Home Forums Discussions Problems Tablet PC and Amazing Charts

We are trying out AC on a tablet PC, and we are having a bit of trouble with the way AC fills the screen when we change from landscape to portrait mode.

When I change from landscape to portrait, the little boxes for entering vitals get so small that I can’t read the whole blood pressure or respiration rate.

Also, the whole screen gets cut off on the right edge, so that I can’t access all the buttons at the right side of the screen. It does this no matter how I resize the window. I don't have the option to scroll to the missing piece of the screen.

Does anyone else have a problem with displays getting squashed on a tablet pc when you change orientations? Have you found a solution other than quitting out of AC and restarting it in the new orientation?

Any assistance will be greatly appreciated.

(BTW, the tablet is a Fujitsu 5020)

We use a fujitsu. Did you hit the "rotate display" button and then maximaize the display? That does it for us.

The problem is that when the screen resizes, it seems to only fire the screen resize event if the screen doesn't fit.. so things get smaller when you go from landscape to portrait, but not when you go back to landscape. I have the same problem with my Lenovo (IBM) X41.

You can set the screen orientation default for each mode in the Windows control panel, and you might find it helpful to make the default in both tablet and PC mode to be landscape, so it doesn't switch modes unless you manually hit the button to rotate the screen.

Regards,

V.

Thanks very much for your responses; I have been experimenting with the situation, but I'm still having problems.

Wcoghill: the problem with the blood pressure windows being overly compressed can be temporarily alleviated by resizing, but they will still be tightly squeezed when I go back to portrait mode. This means I can't see the whole BP unless I'm in landscape mode. However, there is still plenty of white space around the BP display in portrait mode, so it shouldn't have to be so small. Also, I haven't figured out what triggers the event; sometimes the BP is normal size and readable in portrait mode.

Vinny: my Fujitsu is a slate. It doesn't convert into a laptop, so I am not sure how to apply your advice.

Here is the more serious problem: sometimes one of the girls will call me and the Amazing Charts display will actually be *cut off* on the right edge, where the "forward" and "sign" buttons are cut in half, and "vaccine" and "orders" buttons are completely cut off and inaccessible. Resizing and changing orientations doesn't change it at all. The only way to correct this is to completely quit out of Amazing Charts and restart. I haven't figured out what makes this happen yet.

If you find a solution please post it. I have just started using AC, and just purchased a Fujitsu Lifebook Tablet PC. I am also encountering similar problems of being unable to access the right side of the screen when I convert into Tablet mode. If I switch back into laptop mode, I am still unable to access that right side.

I just contacted Fujitsu to see if they had any suggestions. They had asked if I had tried switching the display to a higher resolution to accommodate the larger screen, and if that didn't work then to try adjusting the graphic card (intel icon in Control Panel) output. I have a corporate tablet, so I'll have to wait till tomorrow to get my system administrator to try it.

Okay, here are my latest observations:

Observation 1:

A. If I start Amazing Charts with the slate in PORTRAIT mode:

The schedule display is cut off on the righthand margin, and so is the patient's record. All displays will be cut off until I close Amazing Charts and restart in landscape mode. If I close the patient record, and switch the schedule/message screen to landscape mode before opening a new window, it doesn't matter. The new patient record will still be cut off. ALL displays will be cut off until I close Amazing Charts and restart in landscape mode.

B. On the other hand, if I start Amazing Charts with the slate in LANDSCAPE mode:

The schedule display is rendered intact, as is the patient's record. The displays will remain intact even if I switch to portrait mode. I can't make them become cut off; that will only happen if I *start* in portrait mode.

Vircen: I looked at the Intel icon in the control panel. The only setting I could find that seemed relevant to our problem was the "flip vs. blit" option under openGL, which relates to function in full-screen mode, but I tried switching these and there was no effect.

I did not try messing with screen resolution, because I suspected that the AC text would become too small, even if the window were accomodated.

Does this give anyone any ideas?

