be, and great convertible notebooks. I assumed the practice chose them for the ability to use them in slate mode while moving all around the office, but I was wrong. The audiologists and the doctor admitted to me the 2710p is only used as a laptop, and only in the hearing test rooms. They are in essence thin and light desktop computers, so there is no need for them at all. When the medical practice was set up over three years ago, they were recommended by the consultants employed to get them going. These convertibles were over $2,000 each back then. Very expensive desktops at that.
In the second section of the practice using Tablet PCs, it’s a different story. The nurses and assistants all use HP tc4400 convertible notebooks, and they chose them for the mobility. When a patient is taken to an examination room, a nurse or assistant steps in with the tc4400 and does the prep work for the doctor. They take the vital signs, and discuss the reason for the patient’s visit. Everything is entered in real-time into the convertible, which updates the patient’s file over the wireless network. It works well, and you don’t see a paper file anywhere in the practice.
Once again, these convertibles are only used in laptop mode. This is faster due to the staff’s familiarity with the keyboard. Time is money in this busy practice and they have to spend too much time correcting interpretation errors if they use the pen in tablet mode, I was told. The laptops work well for their use, so it’s no big deal they aren’t using the pen. It is a big deal that they paid for convertibles when they don’t need them, however. Especially considering they have a dozen of them used in this way.
Lastly, the doctors themselves carry Motion slates around with them when visiting patients. Finally I thought I’d see some pen action, since there’s no keyboard on the Motion. That was not to be, as the doctor simply uses the Motion for reference. It’s handy for them as they have the entire patient file at hand (literally). It’s easy to carry around from room to room, and it’s easy for the doctor to show something to the patient when needed.
I spent some time talking to the doctor about this to understand why they have all of these tablets but never use the pen. He admitted he hates the Motion, because he has to dock it in his office if he wants to enter information (with the keyboard). The pen doesn’t work for him and he doesn’t use if for anything but a mouse pointer while walking around. I asked him if he’d looked at tablets with touchscreens, and his eyes lit up at the thought.
Geek that I am, I pulled the ThinkPad x200t out of my backpack and let him play with it. He was pumped up that he could tap things on the screen, eliminating the need to pull out the pen. He was so happy tapping things I was beginning to wonder if I’d get the ThinkPad away from him. He was equally impressed that it weighed not much more than his Motion slate, yet was a full convertible notebook too.
What he really wanted was a notebook computer that could be used as a touch tablet when desired. I explained that this ThinkPad wasn’t the only one that could do this. The new HP 2740p has a touch option too. He had no idea that such technology existed, and sadly this is not an unusual case. One of the obstacles to adoption of the Tablet PC has always been lack of knowledge about them, especially with so-called consultants like this doctor used when he set up his practice. He’s spent the past three years lamenting the big bucks spent on Tablets he didn’t need.
I believe with proper software and training, his staff could get good use out of all these tablets. But it hasn’t happened in three years, and there’s no reason to believe it will happen at all. I find it interesting that a touch tablet is really all the doctor needs to get his work done. Sometimes it’s the simple things.
Related research on GigaOM Pro (sub req’d):
I wonder if the doctor has heard about the iPad?
Yep, the iPad would be ideal in these situations. I got a feeling had James whipped out an iPad on the spot and let him use it the good doctor’s head might have actually exploded from all the excitement. And after James revealed the iPads price, well….the entire office may have just burst into…need I say more.
Went to the doctor and before he came to see me a nurse came in with a full laptop. She left for a moment and returned with a USB mouse. What a waste I thought. Mentioned to the doctor that it was great that they were using technology (he had a laptop also) but to give me 5 minutes and I could teach his staff how to use it. Simplest keyboard shortcuts (they were amazed that the tab key could move them around in fields) and setting the trackpads speed and I had a free visit with the doc.
Why this story? Simple, sometimes the technology isn’t used to it’s potential because no one has taken 5 minutes to learn how to use it.
How you use the tablet depends a lot on the EMR you are using. Some software lends itself well to pre-generated templates, where you could enter data quickly with checkboxes and drop-down lists using a pen. The pen also works well for short notes, prescription refills, etc. There’s also no comparison trying to draw a diagram in a patient file using a pen vs. a mouse. I use the keyboard for entering longer text.
