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| − | The use of laptops affords bedside access to the EHR and allows CPOE, review of patient data and both physician and nurse charting at the point of care. Several institutions have felt that physician acceptance of the EHR and in particular CPOE would be enhanced by the use of laptops with WiFi access. Issues that have been raised with the use of laptops in the healthcare environment include:
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| − | 1. Weight
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| − | 2. Battery life
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| − | 3. Screen display, both touch screen and the size of the display and
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| − | 4. Durability.
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| − | With respect to weight, there is typically a tradeoff between battery life and weight such that very lightweight laptops suffer from inadequate battery life. In addition, larger LCD screens, although they offer improved “real estate” for CPOE and electronic charting, also have a weight disadvantage. At least one institution has used a “device triangle” to evaluate these conflicting issues (1).
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| − | Several different approaches have been utilized in implementing laptop use within the healthcare environment including:
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| − | 1. Rolling carts
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| − | 2. Hand held and
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| − | 3. Combinations of wall mounting and classic desktop configurations.
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| − | There are issues with all the various approaches. Rolling carts take up significant space, are heavier and are by their nature, less mobile (1, 2). In addition, the battery charge is limited as it would be in a classic hand held laptop implementation. Approaches to improving battery life have included the use of chargers incorporated into the cart and multiple battery packs to increase the time to next charge (2). Irrespective of the mechanism of battery charging, workflow must take this into consideration and budgets must include the inevitable purchase of new batteries as end of life occurs with the battery pack following multiple recharges (2).
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| − | Interestingly, there have been studies looking at who should purchase hand held equipment showing that better adoption of CPOE was not impacted by hospital purchase of the laptop. This likely varies with the age and level of training of the physician with house officers more likely to be receptive to use and hospital purchase due to the cost of the equipment (3).
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| − | Finally there is the real issue of security of PHI using hand held laptops and there have been numerous examples of loss of laptops containing patient information (4). At a minimum, laptops that contain PHI should be required to be password protected. Additional security such as data encryption, the use of biometrics and technology such as smart cards should be strongly considered.
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| − | References:
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| − | (1) http://www.zdnetasia.com/itlibrary/casestudies/0,39043351,39001443q-39126323p-Case%20Studies,00.htm
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| − | (2) http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B75GY-4JRVNJK-B&_user=582538&_coverDate=04%2F30%2F2006&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000029718&_version=1&_urlVersion=0&_userid=582538&md5=cfef719d5ea26ef75534196bb61d7c8e
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| − | (3) http://207.196.78.228/meetings/f05/program/poi_event.asp
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| − | (4) http://www.fiercehealthit.com/story/allina-suffers-patient-data-theft/2006-10-23
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| − | [[ldean|Larry Dean]]
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| − | [[Category:OHSU-SP-07]]
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