HealthBlog readers are familiar with my contention that data entry remains one of the primary barriers to more widespread adoption of electronic medical record solutions in our hospitals and clinics. Healthcare is a massively data-intensive industry. Everything we do in clinical workflow must be scrupulously recorded. This has become a huge issue for busy doctors, nurses and other clinicians who often feel more like transcriptionists these days than healthcare providers. Furthermore, it really doesn’t make much sense to anchor highly educated, well paid healthcare workers to a keyboard. Entering data takes time away from patient care.
Today much is being made about the widespread use of Tablet computers in clinical medicine, especially slate Tablet devices. The Tablet offers reasonable screen real estate on a highly mobile platform. Unfortunately, the most popular selling consumer Tablets are much better for content consumption than content creation. That’s why many large scale deployments of consumer-grade Tablet computers in hospitals and clinics are failing, often because they don’t provide all the data entry modalities, particularly handwriting recognition and “digital inking”, that clinicians prefer. I can tell you that there is nothing easier when it comes to filling out electronic forms on a Tablet computer than using a stylus and entering information into discrete data fields on a machine that does handwriting recognition.
Microsoft has just published a new case study that drives this point home. Clinicians at Sutter Health’s California Pacific Medical Center are using Windows 7 slate Tablet computers from Motion Computing to fill out electronic “My-Forms” developed by Microsoft partner, Mi-Co. Data collection is supported on the back end with applications built on Microsoft SQL Server 2008 R2 database management software running on the Windows Server 2008 R2 operating system. Kyle Smith, Director of Clinical Data Integration at Sutter Health said, “We wanted an ink-capture solution, and that meant using Microsoft technology”. He also noted, “Because Microsoft is one of our corporate standards, it was easy and cost-effective to add Mi-Forms to our infrastructure.
The forms developed by Mi-Co may look exactly like their paper counterparts, that is until data collectors start using them. The forms hide or display sets of questions based on the collector’s initial entries. Fields that need responses based on answers to earlier questions are highlighted while those that become irrelevant are dimmed. Furthermore, because data is being captured right at the point of encounter using digital ink, there’s far less opportunity for transcription errors that can occur when data on paper forms is, at a later time, re-entered into a computer. In a pilot test to see how healthcare workers using Windows 7 slates with Mi-Forms performed compared to those using more traditional data capturing modalities, the slates provided greater accuracy and were 36 percent faster. According to Dr. Richard Shaw, director of Clinical Informatics and Reporting, as well as Research Director of Cardiology at CPMC, the solution is likely to be a success not only at Sutter Health but also elsewhere in the healthcare environment. He said, “Combine the feel of the paper and pen approach with sophisticated and immediate feedback for data accuracy, and you have a compelling solution to the problem of intensive data collection.”
I believe this is just the beginning of unparalleled use of Tablet computers in clinical medicine. When released, the Windows 8 operating system will bring in a new generation of slate Tablets and other form factors for clinical computing that will combine the security, compliance, and management features desired by IT, with the mobility, ease of use, and data entry options required by clinical end users. I believe this will finally help tip the scales and take us closer to 100 percent adoption and use of electronic medical records in healthcare.
You can read the entire Sutter Health, California Pacific Medical Center case study here.
Bill Crounse, MD Senior Director, Worldwide Health Microsoft