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electronic medical records for tablet PC

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David

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Feb 8, 2003, 1:15:37 AM2/8/03
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Does anyone have any experience using medical record
software on the tablet PC. There are a bunch out there,
some incredibly expensive. I would love to get some input
from somebody already using the system.
Thanks

Don Miller

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Feb 8, 2003, 12:13:33 PM2/8/03
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I am a "vendor" with a lot of experience in health IT who is promoting use
of TabletPCs in a wireless environment for a very specialized electronic
medical record (for prenatal care) called eNATAL (www.eNATAL.com). There are
a ton of issues to address re EMRs with TabletPCs (adequate horsepower,
networking capabilities, screen real estate, security, battery life, slate
vs. slate/keyboard, point & click vs. keyboarding, durability, etc.).

Basically, if you can run the EMR application on any computer, you can run
it on a TabletPC (I love my MotionComputing TabletPC). If you have specific
questions about any of these issues I would be glad to elaborate or address
specific concerns.

Don Miller

"David" <d...@dbegun.com> wrote in message
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Ben Lightfoot

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Feb 8, 2003, 5:04:42 PM2/8/03
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My clinic is running the MedicalManager system and have
just purchased 14 HP tablets. We haven't actually started
using the system yet. We decided on the HP for several
reasons:
1.Cost
2.seems to be pretty sturdy
3.works as a laptop but screen(tablet) portion detaches
from keyboard.
4.Battery time is pretty good.
5.weight (actually one of the lightest)

If I had my druthers, I'd have gone with toshiba but it's
also 400-500 more. I was concerned with the TransMeta
Crusoe chip as far as speed but it seemed to move along
quite well.

If you want an update, email me in a few months.

Ben Lightfoot, MD

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okogba

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Feb 8, 2003, 5:52:04 PM2/8/03
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I use a Fujitsu tablet PC with Top Charts made by e-mds and it works very
well.

TJ


mitodad

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Feb 8, 2003, 7:07:01 PM2/8/03
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you may want to go to Acer's site to see an article
written about a pediatrician who has been paperless since
1998. he replaced some windows ce handhelds with Acer's
tablet and seems very pleased. Go to their success
storie, and then under Health for the article. here is
the link:

http://aac.acer.com/APP/AKC/INTERNET/AACPubli.nsf/allDocs/
RWP3DFD745C746CE32088256A5C0077016C?OpenDocument

mitodad

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terri stratton

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Feb 8, 2003, 7:11:11 PM2/8/03
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Reposting mitodad's link and hopefully, it won't break.

Great article, btw! :)

http://aac.acer.com/APP/AKC/INTERNET/AACPubli.nsf/allDocs/RWP3DFD745C746CE32088256A5C0077016C?OpenDocument

--
Terri Stratton
Microsoft MVP
Windows XP / Tablet PC
http://TheTabletPC.net
Associate Expert
http://microsoft.com/WindowsXP/expertzone/focuson/tabletpc.asp


"mitodad" <mit...@hotmail.com> wrote in message
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David Begun M.D.

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Feb 8, 2003, 7:43:07 PM2/8/03
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Thanks to everyone who has replied thus far. I actually
already own the Fujitsu tablet and am more interested in
software packages. I am a psychiatrist in private
practice, which limits the complexity of software that I
need, but also makes it difficult to find a vendor with
something affordable, as I am not buying in bulk.
I will pursue the links you have supplied and will get
back to you with follow-up.

Thanks again,

David Begun, M.D.

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mitodad

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Feb 8, 2003, 8:40:09 PM2/8/03
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one thing and a VERY BIG thing at that. from many
aspects, i don't think you want to run an EMR from a
tablet/laptop. HIPAA notwithstanding, security is a very
big deal regardless of which specialy a doc is in. (btw,
currently watching Beggin Strips rorshack commercial).
whether one goes for an ASP model or an in-house server
model, need a lot of redundancy (RAID, etc, etc, etc).
too many docs don't have the computer literacy to
adequatetly set up a SAFE computing environment. also,
may want to think about biometric security issues if
you're really going to set up a fully functional EMR on a
tablet, and make sure it gets locked up. Also, what are
you going to do about daily backups for malpractice
reasons. i had to go with daily optical backups that get
saved in a $500 fireproof media safe as a regular
fireproof sage won't work.

my suggestion would be to contact your carrier about what
they would consider defensible when it comes to backups
to make sure you haven't "doctored" up the records once
lawyers come hunting (hopefully never!!!!).

just my $0.02 on the subject, but really think you need
to make sure you take these steps into consideration
before you make a VERY expensive mistake.

mitodad

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mm

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Feb 8, 2003, 9:10:42 PM2/8/03
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I agree that a little paranoia goes a long way, but how many physicians
store hard copy backups of their *paper* files? (Much less daily
backups...)

"mitodad" <mit...@hotmail.com> wrote in message

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Berry Edwards, MD

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Feb 8, 2003, 10:29:04 PM2/8/03
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I started programming FORTRAN with keypunch around '69, but for my medical
records I don't begin to trust anything but paper! My carrier told me they
can time date ink, so I still sign all my progress notes and evaluations
the old fashioned way and archive all the paper.

