Meeting specific criteria is daunting and for an EMR project to be truly effective and compliant with official regulations it will require a reliable mobile computing solution that offers security options like fingerprint scanners and smartcard readers. Durability is also a critical element in order to withstand inevitable bumps, drops and spills at the point of care.

I recently discussed critical points for EMR deployments in a blog post titled ‘It’s All About The System…’ The post is worth reading if you are in the process of rolling out an EMR and in search of tips for a successful IT system.

For the study, two members of the nursing staff were equipped with Toughbook H1 Health MCA devices.  The nurses were able to access the hospital’s information system as well as frequently consulted information.  The Toughbook H1 Health was used in day-to-day care for a group of hospitalized patients and workflow was observed and measured repeatedly over the course of the study.

Prior to the deployment of the Toughbook H1 Health MCAs, observations and measurements were made of the nursing staff conducting the same procedures with a group of patients in the same areas of the hospital. This was done using conventional methods which included taking notes at bedside using pen and paper and later inputting data into the appropriate hospital information system.

After comparing the results, the hospital saw a dramatic improvement in workflow efficiency when using the Toughbook H1 Health.  Perpetration time was eliminated; medication and note taking was cut approximately in half and water (or fluid) balancing time was cut by approximately one third.  In total, the hospital saw a 40 percent reduction in the time its nurses used to conduct their daily work.

The full study is available for download on the Panasonic Computer Products Europe web site at the following link

The topic of tablet computers in healthcare has received an enormous amount of attention since the introduction of Apple’s iPad and tablets using Windows 7. While demand for mobile devices in the healthcare market is growing, there is still no one perfect solution for healthcare users – and there never will be. Radiologists have different needs than surgeons and nurses have different needs than phlebotomists. If your goal is to improve patient safety and workflow, then you’ll need to find devices that work best for each user.

This sudden swell of interest in tablets merits a discussion of issues healthcare organizations should consider when looking for a tablet of any kind. Before deploying a tablet, you must consider a number of factors, including ergonomics, connectivity, durability, security, vendor experience, service and support, functionality and the ability to repeatedly sanitize the device.  These will all impact the success of the deployment.  The worst thing you can do is just look at price!

Ergonomics
Ergonomics is a critical consideration for a tablet.  If a clinician is going to carry a device all day, it needs to be lightweight and easy to hold for long periods of time.  Years of working with healthcare professionals resulted in Panasonic designing a “hand-free” ergonomic strap and dome hand support system that cradles the hand for comfortable long-term use.  You can see this technology in many of our devices.  When considering a tablet, I encourage you to look at the ergonomics of the design and to have clinicians consider this element as part of the testing process.

Connectivity
Tablets are designed to facilitate mobility, but the true benefits of mobility can only be achieved with connectivity.  Most healthcare facilities gain connectivity via Wi-Fi, but home health workers may require mobile broadband.  When looking at a tablet’s connectivity, consider its ability to capture a signal in fringe areas.  Most devices will have a clear signal near a router or cell tower, but how strong is the connection as you move them away from an access point?  Wireless testing is simple and often overlooked.  It’s common to blame the wireless network when you can’t get a signal, but often it’s the device.

Durability
In Panasonic’s experience, healthcare customers are some of the most demanding. This highly mobile and dynamic work environment often leads to dropped devices.  As a result, durability is a chief consideration for tablets. Fragility is not an option when your work is mission critical.

For those considering the new iPad, I’d point to a recent article from PC World.  The title – iPad Stress Tests: Buy a Case and Don’t Drop It – says it all.  At the end of the day, if you can’t rely on a computer to operate after an inevitable drop or spill, then your ability to transform your workflow is significantly reduced.  Be sure to ask about the drop rating (for both the device and hard drive) for the tablets you are considering.

It’s worth noting that the average annual total cost of ownership (TCO) of a ruggedized notebook is 40% lower than the average TCO of a non-rugged device, according to VDC Research. So purchasing a consumer-grade product and trying to make it work in a demanding enterprise environment is probably not the best solution.

Security
Security is crucial in a healthcare environment. Having options such as fingerprint scanners and smartcard readers, paired with bios-level security technology like Computrace, is critical. If mobile devices don’t offer these options, you need to consider if they’ll provide the appropriate level of HIPAA compliance.

Expertise
Since the announcement of the Recovery Act in February of 2009, we have seen a lot of interest in the healthcare market from technology companies.  When considering a tablet, make sure you are working with a vendor that has substantial healthcare market experience. Lack of domain expertise can significantly complicate your launch efforts.  You need a partner that can provide support from the evaluation process well into the deployment, not someone that will simply sell you a device.