OBSERVATION #2

A. If I start Amazing Charts with the slate in PORTRAIT mode:

The text windows will start out adequate to contain a full three digits of the systolic blood pressure, and they will remain the right size, even if I switch back to landscape mode.

B. On the other hand, if I start Amazing Charts with the slate in LANDSCAPE mode:

The text windows for the vital signs will become squished if I switch to portrait mode, and will become normal size only when I revert back to landscape mode.

Any slate/tablet users out there with a solution, for this problem or the one in the previous post? Any ideas where to post for more ideas? My suspicion is that this a certified Amazing Charts *bug* that needs to be addressed. What is the best way to bring this to the attention of High Command?

I have never used a tablet (except when signing for samples), so I probably have no clue -- which has never stopped me before. Would getting a BETTER video card help. I do have a Princeton 19 inch monitor which can be converted from Landscape to Portrait, and it comes with special software, which I am sure yours does as well.

Since, I have no clue what I am talking about, why do you have to change back and forth anyway?

Re: better video card

The fact that other people are having this trouble on other convertible-display computers, with presumably different hardware, makes me doubt this would help.

Re: why change?

Comfort when cradling the tablet in your arm in an exam room (slate/stylus/portrait mode), vs. increased room in data fields when you're typing into it (laptop/keyboard/landscape mode).

Oh, I see on the second. I didn't know that.

On the video card, just wondered because maybe it would supply a higher resolution. On Vista, for example, if you use a low-end video card, you don't get a very good effect and can't use Aero. I know we aren't talking the same thing though.

But as I said, I have no clue...

I've been using a Gateway CX210S. Has been very reliable other than replaced the digitizer pen four times in six months. I've found that if I double tab in the top windows bar to split the screen, then double tap again to enlarge, the formatting is then OK.

I am curious about those who are using the tablets. Are you still using them? I have been invited, (a sort of guest Luddite) to speak to my state association regarding some do's and dont's for start up with an EHR and I am recomending against the tablets. We used them for a time and found the full keyboard to be too valuable to be without. I would be enlightened if you let me know if you have tablets and have continued to use them. Thanks.

My sister no longer even tries to use the tablet function on hers. She was a typist in college so we bought a mobile pc table to wheel to different rooms. I had bought her a convertible tablet luckily. She just uses it in labtop mode and types. Its faster for her and we dont have to worry about the handwriting recognition software learning her horrible handwriting.

I am not using my tablets as tablets right now, but I have not given up on the concept.

I was initially very attracted to the idea of carrying a tablet (I actually have slates) into the room, for several reasons:

It is so analogous to what I have done all these years, i.e. carrying a paper chart into the room, and writing on it with a pen.

I don't really trust my patients (especially children) alone with a computer in the exam room, especially a laptop; I have never ceased to be amazed at the depths of poor judgment parents exhibit at times. Truly, I don't really feel that I could turn my back on them for a moment. With a tablet or slate, you carry your valuable PC and sensitive PMI out with you.

I don't have room in my exam rooms for a standalone PC, or even a thin client. It would mean a major remodel. At one point, I had planned on rolling the laptop into the exam room a la Coghill. Most of the stands I saw looked rickety. I had nightmare visions of my brand-new Dell crashing to the floor. I actually found a great laptop stand, designed for hospitals, that was very stable, sturdy and compact. However, I found it to be too crowded when I rolled it into my exam room. Also, it created quite a show, clattering across the threshold.

I ran into some problems while trying to execute my tablet plan, however.

Some of the problems were directly related to Amazing Charts:

The screen is smaller than a standard screen. Amazing Charts' display is already a little small. The combination can make it a little harder to navigate.

There is a glitch with the vitals fields. When you change your laptop from landscape to portrait views, the vitals fields "squish", and can't be restored.

Some of the problems were related to my personal conversion from paper charts to electronic records.

I find that I am still needing my paper charts to a large extent, for reference to past notes, labs, etc. it was a little clumsy, trying to riffle through my old paper chart and deal with the tablet.

When I started, my wireless network was bone-achingly slow, due to the most incompetent network installation in recorded history. You have got to have a fast network, or your tablet will be a real source of frustration. If you're not using it wirelessly, what's the point of a tablet?