My only experience with a complete EMR was expensive and didn't work, so
we've (my office manager and me -- I'm a psychiatrist, too.) have patched
together a workable system with GoldMine for contact management
(scheduling, refills, calls, ID info, etc.) and MSWord for the records.
Input is via NaturallySpeaking. We still use a sneaker network, but expect
to go wireless when my Motion tablet arrives next week.

My grand plan is to take notes on the Motion during the session, the
dictate into it with DNS. We'll still print the notes.

For security I'm interested in the Copytele PC card Winbook was selling
for awhile. There are several such devices that allow encryption, password
protection, and even shredding of files (I use Eraser for that now.) Some
use USB, others PCMCIA.

If you do get sued, tell you attorney to look me up to testify for you! I
think the expectations placed on physicians to guard private data are way
too high, ie, unreasonable. HIPAA will be a windfall for lawyers and will
force lots of docs into early retirement.

BE

Don Miller

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Feb 9, 2003, 9:28:02 AM2/9/03
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> I actually
> already own the Fujitsu tablet and am more interested in
> software packages.

With all due respect, that is exactly the WRONG way to solve problems in
your office (you should first find the software that solves your problems
and the actual hardware is irrelevant). It may be possible in psychiatry
(free form text vs. structured data, one consultation room vs 20 exam rooms
where mobility is needed and the cost-effectiveness of one device vs 20 is
compelling) that dictation and transcription is still the best way to go and
trying to invent uses for gadgets and software is fun, but not necessary.

With that being said, I admit (probably along with all other posters on this
subject) that I too have bought many neat, cool, deductible gadgets before I
knew what to do with them, (e.g. Apple Newton) :).

Donald W Miller Jr MD FACOG
Founder & Chief Architect
eNATAL, LLC
www.eNATAL.com


"David Begun M.D." <d...@dbegun.com> wrote in message
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Don Miller

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Feb 9, 2003, 9:44:38 AM2/9/03
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I think your points are all true statements but slightly overboard
especially with regard to relying on malpractice carriers (or lawyers -
they'll invent all kinds of reasons to not even use computers) to be expert
or even competent in such issues as security of electronic data (there's as
many of them in the stone ages as are doctors - I've talked to them all).

I come from a specialty in the middle of a liability crisis and my company
(securely) hosts electronic medical records from all over the country that
have in-place the kind of security you have outlined. I too personally
believe this necessary security/redundancy is *well* beyond the competency
of most practitioners and I would NEVER advise any physician to keep their
medical records on a TabletPC (and not put themselves through daily backups
and archival on optical disks).

IMHO (and yours?), the TabletPC should only be used as a front-end to the
data, with the actual data locked up/backed up/duplicated on some secure
server either in the office (with automated security procedures) or remotely
(ASP model - let the vendor deal with it) and patient data should only
temporarily reside on the hard disk if at all.

Donald W Miller Jr MD FACOG
Founder & Chief Architect
eNATAL, LLC
www.eNATAL.com

"mitodad" <mit...@hotmail.com> wrote in message
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mitodad

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Feb 9, 2003, 11:52:05 AM2/9/03
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don,

first of all, glad to see that someone thinks i'm not way
off base. as for neonatology/liability issues, i know
it's fun being at the receiving end of medical (both
practice-related and not practice-related) catastrophies.
i'm still being black-balled for "whistle-blowing to dept
head 12 yrs ago after baby-doe laws from OH went into
effect.

though i, too, remember my programing days with ibm's
music 360 computers at BU, and though i've rebuilt
several computers - motherboards and all - in my day,
still don't consider myself a computer genious (like when
called software developer/vendor about why isdn modem
wasn't working - FORGOT to plug in phone line
<GGGGGGGGGG>, there are too many of us docs who dabble in
things without really thinking things through.

my tablet is strictly a citrix thin-client at work which
is all it should be IMHO. what i do with it afterwards is
full-fledged computing - see acer article. as a client it
is super fast compared to win ce mips products, and only
running on dual processor pII 450's with 768Mb ram and
9.2g mirrored system (thank g-d, as has saved my
proverbial rear, twice).

mitodad

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Gregg

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Feb 9, 2003, 5:03:43 PM2/9/03
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What do you think about using the new Smart Display
to "take the computer" into the exam rooms, rather than a
full-fledged tablet pc?

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Don Miller

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Feb 9, 2003, 6:17:25 PM2/9/03
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"Gregg" <gregg...@attbi.com> wrote in message
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> What do you think about using the new Smart Display
> to "take the computer" into the exam rooms, rather than a
> full-fledged tablet pc?