Service & Support
Many new tablet products on the market are not replacements for current technology, rather an extra device for an IT department to manage.  Multiple devices running different operating systems can complicate IT management issues.  Also, since many new tablet devices will be widely available through consumer channels, it’s likely physicians will purchase their own, bring them into the hospital and ask for IT support.  We saw this very phenomenon in commercial markets with the iPhone.  This forced IT departments to debate the pros and cons associated with having an “our technology only” rule versus a more open policy.

You should also consider the availability of software written for the device.  In particular, how many full EMR applications are written for the platform?

Functionality
Although I stated earlier that there is no one-size-fits-all solution in the healthcare market, you definitely want to avoid devices that are one-dimensional. The ideal tablet (convertible or slate) allows clinicians to accomplish as much as possible with a single device.  A well designed, lightweight convertible tablet can serve as both a physician’s desktop computer and hand-held tablet for rounds and patient interactions.  Mobile Clinical Assistants (MCAs) have integrated features such as barcode scanners, RFID readers and cameras to improve point-of-care productivity.  Not all tablets can serve multiple roles or even allow for multi-tasking – something the demanding physicians we work with have come to expect as the price of entry.  A well designed tablet will allow your staff to maximize productivity while limiting the number of devices your IT department needs to support.

Sanitization
Since hospital equipment must be frequently sanitized, choosing a tablet that can be repeatedly cleaned is another key factor to evaluate during the purchase process.  If not properly designed, screen viewability could significantly degrade after repeated sanitization.  It’s good to ask what sort of testing has been done in this area, and if the device is IP (ingress protection) rated.

The move towards EMRs and the abundance of mobile computing solutions coming to market make it an exciting time to be in the healthcare IT business.  Pure tablets like the MCA (including our Toughbook H1 Health), along with new generations of convertible tablets running Windows 7, are generating a lot of interest.  Devices like the iPad will push the market forward and keep tablets at the forefront of the healthcare mobility discussion.  But before you make a decision, step back and thoroughly evaluate your options.  The wrong choice can have long-term ramifications for both the quality of patient care and bottom line performance.

Frederick Memorial Hospital, one of the most comprehensive home health care systems in Maryland, knew that pairing the most reliable mobile computer with the best wireless broadband network would be a critical part of improving the quality of care offered by its home health clinicians.  The solution the hospital deployed was the Panasonic Toughbook T series laptop with embedded Verizon Wireless mobile broadband.

Recently, Frederick Memorial was placed in the top one percentile of hospitals nationwide for EMR adoption.  The hospital credits a large portion of this recognition to its Toughbook/Verizon Wireless solution, for its ability to easily collect and share standard information in the field.

Take a look at the video of Frederick Memorial’s mobility success story.

This is a modified version of the original post.

More often than not, those organizations are disappointed in the results of their investment.

When you buy a car, you don’t buy the engine, tires, airbags and seats separately – you buy a solution designed to work together as a whole. We all know that an EMR roll-out is more complicated than a car! So, why would you treat such a complex process as a series of separate investment decisions?

Every EMR system is made up of a standard set of vital components: software, hardware, networking, integration, security, user buy-in, training, support, etc.  None is any less important than the other.  If any one of those items is not compatible with the other, your million dollar investment will end up collecting dust in a corner.

Many aspects of an EMR deployment can lead to disaster.  Failing to appropriately train users on new EMR software; not ensuring sufficient connectivity across the user environment and deploying hardware that is too heavy and unreliable are typical complications.

Rather than create an EMR solution in an ad-hoc fashion, healthcare organizations need to invest in a system that will meet the needs of their users for years to come.

When tackling healthcare deployments serially, organizations run the risk of failure. It is important to take a step back and think about the pieces of this intricate puzzle before putting it together.

So, what should you do?  Every organization is different.  There is no one-size-fits-all EMR solution. However, there are a few commonly-accepted best practices that should always be considered.

1)     Create a multi-departmental planning team.  No one individual or department can foresee all the potential impacts and roadblocks in a deployment. Members from multiple departments bring unique perspectives to the project by identifying challenges that others may overlook or deemphasize.  In addition, including end-users as part of this team helps build crucial buy-in early in the process.

2)     Do not downplay IT support and end-user training.  In many instances, organizations focus solely on the up-front acquisition cost of the system.  However, saving a few dollars on the front end and not investing in training for end-users might cost tens of thousands of dollars over the life of the project.

3)     Consider working with a vendor who can deliver a complete solution.  Not only does this ease the buying process and increase the success of system integration, it lessens the red tape should anything go awry.

