Hospital doctor and former computer programmer, Andrew Harrison, has been testing a Tablet PC on the wards with some interesting results…
Pen, paper and a computer terminal are essential tools in my work as a junior doctor. I use the computer primarily to look up test results, and pen and paper for everything else. When the Tablet PC was launched six months ago, I wondered if it might help me by allowing portable access to results and perhaps replacing the pen and paper.
Over a period of three weeks, I tried out two implementations of the Tablet
PC: the Acer Travelmate and the Compaq TC1000. My experiment had one major limitation in that my hospital does not have a wireless network, so I was not able to look up results.
At work I carry around a list of patients and tasks associated with each of them, such as tests to be booked and specialists to be consulted. I also have notes on each patient about the progression of their treatment. I switched all of these to the Tablet, in order to alleviate the chore of regularly reprinting paper lists. In doing so I hoped to give myself an insight into a future world of portable electronic patient records.
I worked in "Tablet Mode", using only the special pen rather than the keyboard for data entry, so that I was able to stand up and write on it at the bedside. Text entered into a Tablet can either be stored exactly as it is written ("liquid ink") or it can be instantly converted into "typed" text. I used the latter because electronic patient records are going to be no good if people still can’t read the doctor’s handwriting.
Otherwise I continued to work as before. The great difference was that the Tablet gave me clear organised electronic lists instead of cluttered-looking paper sheets. The only software I used was a word processor.
However my overriding memory of the experience is one of fear, because I spent the entire time terrified of dropping the Tablet. Previously I have used a Palm Pilot and that has landed on the floor many times, fortunately undamaged. But dropping a Tablet was not an experiment which I thought likely to be beneficial. I was also worried about it being stolen, so I had to hold it carefully in my hands all day. I wondered why the designers had not included comfortable handles and a wrist strap.
My handwriting is very bad, and I hoped that an additional benefit of the Tablet would be a gradual calligraphic training, as I adapted my writing so that the Tablet could consistently interpret it. Unfortunately after three weeks my handwriting was as bad as ever. But even when I did write a line of completely clear well-formed letters the Tablet often converted it into something ridiculous. It had particular problems with abbreviations and deciding what should be upper and lower case. In time I am sure that I would have learnt techniques to avoid these problems, in the same way that I became proficient with Palm Pilot Graphiti.
An unexpected use for the Tablet was as an X-ray light box. And ironically it also provided a useful firm surface for when I had to write on paper, though I wished that the special Tablet pen had had a normal pen at the other end so that I did not have to keep switching between the two.
One problem with IT in the NHS is that doctors do not like using computers. At work we have "downtime forms" which are paper slips that can be used instead of the computers whenever there is a technical problem. Many of my colleagues use these forms all the time, out of preference. Therefore I cannot see many doctors incorporating Tablets into their work at this stage.
Personally I would use one if I could connect to a wireless network. But I would buy the lightest model available and make sure that it had a wrist strap. And I would get good insurance.
andrew.harrison@imperial.ac.uk