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Monday, March 10, 2008

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Pictures That Make You Cry

- Rob Bushway

The last time my daughter, Maggie, was in Memorial Hospital in Colorado Springs, Motion Computing Tablet PCs were easily seen being used on nursing stations and in patient rooms. That was two and a half years ago.

This weekend, Maggie was back at Children's Hospital  at Memorial Hospital, which is a whole different story. In between waiting for doctors and trying to pass time, I began looking for those same LE1700 Tablet PCs I spotted several years ago. I couldn't believe what I saw when I finally found them. They were locked down with Kensington Locks, with the pens gone, in docking stations underneath some nursing stations located next to patient rooms - pretty apparent that they were not to be removed. They had been relegated to just powering external monitors at a nurses station, clearly no longer being used for what they were designed for. I asked a nurse if they used them as Tablet PCs any longer, and she said no. They found the pen, what she called a "Magna Doodle thing", to be difficult to use, and found the lack of a keyboard to be frustrating. On the main nursing stations, they were using desktop pcs.

I can't tell you how hard it is to pass that station on the way to my daughter's room....There is another station just like it down the hall, that I try to avoid, because of the mere pain it brings my heart.....I just can't take it.

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3/10/2008 9:37 PM MST  

Pictures That Make You Cry     Comments [10]  |  Digg This |  del.icio.us |  Citations 
Monday, March 10, 2008 10:24:57 PM (Mountain Daylight Time, UTC-06:00)
hmm, strange solution with those external screens...

do you know if they had pen specific apps for their work stuff, or did they just operate "normal" apps with a pen?

hell, the lack of keyboard could be that the apps in use have a heavy focus on hotkeys or something.

the apps used are really a big issue here...
turn_self_off
Monday, March 10, 2008 10:39:39 PM (Mountain Daylight Time, UTC-06:00)
Hey Rob,
That caused me to think - our own Marshfield Clinic system in Wisconsin (statewide from central WI to the northern area) has made extremely good use of Tablets. The chairman of my non-profit board is the director of the education division - I should get some information/pictues on their system as a counter this the disaster you discovered.
Monday, March 10, 2008 11:04:10 PM (Mountain Daylight Time, UTC-06:00)
It's so incredibly difficult to deploy Tablet PCs in a business environment. By that, I mean to introduce the technology as a requirement to a broad group of users who may or may not "buy-in" to the effort. I've done it myself. We did a deployment of laptops (over 200). Some people wanted to use Tablet PCs as the primary device. I knew it wouldn't work. We tested it with a small group of people (12) with five different devices (2 tablets and 3 non-tablet) over a period of several months. No one mentioned the Tablet PC as being superior. Fault of the Tablet PC? Heck no. There was the lack of applications that took advantage of the unique input capabilities of the device and there was an excessive amount of unreasonable expectations surrounding it. "I'll never have to type";"handwriting recognition will be perfect". So unrealistic. As big a fan of Tablet PCs as I am, I knew it was doomed.

Simply put, changing the methods by which users interact with a computer is a herculean task. Especially a slate. It's never even remotely as easy as people might think. It's a god-awful, mind-numbing, where's the Excedrin task. Herding cats is more fun. (ok, maybe not)

It's why UMPCs have not taken off. It's why MIDs will have a huge obstacle to overcome.

Look at the iPhone. I don't want it. I don't like AT&T, I don't like the closed environment. The data is unbelievably slow. I have smartphones that do everything it can do and more... and yet people buy it in droves, it's getting more mobile web attention than anything before it (COMBINED!). The iPhone will, as Warner said, "own mobile for some time to come". I couldn't agree more. It's amazing.

It will do so because instead of figuring out how to do everything a computer can do and shrink it, they focused on the user first. Then they took the best technology they could muster and put it together. But they focused on the user.

Oh yeah, our users also lost the pens, wrote on the screens with real pens (my personal favorite) and cracked more screens than I care to recall.

