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The ABCs of Tablet PCs
How to Choose the Right One for You
By Bill Crounse, MD

For on-the-go data entry, the traditional pen and paper has been a tough act to beat. A physician walks into the examination room, opens the patient's chart, and makes notes throughout the interaction. But the efficiency of paper-based medical records breaks down in a hurry compared to electronic data capture.

The stacks of paper generated by traditional patient charts make it difficult to search and sort through, especially when a patient is being seen by multiple healthcare professionals. And too often, the patient record simply isn't available. In the emergency room and other hospital settings, critical decisions may need to be made long before the physical record can be pulled and delivered.

To be sure, a traditional notebook can perform many of these functions, but it lacks the natural visibility that comes from the tablet PC's form and input options. With a notebook, a physician visiting a patient in the hospital must find a flat space for the computer, or locate a chair, and try to keep the notebook from sliding off his lap. And bedside manner goes downhill as the physician breaks eye contact to concentrate on the screen and keyboard.

With a tablet PC, the physician walks into the examination room with the patient's complete medical record in the crook of one arm like a clipboard. Data gathering is completely unobtrusive, and the tablet PC, which typically has 20 to 80 gigabytes of hard drive space, can hold all the records that once were stored in a room full of filing cabinets — and more.

Depending upon the medical practice software you choose, you will have a rich field of patient data on a screen that's about the size of a standard tablet sheet of paper. Tap your stylus on the patient's cholesterol level or blood pressure and you'll see a history of all of their previous readings.

Medical practice software designed for the tablet PC can include templates with hierarchical branching to help you aggregate data with a simple tap of the stylus, and provide checklists to help ensure you are providing best practices.

If you have access to a medical center's EMR you can bring up X-rays, CAT scans, and other images to show your patient using the stylus to circle areas of interest, or to make a drawing to show what a future surgery will do. You also can use the tablet PC to show the video taken during an endoscopy procedure, for example.

When you prescribe a medication, the tablet PC can instantly search online databases to see if the drug is reported to have side effects with medications the patient already is taking. The tablet PC also can display generic equivalents, and determine which ones are covered by the formulary of the patient's health insurer. After the prescription is written, a tap of the stylus can transmit it to any pharmacist equipped to accept digital prescriptions.

Benefiting physicians

The tablet PC helps physicians deal with three of the greatest challenges they face:

Enhancing patient outcomes  — Whether responding to an emergency room telephone call in the middle of the night, consulting with a colleague across town, or standing at a patient's bedside, the tablet PC helps physicians access the information they need. And customizable templates and checklists help ensure that best practices are followed.

Remaining efficient across their highly mobile workday — The physician is the ultimate mobile information worker. Some studies have found that about 40 percent of the average physician's time is wasted — much of this caused by the lack of timely access to information causing duplicate efforts and other inefficiencies. The tablet PC lets you stay connected to all the information you need.

Minimizing time spent on documentation — Medical practice applications created specifically for use on the tablet PC make it simple to point and click your way through a patient interaction, using logical hierarchies and decision trees to document the patient encounter. The physician can augment the information, entering notes with the stylus or keyboard, or through dictation. The result: documentation is done in real time — not stacked up to be entered later. In many cases, transcription costs can be dramatically reduced or eliminated entirely. Earlier patient records, lab reports, and other documents arriving on paper can be scanned into the system.

Choosing a tablet PC

If you decide to purchase a tablet PC, some of the basic questions you'll face include:



Additional Resources
View more articles from the April 2004 issue

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In Summary
The tablet PC is the "next big thing" for the increasingly mobile physician, combining wireless access to data with the natural simplicity of using pen and paper. Before you purchase one, here are some things to know: You can choose between a keyboard-less version called a slate or a convertible model with keyboard and stylus. Tablets allow you to connect with your desktop, private practice servers, your medical center's electronic medical records (EMR) system, or the Internet. Built-in security protects patient privacy and data integrity. Tablets offer logical hierarchies and decision trees to document the patient encounter. Your documentation is done in real time. Processor speeds are sufficient for just about any application you'd use; you'll need to decide which model works best for you and how much storage space you'll need on the hard drive.