Home Forums iPad (other tablets) vs In-room PC

Hello...I'm new to this forum. The office I work for is leaning towards Amazing Charts, and I have a couple hardware questions.

1. Does anyone run Amazing Charts (as a client) on an iPad? If so, what model, and how well does it work?

2. Does anyone run Amazing Charts (as a client) on a different tablet? If so, what kind?

3. Which configuration is prefered...a PC in each exam room, or a tablet/laptop for each practitioner?

Your input & suggestions are very much welcome!

Thanks,
Dean

Welcome to the userboard.

I can tell you that you will get many different recommendations for this. I prefer workstations in each room. You get the most consistent performance especially if everything is wired. You don't have to worry about carrying around your laptop or tablet.

I think some will say laptops. I don't think that many use iPads. Obviously, with those two devices you usually have to use wireless. I can't speak more against wireless. You will get dropped connections.

In the end, it is up to you. Also, depends on whether you are going to finish your charts in the room, which I also recommend.

I use an ipad in a limited fashion connecting to one of our workstations - AC is not designed to run on an IPAD and I do not think you will have great luck doing it this way.

I agree with Bert - hardwire in workstations - you can buy decent workstations for around $400-$500 each and this is a good investment.

I use the iPad a lot, but when it comes to AC, only to remote in via logmein when I am too lazy to get out of bed on a weekend. It is cumbersome, the typing glacial, and the "mouse" takes several tries for each selection. Bluetooth external keyboards are only a little better, since no Bluetooth mouse exists. A good laptop running windows and AC directly is much, much easier if a fixed workstation is not in the cards for whatever reason. I think tablets sound good, but unless your fingers are much smaller than mine, you will appreciate a real mouse and keyboard very quickly. I have a Dell laptop that can be used as a tablet, andI disabled that feature after the first day. I have a mouse in every room.

Wireless connections CAN work well, but if they don't they can complicate matters tremendously. They are inherently not as secure.

To use an iPad, you are crossing operating systems from iOS to Windows, thus you would have to use logmein or some other remote desktop program. While they are good, they are not as fast as running natively in Windows.

Laptops can work, but laptops and iPads have a higher likelihood of being stolen. They also cost more than a desktop system and probably do not quite have the lifespan. Repair costs are higher as well.

Thus, hardwire (gigabit lan is much faster) systems with desktops in every room is the most frugal, secure and lowest maintenance method. It does take up additional real estate and theoretically you cannot face the patient as easily (turn sideways works.) It's not as high tech as walking in with a tablet, but ....

There may be some Windows 8 tablets on the horizon that may work. But they are not available at this time.

Great post. Forgot about the OS.

We have a office with 5 doctors and have been using Amazing Charts for a year & a half and have used each beta version since 5.029 (including some that took several minutes to pull up a chart). Our original plan included getting each doctor a fast high dollar Dell tablet PC and each nurse with a 10" HP netbook working on the wireless network.
After a couple months one of the doctors got a Dell desktop PC for his office to gain the extra speed of the wired gigabit network. In a couple days he had me order similar PC's for each exam room and have them wired. A second doctor did same with in a month (these are the two that see the most patients). Now all the doctors are using laptops or PC's that remain fixed in each exam room most on wired network.
The time savings of the increased speed plus having the patient's chart already pulled up by the nurse when the doctor walks in the exam room made this in the words of the first doctor a 'no brainer'.
We were using $2300 Dell tablets & $435 netbooks. The new Dell PC's cost about $550-600 plus wiring of $150 per room.
The docs who did the PC's & wiring love it and found other uses for their tablets at home.

When we first started with AC, I used a laptop in the room hooked up to our network wirelessly. This worked fine but on occasion the wireless wouldn't connect for some reason.

We now have rather inexpensive "newer" used desktop PC's running XP hardwired to our network (gigabit). We got the PC's rather cheap and this has worked really well (except when our RAID connector died, but that's another post).

