Technology and Medicine

	TECHNOLOGY & MEDICINE A Stylus in the Exam Room by Wynne Keller, Tracker Managing Editor

Interfacing with PDAs Using a Tablet with SYSTOC Additional Resources Interfacing with PDAs One of the most often-requested features for SYSTOC^® is the ability to interface with the Palm and similar hand-held devices, yet Occupational Health Research’s software design team decided not to develop such an interface and recommends the use of pen tablet computers instead. The Tracker recently talked with Ken Martin, Vice President of Customer Solutions, to find out why. According to Ken, interfacing with Personal Digital Assistants (PDAs) such as the Palm Pilot is simply not practical because the screen is too small to hold a meaningful amount of data, it is too hard to read and enter data, and the devices lack real-time connection to the primary data storage, making their data obsolete the moment the “hot-synch” is complete and they are disconnected from the source computer. The market is moving to tablet technology—even Microsoft is joining the party with its planned launch of a tablet PC operating system early in November. A tablet is an ideal choice for an application like SYSTOC 7.1, which is designed for the medical staff to use at every step of the patient visit process. The tablet screen, being small and portable, permits the physician to have a more face-to-face interaction with the patient than would be possible seated behind a standard desktop computer. A tablet’s touch-sensitive screen is typically about ten inches in diameter. Unlike a notebook computer, it has no hinge connecting it to a keyboard, so is much more portable and lightweight, and the batteries last longer. Data entry is much like a PDA, with input via a stylus that is used to tap on the screen. To enter text data, you can display an on-screen virtual keyboard, or you can use the entire screen surface as a writing tablet, forming large, handwritten letters, which the computer interprets and enters in whatever field had focus when you began writing. Unlike the special “graffiti” that Palm-based hand-helds use, the tablet computers typically accept “normal” handwriting, provided the letters are carefully formed. Most tablet computers have a wireless keyboard that can be used instead of or in addition to the stylus, and this is certainly easier if space and mobility permit. [top] Using a Tablet with SYSTOC We tested a ViewSonic Viewpad 1000 that retails for around $1,600. The tablet computer is connected to the network using a wireless 802.11b card. The range is typically 300 feet in any direction from the hub. The further you are from the hub, the slower it runs. Bandwidth can be an issue: multiple hubs may be needed, depending on the number of tablet computers. You install SYSTOC on the tablet computer just as if it were any other workstation on the network. At the beginning of the day, you start the tablet, log onto the network, start the software for character recognition, and then start up SYSTOC. Many sections of 7.1 have point-and-click orientation, which is ideal for using a stylus. For the sections that require text input, such as search fields, you can point to the field and then either form your letters carefully on screen or else click on the virtual keyboard in the bottom Windows tray to tap the keys you need using a picture of them that overlays a portion of SYSTOC. The advantage of the virtual keyboard is greater accuracy, but it obscures part of the screen until you are done. After a little practice, you will probably find you can work without the virtual keyboard and form your handwritten letters so that the computer recognizes them. Although you would want the wireless keyboard for long text, the handwriting is adequate for short sentences. Making corrections is probably the most difficult part, at least with the tablet we tried. SYSTOC 7.1 supports templates for the medical record. These are ideal for tablet use, as there is minimal descriptive text and the physician instead makes choices by marking Xs in the appropriate spots. Version 7.12, which is not yet released, will replace the normal memo text in certain sections with HTML memos so that true check-off boxes can be used. This will be even better for stylus use as you will not have to be so careful about where you place the stylus. If there is any downside to using the tablet, it is probably the process of entering passwords. Because passwords are not displayed on screen (most software replaces them with a series of asterisks), it is difficult to tell if the text-recognition software has picked up the letters correctly. Also, such software typically puts a space after any word you write, so you need to erase that space before tapping the OK or the password will not be correct. Probably the best solution for passwords is to use the virtual keyboard and tap the correct letters, rather than handwriting them. Some of the factors to consider when planning to implement tablets in your clinic include whether the software you use will work with the technology (i.e., are all functions available with a point and click approach), the price of the tablet computers, the number of wireless hubs needed for linking the tablets to the network, the physical distance to those hubs from each exam room, training the staff to use the writing-recognition software and virtual keyboard, and providing sufficient practice time for them to be comfortable with it. If you will be using the tablets to do medical records within SYSTOC^® 7.1, you will also need to create templates for your most common types of injuries, then gradually build more as time permits. If tablets are carefully implemented with a trained staff, your patients should find the real-time, computer-based recording of their visit just as natural and friendly as clipboard-based methods. Additional Resources Fujitsu ViewSonic Microsoft News about Tablets [top] [Return to Autumn 2002 main page]