As the old adage says, “an ounce of prevention is worth a pound of cure.”  For a successful EMR implementation, it is essential to spend the extra time up front in the planning process to truly understand how the various moving parts will work together in your environment.

It’s great to know that house calls, a healthcare service reminiscent of the 1950’s, is coming back to practice. Doctors agree that seeing people in their environment allows them to get a better grasp of what their lives are like; and therefore, can assess their progress more accurately.

Whether it’s an increase in the number of mobile healthcare workers or clinicians working in multiple facilities, the healthcare industry is becoming increasingly mobile. And technology is the driving force that is letting this happen. According to the Journal of the American Medical Association, advancements in portable medical devices, information technology, point-of-service laboratory tests, and handheld computers all have attributed to the comeback of home health visits.

Mobile technology provides clinicians with the gift of flexibility and versatility, allowing them to be freed from their traditional environments and into real-world clinical settings without compromising access to critical patient information at the point of care. From a patient perspective, mobile technology is providing them with greater independence and quality of life. Patients such as the elderly and the chronically ill, for example, who are too sick to leave their homes and disabled can be easily monitored and cared for from the comfort of their own environment.

Clinicians have been adopting mobile technology solutions in their practice for decades, but they’ve had their clear limitations. The COW (computer on wheels) was introduced as a way for clinicians to bring computers closer to the bedside, but its size actually hindered mobility and cluttered hallways. Business-centric laptops were also introduced, but clinicians soon realized that they were a unique breed of user and needed a technology solution that was better suited for healthcare applications. Also, tablet computers were widely adopted but users found that they weren’t very comfortable to hold, lacked durability and had an unsatisfactory battery life.

So what are the elements that clinicians and healthcare facilities should look for when equipping highly mobile professionals?

• Mobile, durable, and rugged computing devices – The mobile technology solution must be able to withstand the drops, spills and blows associated with being a mobile worker. Whether it’s a home care nurse leaving the laptop in a sweltering car or a doctor dropping the device when traveling to and from a patient’s home, the mobile technology solution must be able to keep up with the demands of the application.
• An ergonomic and light-weight design – If mobile healthcare workers are expected to rely on mobile technology, the device should be comfortable to hold, light-weight and have a portable design. Otherwise, it will become a nuisance and hinder the efficiency of day to day clinical activities.
• Advanced wireless technology – Advancements in wireless technology has enhanced mobility in both facilities and in-home environments. Especially, in the area of embedded wireless wide-area networking (WWAN) as they offer healthcare workers new and higher levels of functionality and flexibility.
• Long battery life – Not only must the mobile technology solution have a long battery life, it must also be appropriate for the healthcare industry. A device with a typical four-hour battery life is inadequate in mobile healthcare applications where clinicians work long hours often away from plugs and power sources.

Those in the healthcare industry should take a moment to understand the powers of information technology, and the benefits it provides to clinical workload, business and most importantly patient safety. The healthcare market is experiencing major challenges right now, including nursing shortages, an aging workforce, greater demand for healthcare services, to name a few, and the fact that technology advancements are able to initiate a shift in the way healthcare is being delivered, in an effort to better serve patients, is remarkable.

In a sense, technology is bringing back clinicians to their roots – patient care. Home doctor’s visits, a thing of the past and the epitome of patient care, can be reinstated thanks to the advancements in today’s technology.

Steve thinks there are many groundbreaking solutions out there that could effectively help pull solution providers out of a tailspin.  Five of these products are listed in his post, including the Toughbook® H1.

Regarding the Toughbook H1, Steve says:

“Panasonic: A life saver. A 100 percent channel-focused company in a hot horizontal (rugged notebooks) that has just launched a slam dunk: the new H1 Mobile Medical Assistant. The H1 is a breakthrough product in a market that badly needs it.”

Click the following link to see Steve’s full post and the other four vendors/products that made his list:
It’s Time To Take Off The Blinders

According to JEMS, whose product review team selects the winners, its Hot Products represent “the most innovative, functional and potentially life-saving products to come onto the (EMS) market in the past six months.”

JEMS’ reviewers found that the fully-rugged mobile clinical assistant (MCA) “truly meets the demands and ever-changing needs of EMS providers” through its long battery life, integrated Gobi technology, dual hot-swappable batteries and a daylight-viewable screen.  These advances are “critical to maximizing EMS responders’ efficiency and productivity while protecting vital patient data.”

You can find the Toughbook H1 and other Hot Products winners profiled in the June 2009 issue of JEMS Magazine.

Announced in November of 2008, our fully-rugged Mobile Clinical Assistant (MCA) is based on the Intel® MCA Reference Architecture and aimed at healthcare professionals.