My tablets didn't have the memory or sound card capabilities to give me the voice recognition capabilities.

Now that I'm changing from paper charts to Amazing Charts, I have to basically create a complete history and physical for every patient the first time they are entered into the system. The first day of Amazing Charts, *every* patient I saw had to have a *complete* history and physical. About half of these patients were complicated, internal medicine type patients. I found that there was no way I could input that much data into Amazing Charts in a reasonable amount of time, except via dictation, using Dragon NaturallySpeaking.

I am not saying that tablets aren't available with voice recognition capabilities, only that I didn't have them. As a matter of fact, I have seen demos of tablet/slate PCs which seemed to have excellent voice recognition and internal microphones, and did a creditable job of voice recognition.

Peripherals increase tablet functionality

There are also wireless and Bluetooth dongles now, which just plug into your USB port and interact with a wireless dictation headset, which give excellent voice recognition accuracy, and would in fact be compatible with my slates.

Since my initial discouraging experience, I have added some other peripherals which have improved the functionality of my slates. I got some great "bump cases" for my Fujitsu's, which makes them much easier to handle. I got a couple of little light weight folding stands which they rest on. They have wireless keyboards and mice which rest in the vicinity of the folding racks. You can take the tablet into the room, jot down your notes, bring the tablet or slate to the dictation area, rest the tablet on its stand, and it immediately starts working like a regular computer, via the wireless keyboard and wireless mouse. You can type and mouse around all you like, and then snatch it up and dash to the next room.

I am now considering adding the wireless microphone dongle, so that I would also be able to slip on a wireless headset at this point and just start dictating into the tablet. That might be the missing piece for me.

Amazing Charts with Tablet PCs - suggested improvements.

If Jon could make just a couple of minor adjustments to the program, Amazing Charts would be an ideal EMR for a tablet, maybe the best on the market.

Fix the vitals glitch.

Change the vitals input screen, to make it ideal for a touchscreen, as I described in another thread.

Make a few changes to the layout of the patient record for people viewing it in portrait mode, a "tablet" mode, if you will.

Allow a "Print Preview" before moving to the "Sign" screen, to allow a larger-print view of the whole note, to allow users to see any items which might be hidden in scrolling screens. This would actually be a good feature for non-tablet users, especially those of us with less-than-perfect eyesight.

In conclusion, I think tablets can be a viable (even ideal) method for recording and displaying patient information, but implementation is definitely not as simple as it appears.

Man, your wireless installation was more incompetent than ME???!! Ouch!

You said the carts were "mostly" rickety? If you tell me of a cart for under 2 bills that 1)is not rickety on-screen and 2)does not take up the whole room , well I'll, I'll,...uh, uh...I don't know. Say "Thank You". Honestly, we took a risk and it turned out to be "not too too rickety." Even bought a second one. I'm trying to get her to just leave them in the room and carry the laptop down there, but she insists on wheeling the cart. "rattle...rattle...rattle..." What is it with you doctors, anyway? Can't follow instructions....<smile>

Wayne, my whole staff was checking the want ads over my network snarl.

I have a whole folder full of links to rolling laptop stands if anyone is interested. I got mine on eBay, 4" casters with shock absorbers. Very smooth, but still ungainly and noisy.

Your sister would be in great shape with my setup, Wayne, if she had tables in her rooms that she could sit down at to type.

You leave a stand on your typing table with a wireless keyboard and a wireless mouse. You just carry in your tablet, in tablet mode, and set it on its little stand. Sit down and start typing. When you get done, pick up your tablet and leave the room. The tablet doesn't have to be connected to anything.

The wireless keyboards come in very comfortable and ergonomic models. Yes, you would have to have a stand (cheap!), a keyboard, and a mouse in each room. But, the truly expensive component leaves the room with the doctor.

I am strapped for space presently. I was thinking about creating a wooden stand that is affixed to the table, and having the keyboard and mouse in a little drawer that slides out and folds down. That would be cool, but I don't have time to do it now.