Tablet Computers

From Clinfowiki
Jump to: navigation, search

Tablets have become increasingly popular in Home Care where the nurses, therapists and aides travel to the patient home to provide care. The ability to use handwriting recognition has proven very popular, especially in areas where there is no clean flat surface to set a laptop on. Average battery use is approximately 6 hours with the extended battery. Automobile chargers are available with most tablet computers.

We have a few midlevel providers that are using tablets or laptops with success, most notable Physician Assistants (PAs) that round for the cardiologists and anesthesiologists. Most of our physicians use either COWS, PDAs or the fixed thin clients/workstations. Even with a much improved wireless network, our nursing staff who does ALL their documentation in the computer have NOT found these devices to be very useful. Nonetheless, we have several hundred tablets deployed since we try to offer all possible access solutions to our users. We have docking/charging areas on every floor and nursing staff monitors that the units are being charged regularly. They much rather use the thin clients and workstations we have deployed in or near virtually every patient room. At another site, they have hundreds of laptops in use by the nursing staff who prefer them to the Computers on Wheels (COWS).

Advantages

Spyglass survey reports "TabletPC gaining support with outpatient physicians. Private practice physicians are finding the TabletPC is more usable and capable than the PDA for accessing more complex clinical applications due to increased screen real estate, integrated communications, a full sized keyboard and advanced handwriting recognition. With TabletPC, outpatient physicians can access a patient’s medical record; generate structured clinical documentation, initiate medical orders and view radiological images." [1]

We haven't had a problem with theft. Our devices ONLY work in house and each is labeled clearly. We have been very fortunate in all of our audits that we have not "lost" any.

Battery life has been up to 6-8 hours if you get the second battery instead of the CD reader. As far as battery maintenance, be careful. Different batteries have different needs. Some need to be allowed to run down, some do not.

We learned a hard lesson when we left laptops attached to the charger at nurse server work stations. They were not allowed to run down, and we were not aware that they needed to. A doc unplugged one to take to a critical patient during a "near code" assuming that since it was plugged in it would be fully charged, and the battery died in less than a minute, and he got a second one and the same thing occurred.

We now have an IS team that rounds and checks batteries.

Drawbacks

The overwhelming consensus of physician users in the Spyglass survey was that tablets were not useful in in-patient practice for most physicians surveyed due to: large size, heavy weight, limited portability, short battery life, and dropped wireless connections.

In controlled outpatient environments, the numbers reversed and physicians loved them; but not so in the ER. Issues raised in inpatient use were worse.

Optimality

Yet another site has put 12 Motion 1400s (slate tablet) and two HP tc1100s (convertible tablets) into use with physicians in the hospital. There are many issues to resolve here. Our findings include the following:

  1. Battery life is about 3-3.5 hours while on WiFi. If we went forward with tablets at this point, we would have to have a power cord for swapping batteries without having to go into Hibernate, and we would have to have batteries recharging in "toasters" nearby.
  2. Docking stations with attached keyboards and mice available in multiple locations on the floor is recommended. There is still ta need for entry with the keyboard, especially if you do order entry or physician documentation online. Then users can use the keyboard when they need to write a paragraph and recharge while they are writing. But to avoid that, they would need to keep the tablet with them at all times, even if the docking station is within the medication room or a side room on the hallway.
  3. Tablets are often too heavy to carry around. Physicians need something that they can put in their pocket.
  4. The ability for a doctor to show a patient in bed their x-ray is a very valuable. But it is hard to put down a heavy device like a tablet in the patient room without fear of contamination or dropping it. It's not a good idea to put such objects down on the patient bedtable or on their bed covers. Putting it in one's pocket would work better.

See also: iPad