Home Forums advice for a laptop

Currently, we are working with desktops in our offices, and no computer in the patient exam room. What mobile computer would would you suggest? I have seen some old threads suggesting convertible tablets, but I am thinking that an ultrabook would be ideal (light, powerful).

We will need to run a few web based programs at the same time to interface with our lab and the hospital. I need to make sure that whatever we try has enough power to do the job quickly. Probably needs to be able to run dragon.

Any thoughts?
We are a smallish practice, have 5 MD's, and three midlevels. Three physical locations. Equal number of MA's.

thanks

Hi, SWheaton.

I would wait until the end of October, when Microsoft unveils its Surface:

www.microsoft.com/surface/

So much is in flux, and there will be many new competing products coming out this fall. I use an i5 Sandy Bridge (pre-ultrabook) Toshiba that works great for me, though.

Best,

Marlene

SWheaton,

We have 8 docs in our office, and no midlevels. 6/8 are on an EHR. 5/6 on AC. 1/6 on e-clinical works. In the exam room we are all doing things a bit differently.
2 are using the I-pad, one with blue tooth keyboard, remoting in to their office desktop. One is using a tablet remoting in. One is hardwired using MTech touch screen desktops in each exam room. One is using a tablet in one room and hardwired desktop touch screen Mtech in another.
I am using an 8460p elite notebook which I carry from room to room (only have two exam rooms). For my first month or so after starting AC in 11/11, the mother board went out on the brand new 8460p and eventually got lost by fedex after the second repair trip to Texas. So if you had asked me then I would have said to steer clear of this product. But since getting a replacement I have not had one issue, however I do not utilize dragon on this. I only do education with up to date materials, (P1102W HP laser jet printers in each exam room-compatible with windows 7 or XP), electronic ordering, efaxing with updox or e-scribing from the exam room. This is not hardwired but use a gigabyte switch, and no speed issues or dropped connections. My desktop and nurses desktop (an 8460p elite notebook functioning as desktop) are hardwired. I only have 3 computers back in my pod.
The elite notebook has 8 ram of memory and a dual i5 processor and functions efficienctly. I wish the screen were a bit bigger, now that I upgraded to a double 23 inch screen on my desktop, but it works. Hope this helps.

http://amazingcharts.com/ub/ubbthreads.php/topics/41482/iPad_other_tablets_vs_In_room_#Post41482 --this discussion below on the tech talk section is a fascinating read, if you have not seen this already it is worth a look.

The majority of Providers that have an opinion about screen size prefer at least a 15" machine. Once folks are in the bifocal demographic, the preference for screen size goes up. For price/performance, a solid alternative is a walk mounted desktop with the monitor and keyboard on a swivel tray.


Not sure if I am miss-reading your mention of the interfaces, but those generally run on the server if there is an AC interface. If the interfaces are for individual users, then your network throughput and Internet provider performance will have the largest impact on the speed of the connection.

As far as Dragon, performance of the local machine is going to be key. We have had a few conversations around here about implementing Dragon - the short form - the more memory and processors the better.


So, one of the challenges of having multiple Doctors and mid-levels practicing in multiple locations is having a central server, as well as backup servers in each location in the event of a connectivity outage. An alternative solution is a shared managed environment, with machines in each location that can serve as a backup server in the event of an outage, as well as a rolling disaster recovery and data resolution system. {disclosure - that is one of the services that we offer, so I know a bit about them]. The last bit is a mouthful, but that basically means having a plan so that each location can continue to practice, and then dealing with smoothing out the data after you outage is repaired.

You may find that different users are going to desire different implementations; that may also weigh on your final choices.

We use high powered desktops in our exam rooms. The Intel Ivy Bridge i5-3450 processor along with 8GB of RAM and 128GB SSD. The real kicker is that we mounted a 23 inch touch screen monitor on an Ergotron arm. You can either pull the touch screen up to the exam table and type using that. Or leave it near the counter and use the keyboard and mouse. Dragon could also be easily implemented. The Ergotron arm allow movement and rotation in virtually all directions.

So we get the benefit of having a touchscreen tablet and a full powered desktop. We also get the freedom of motion too with the arm.

I noticed you have 3 locations. I'm curious about how you have it set up now. VPN or a Terminal Server?

If you have a Terminal Server, the laptops you choose are more or less irrelevant as all the processing will happen on the Terminal Server. So you can make sure you load that up with plenty of RAM and very fast drives (SSDs or SAS 15K drives).

If you're using VPN, well...

yes thanks,
yes, Jimmie I found the thread about tablets.
Sandeep: I am luckily located in the office with the server, our two other locations are connecting via remote desktop.
Its a work in progress...

Yea, you should use RD Web App for AC and have regular desktops at the remote offices. RD Web App will make AC seem like an application instead of the entire desktop. Use the computer for normal stuff like browsing the web, MS Office, etc. They should be good enough to run dragon and other common office tasks.

Either that or you all have laptops which you will have to take from office to office. I'd like the first one more.

Hi all, update:
I now have a thinkpad ultrabook which I take to my exam rooms, the desktop at my desk is still the easiest to use for inputing complex data, but I am getting more done in the room with the patient which saves some time.
Now, I need to get my MA's something so that they can more quickly room patients, enter vitals and update med lists. Don't need much computing power or screen size at all. I'm trying to replicate the efficiency of the paper chart where they just wrote the BP down and handed the chart to me.

ipad? surface? other tablet?
what is this check-in and check-out feature that I see people discussing? how does that impact what I ask my employer to get for my MA's?

My suggestion would be a Nexus 7 .

Small enough form factor that usually will fit in the pocket of scrubs, large enough to read easily, an interface that most MA's know intuitively, and Swype FTW!

Starting @ $199, the price point is tolerable, and lower maintenance than most of the options. As James mentions elsewhere, the Surface is both limited and locked down, and does not [currently] have the developer community behind it.

As Android is now the dominant mobile platform, more developers are adding/moving to it.

Personally, I like to have a machine in each exam room, hard-wired. I have had machines go down, leaving me out on a limb but, having machines in other rooms that work has kept me on that limb. I can only imagine the terror and interruption if my "take with me" laptop went down. Also, we have some rooms that have software on them that not all the rooms need to have, e.g Midmark Spirometry.