Give me a Fujitsu P1620 with a capacitive touch screen, integrated WWAN and half a dozen web-developers and maybe, just maybe I can make something happen. That is, of course, until the users complain that a 2.5lb laptop with a 5 hour battery life is "too heavy", "too small", "too big", "too..." Ahh Goldilocks, what porridge shall I get you next? :-)
Stephen Feger
Tuesday, March 11, 2008 5:38:59 AM (Mountain Daylight Time, UTC-06:00)
One my school's hospitals had two motion tablets on the floor of the ER. Unfortunately they were bolted down to moveable carts and docked to a monitor, mouse, & keyboard. I asked one of the headnurses and a few residents about it and they had no clue that it was a tablet PC.

Rob, I completely agree, it's too painful a site to see.
Yonatan
Tuesday, March 11, 2008 6:05:39 AM (Mountain Daylight Time, UTC-06:00)
tsk tsk... what a waste of good technology. :(
Tuesday, March 11, 2008 9:13:30 AM (Mountain Daylight Time, UTC-06:00)
At the new hospital in Denver (Lincoln & I-25), they use M1700's exclusively. The ER doc's carry them to every room, and from the short time that I've had to talk to them, generally appreciate the technology, however, I think the most important thing they like is not having to find a place to put the laptop to type.
Jethris
Tuesday, March 11, 2008 9:59:28 AM (Mountain Daylight Time, UTC-06:00)
Hey Rob,
The problem is APLICATIONS, APLICATIONS, APLICATIONS.

The clinic I go for medical assistance has, as of last year, a whole set of Toshiba Tablet-PC. My Dr. was aware of the pen but did not kenow the usefulness of the pen, He never used it.
The program the Dr. was using is not written for pen usage, it is standard medical computer sofware, so he did not know how to use the pen with it.

I told him I had also a Tablet Toshiba, and tried at least to show him Journal. I COULD NOT FIND JOURNAL. Was not there.

They are being deployed without the proper training and the proper software for tablets.
Erich
Tuesday, March 11, 2008 3:23:41 PM (Mountain Daylight Time, UTC-06:00)
I wonder which generation of the Tablet PC OS they were using, because the handwriting recognition on Vista is soooo much better. Then again, Vista brings its own headaches.

All told, what a huge, sorry waste of money and good design !
borax99 (Alain)
Tuesday, March 11, 2008 7:16:57 PM (Mountain Daylight Time, UTC-06:00)
What a bunch of Morons!
schmolch
Wednesday, March 12, 2008 11:45:40 AM (Mountain Daylight Time, UTC-06:00)
I felt I should add my 2 cents worth here on this sad story. In healthcare in order for the tablets to work you need to get the physicians to "buy in" and that is not always an easy task. We see the value, but they need to see the value and that is an issue that has been plaguing the advancement in healthcare for quite some time. On my own blog I post articles about "frustrated" nurses and others in healthcare who "get it" and are flat out angry about the resistance of the physicians.

To get the "buy in" from the physician's standpoint, the combination of software to make this an easy task is required, i.e. dictation and software that makes it easy for them. Training is also important and many electronic record companies devote a full week of either training on premise or sending physicians to their facility to learn how to chart with a tablet with their software. Unfortunately, this is not done all the time and it is a shame as you end up seeing what you saw at the hospital.

My personal opinion is that the support needs to come from the top level of any organization to support this, i.e. the CEO. That is basically true of any new technology to be introduced. There are some nice tax breaks coming in to effect this year that also might help the cause as well.

It is truly sad to see technology like this wasted, I agree. There are a bunch of physicians online who do appreciate and use technology and I discuss and answer their questions all the time as relates to medical records and tablets and this group is growing, so that's a bit of good news! The more physicians we entice to the forums, the more we convince to make the change and use a tablet, so there is work in progress to change from old methodologies.

www.emrupdate.com is one place you might want to check out to see what physicians "in the know" about tablets have to say, and how they are promoting the use for other MDs.
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