I recently bought an iPad for personal use. I installed Logmein on it. I don't find it practical for daily use in the clinic. It's a bit slower and harder to use. I would say if you were on-call and needed to remote in to look at the chart it works fine. But for daily use I find the wired desktop PC's are the way to go.

Marty, I think this is a little backwards. Many people bought them for business use, only to find out that they did not work well for the business, and had to make due with personal uses.
One thing that helps a bit is a decent blue tooth keyboard built into the case. Logmein is a little slow, but notes or other typing becomes much more feasible.

I would love it if AC made an iPad app (not the On-call app). I think an iPad with a decent keyboard could work well. I'd be afraid to set it down though and have someone walk off with it.

I have never really understood this. Cars work great to drive on roads that allow speeds upwards of 55 mph. Can a bike work, sure. But, it certainly has its limitations. (Ok, no ripping on my analogy).

I think workstations and laptops were meant for networking and crucial business applications. Smartphones and iPads were meant to complement them. To me, it's a no brainer.

Have you heard about Windows 8? I think the line between them is blurring.
Many people want a motorcycle or scooter. (No ripping...I actually used your analogy).

Maybe I am wrong, but I thought Windows 8 is an OS for a workstation of Laptop. Still back to the bicycle.

As I said above, Jon, I think it helps, but the lack of a USB mouse is the main thing for me. The psuedomouse on the iPad is really painful.

I agree. The initial problem so many of us had was trying to decide what to do, while still thinking in a "paper chart" frame of mind.
Like you Dean, when we started in 2007 we looked at all sorts of options, (and we wasted a LOT of money on tablet computers) because it emulated our interaction with the paper chart. The reality is that you are now interacting with a database and the tool to connect your brain to the database is a keyboard and a mouse. The first three tablets we bought? My partner broke his the first month, I moved on to computers in the room briefly and then on to a laptop. My associate got a fancy case for the tablet that would accomodate her blue tooth keyboard and mouse. Eventually we got her a real laptop to replace the one she was creating with accessories for the tablet.
We all have iPADs as well. Great for a phone call at home, using Remote Deck Top to our server. Great for signing off labs or imported items while watching television at home, ( but you need the little magic pen to improve the accuracy of your finger). Vastly inferior to the laptop for seeing patients.

Currently we are revisiting using a wired console in the room, and eliminating many of the bugs the wireless network causes. (In other words Bert is right, but I didn't want to just say so right up front).

Fully agree with DocMartin
We use wired work stations in each room, and I use an iPad for convenience in lot's of places. The latter is awful for data entry, even with a bluetooth key board it is not easy.
Use what fits your work flow, but I bet a notebook or wired desktop, + and tablet of some kind (Android tablets work just as well) of tablet.

I recommend desktops as well. Much easier to maintain, more powerful, and more reliable.

I have used all of them with AC, as a matter of fact, my PA has work stations in each of his rooms and he seems to be doing ok. My rooms however, have no PCs. I use my iPad 2 connected to my server via logmein pro and I can not be happier. It works much, much better than my wireless tablet, more stable and very speedy. Not to mention how light is the device and how easy to handle and zoom in when showing reports (I.e. growth charts, lab reports) to patients. They are left very impressed. I do not enter anything but the meds (e-prescriptions) and right click info (pmh update, etc) while in the room. I do not use my fingers or a keyboard, but an iPad pen (~$10) that i got in amazon.com. HOWEVER, I must add that I would not do this without having dragon medical hooked up to my tablet pc which now sits on my little desk just outside the rooms for immediate dictation. The good thing about AC is that you can log in into more that one computer with your user name/pw at the same time. I can not imagine how great it will be when the AC folks develop an app for the iPad but so far no way to go back for me, iPad it is over Desktops or tablets. Using version 6.02, and very very happy with AC. Looking forward to the practice mgnt version. Go AC!!

have been using AC for 7 years best to use with desktops we use it with desktops, in all patient rooms, and have 2 laptops for use when extra computers are needed. I use the logmein app when i am not in the office and find it very useful though cumbersome.