James, if you were my patient I’d devote extra time for each visit to demo all your techie toys… ;)
How much paper did they use there?
I ask because for me, the Tablet PC is not about replacing the pen in “pen and paper”, but replacing the paper. Pen functionality (Wacom specifically) is an expectation in being able to realize that-especially if I want to convey something that a keyboard alone will not permit.
Nevertheless, the simple fact is that they are using applications built around a keyboard-and-mouse paradigm on a similarly-designed OS, and they probably have it ingrained that the only way to use them is with-you guessed it-a keyboard and mouse. Perhaps the pen only seems natural if they’re using it with dead tree sheets.
Tablets need an interface to match, both OS and apps. As much as I like Win7 on a Tablet PC, it still mostly feels like a keyboard-and-mouse OS with a slick Tablet Input Panel, if only because most applications (the exceptions being OneNote/InkSeine/Windows Journal and art apps, of course) are still designed around a keyboard and mouse. Maybe then, the average user will better understand the functionality a tablet computer can offer.
Even Microsoft finally realized that, and thus we have the Courier. (I really hope that won’t just be a concept, but a real product…)
This was hinted at above…I think the problem in JK’s doc’s office was a lack of forms software suited to the hardware tools. You can’t expect people to to abandon familiar keyboard-based tech just because of some vague gee-whiz vibe. That’s really been the prob with tabpcs all along. Cool hardware that has nowhere to go, software-wise (unless, like many of us here, you’re willing to seek and suffer for your gizmo jones).
That’s where the Ipad will triumph. Corralling the experience, but making that experience delightful.
T
t
Its a pity you did not tell your doctor about the iPad. I think he would have been very excited about trying it out as soon as it is available. Your post is in many ways a huge argument for the iPad. OS and Apps design from the word go with touch in mind. Also the hardware is thin and weighs just a gram +. The UI is also easy to use, no major learning curve. These are the reasons why the iPad will win where Windows based tablets have failed.
So none of the tablets they used had a touchscreen? I wasn’t even aware there were tablets that didn’t have touchscreens. Sounds extremely awkward to use
You’ve got it all wrong. The reason doctors don’t like Tablet PCs is because it can decypher their awful scrawl and no doctor wants that. :)
Too true. ;)
Actually, one of the huge benefits of EMRs is reduced medical errors by removing that variable. I know the local pharmacists love my prescriptions compared to before. A computer generated prescription vs. my old “chicken scratching.”
Thanks for this piece. It is a sobering experience to see how people actually use these tools in their work environment.
Obviously training such as Mr Frost mentions combined with Nameless’ observations of forms not built to purpose needs to be addressed to provide the best setting for tablet devices. However, I doubt this medical office is unusual in spending lots of money upfront and then being left to their own devices in day to day work.
Andreas: Until very recently, most tablets either had an active EM pen digitizer or used a resistive digitizer.
The former was preferred for Tablet PC because of better accuracy, sensitivity, and the ability to detect the pen near the surface as well as the pen touching the surface. This made for a better inking experience, but required a pen, particularly since you didn’t have to worry about the user’s hand/wrist/arm also laying on the surface.
Resistive digitizers are cheaper and only detect when something is pressing hard enough onto the surface. Hence, this can be used with both a stylus and finger touch. The minimum pressure required affects both inking and touch experience, lighter is better for touch, heavier is better for inking as it reduces accidental touches.
Capacitive touchscreens are more expensive than resistive touchscreens, so weren’t very common until recently.
There’ve been some dual digitizer (active EM digitize with a resistive touchscreen layer) tablets but they’ve been rare and even more expensive than more usual tablets. Active EM + capacitive digitizers started showing up about a year ago.
Anyway, its the software. Medical practices are extremely loathe to change software since that means they’ve got to convert their records into the new system. What’s a bit surprising to me is that whatever consultant they originally hired didn’t recommend software that went with having tablet PCs, otherwise the question is why did he select tablets in the first place?