I haven't had one of these in my hands (has anybody?). Response/speed is
always an issue to clinicians (again, I have no experience to compare
TabletPCs with Smart Displays as far as response times - my guess is that
the differences would not be detectable by the average person). Increasing
the number of hardware devices/processors/accessories (remote monitor AND
computer AND desktop monitor AND extra keyboards vs. just one TabletPC that
plays all roles) is of concern as far as maintenance, theft, loss, etc. but
altogether may be cheaper than a single TabletPC (I also haven't looked at
pricing). So I guess you could even have a "desktop" (server) back room with
a couple dozen inexpensive desktops (~$500) connected to a network or in
each office and this could possibly conserve desktop space everywhere,
especially in cramped exam rooms and eliminate the objections to computing
equipment left in rooms with patients (the same with TabletPCs). Personally,
I would prefer a TabletPC unless the Smart Displays start weighing a pound
or less (they weigh about the same as some TabletPCs now).

I don't remember the name of the company or product, but about 8 years ago
there were wireless modem-based "dumb" terminals that did just this and
interacted with a server (rather than a desktop computer that are certainly
more powerful than servers then). It seemed like a good idea then, and with
the addition of HW recognition and many of the OS features of a TabletPC,
maybe the timing is right this time around if the displays get REAL light
(the companies that made these devices went bankrupt or pulled the plug).

Donald W Miller Jr MD FACOG
Founder & Chief Architect
eNATAL, LLC
www.eNATAL.com

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mitodad

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Feb 9, 2003, 6:58:45 PM2/9/03
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My set up includes a dual processor PII 450, 768Mb RAM and mirrored 9.2G
SCSI HD's (there was no ATA RAID when I opened. for clinical people
(nurse/doc/ma) initially had full screen Sharp Mobilon TriPad and Vadem Clio
1050 full screen windows ce devices. ultimately upgraded to NEC Mobile Pro
880 win ce with 800x600 screen instead of the above's 640x480. all of us
have been carying from room to room. as concerned about lack of tech support
for NEC in the long run as Sharp/Vadem products no longer supported, was
intrigued with tablet. needed convertible and not slate as do free text
entry (hpi, plan, and all abnormals that don't fit in template for
particular organ-system) and didn't want to get docking stations for all of
the rooms. Front desk has dumb terminal as everything is a thin client as OS
is windows nt terminal server edition with citrix metaframe.

my concern about slate is there is no easy way for free text entry as input
panel won't cross over rdp session, and as i type faster than i write,
convertible made most sense.

only downside of NEC MobilePro and Acer's tablet is that they're a little
more awkward than the Clio to carry with it's swing arm. Downside to Clio
(Sharp twin) was that curvature of keyboard put the ESC key too close to "1"
key so every once in a while hit ESC instead of 1 and deleted what rarely
was a 1/2 page of full text!

just my experiences and now one of acer's success stories.

mitodad


"Gregg" <gregg...@attbi.com> wrote in message
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Paul Tyler

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Feb 10, 2003, 12:30:52 AM2/10/03
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We sell thin client tablet devices as well as the Tablet PCs. Motion in
particular. Most of my users have not really noticed and neither have I any
real degradation in performance in using the Thin Client Tablet over Citrix
or RDP(like the smart device) compared to the Tablet PC. Infact one main
reason why enterprises have liked the Tablet Thin Clients is that (in a
citrix/ Terminal Server environment) they are light, less expensive, and if
they are stolen, they are only in reality a glorified Dummy terminal, we
have had customers who have had some stolen and then returned later
surreptitiously as they were bloody useless outside of the Hospital
environment, not only that very little can be locally stored. Which is a lot
more secure. Something that could be a benefit in the HIPAA time to come.

If you do use a Tablet PC, then I would make sure the Patient's Files only
stay briefly on the device's Hard Drive.

--
Paul Tyler
Athena USA
6524 Walker Street
Suite 230
Saint Louis Park, MN 55426
952-876-0428
952-883-0065 FAX
www.athenausa.com

"mitodad" <mit...@hotmail.com> wrote in message

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W.P. Sawyer

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Feb 13, 2003, 1:04:27 PM2/13/03
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I use a Fujitsu Tablet PC as a thin client with Misys EMR
and love it. I have worked hard on customizing the
templates that Misys provided and can now do about 95% of
my office notes "point and click". The Fujitsu Tablet PC
now lets me do that comfortably real time in the room with
the patient. The Tablet PC extensions don't work yet inside
the Misys EMR but the point and clicking through the
templates works well for me and is saving me time. I also
can read my own notes a whole lot better now as well!!
WPSMD
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mira.n...@gmail.com

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Oct 25, 2016, 8:33:00 AM10/25/16
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Hi David,
what exactly your software? I've been using clinicspro you can see the website www.clinicspro.com. they offer cloudbase software that is very cheap and their software is very flexible ;) you can access their medical software from any devices easily.

mira.n...@gmail.com

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Oct 25, 2016, 8:35:29 AM10/25/16
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Pada Sabtu, 08 Februari 2003 09.15.37 UTC+3, David menulis:
HI David,
what exactly your medical software name? I've been using clinicspro you can see their website at www.clinicspro.com they offer cloudbase medical software so you can access their software from any devices easily and their software is so flexible and they are very cheap :P Hope it helps :)
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