There really is no substitute for a keyboard and trackpad found on a laptop. A tablet will not let you enter the information as the patient talks, and thus is very inefficient. You will be left with a pile of charts to finish later, or a break between each patient to do this. You are losing out on the time saving features of the EMR that come with being able to enter information directly at the point of contact. It is wonderful to finish the chart before leaving the room. I have done this since residency and patients generally understand the need to type, and I am usually able to maintain some level of eye contact.

I see many have gone with hard wired PC's in the room. The problem I see with that is not being able to face the patient, or step out of the room with a laptop and finish the chart while blood is drawn or some such activity happens. In my old practice there were connectivity problems with WiFi on the routers. However, I have had minimal problems with laptop wireless connection since opening my own office with an Apple Airport Extreme router. This device is much more reliable than others I have used and I see no reason to use a hard wired PC at this point.

Some of us who would like to use iPads to run AC "natively" may be a small step closer. There is now a cloud version of Windows 7 that runs on an iPad. At present it only runs standard Microsoft applications, but a version is promised that will run any Windows app. I don't think it will be practical for AC, because of the database issue, but if a third party can do this, why not the geniuses at AC?

sounds interesting, but it is not window seven on the IP had. It is a remote desktop protocol type (virtual desktop) and right now I can do all of that plus more using log me in ignition or Citrix.

I also use laptops in the room, but mine are hard-wired and fixed to a mobile kitchen butcher block on wheels. I can move it around the room to face the patient anywhere. I can wheel it over to the patient to show them strengthening exercises or Netipot demonstrations on YouTube. I can log into the local hospital system and review their MRI w/ them on the computer.

I don't take the lap tops from the rooms, I mainly like their small footprint. So for the same reason as Boondoc, I maintain eye contact and portability within the room. I virtually always have the office note complete when exiting the room.

Adam:

would you mind posting a picture? I am interested in doing that. I have network connections in each room, would it be feasible to unplug and take your laptop between rooms and just connect to the network in each room?

Desktop! I made the change from laptop 3 years ago and have never looked back.

Gerardo,

Se this previous post from 12/11/2011 for a similar discussion:
#39087 Re: in room workstation
(How do you insert the link to a prior post? Hmmm... I don't know)

I do use a laptop that I carry between rooms. In the room, it rests on a lightweight rolling cart. There is a bad quality picture of it in the above post, but you can find the cart on the Office Depot website (and other similar ones).

Your post is here.

In the future, you copy the URL at the top and inset the post number after the word post. Normally, this would take you directly to the post in question, but I had to use a different process to find the post you mentioned.

Or you can go here to see it in higher resolution with a link to it online.

Master Bert,
Bless you for teaching me and fixing up my crappy picture.
Your ever indebted Piglet.
You see, I am trying out all of the dysfunctional Pooh characters.

NP,

Winnie...

HA HA HA, You're too fast!

I would have been faster if I could have chosen a character from the 100 Acre Woods more quickly.

Gerardo,
I am out of the office for a few days, but I will do so when I get back middle of next week.

Yes you could unplug and replug your laptop and bring it from room to room. I don't do this because if you leave AC open, unplug the network connection, then replug it, AC will have to search for the database. AC may reconnect automatically but usually doesn't in my experience, so it might be safer to close AC before unplugging the network cable.

In addition, the laptops overheat easily so I place each on a cooling pad/fan that runs off the USB port. This keeps the heat down and helps preserve the life of the computer.

As a new AC user, thank you all for this educational thread. I hope to learn from all of your experiences.

Gerardo,
this is my setup in the exam rooms.
The butcher block with laptop mounted on cooling fan.




Bottom of cart: drawer for pens and paper, shelves for books and medical models.




reminder notes for Meaningful use stuck to the top of the butcher block.

Very Nice Adam! Thanks for posting. BTW, I just noticed the quote from Benjamin Franklin under your name.

I have been using wired laptops in my rooms also. This set up works very well for me.

Adam,
what are those white things on the top shelf, one has your name written on it?

Roger,
This video may help you to understand what they are and how to use them.

So that's what you do with those things!!!

Funny video Jon, I'll have to pass that on