I'm thinking of getting a Microsoft Surface Pro 2(full windows Pro 8.1 software) with 128 gb to use in exam rooms with AC, being that it is a $1000. price tag wonder what others think of functionality. Have never used a tablet or touch screen device save my smartphones.
Having seen JamesNT's (aka Mr Microsoft) at our Laramie meeting, it looks pretty nifty. He seems quite happy with it, and probably will chime in with details.
I haven't used the Surface (1 or2), but... (I'm in the hard wired camp)
There are a couple of differences in tablets in general. The type is usually smaller, yes, you can magnify but that takes a couple seconds. The screen is smaller. Then there is the whole issue of compatability. Then there is the need to adapt a keyboard, which I'm sure can be done, but now are you going to carry it around too, or have one in each room.
Then it will require wireless connection. Overall I try to avoid wireless (for security and speed), but then the whole point of a tablet is portability, thus it is mandatory for a tablet.
There are a number of folks who post here that use iPads. They work mainly through RDP or Logmein or such. Remote Desktop is "normal" desktop Windows so compatability is not usually an issue, but they do OK with the size, resolution and keyboard workarounds.
My suspicion is it that it will work, but.... (I do have an iPad, but not in the office)
Wendell Pediatrician in Chicago
The patient's expectation is that you have all the answers, sometimes they just don't like the answer you have for them
I haven't used the Surface (1 or2), but... (I'm in the hard wired camp)
There are a couple of differences in tablets in general. The type is usually smaller, yes, you can magnify but that takes a couple seconds. The screen is smaller. Then there is the whole issue of compatability. Then there is the need to adapt a keyboard, which I'm sure can be done, but now are you going to carry it around too, or have one in each room.
Then it will require wireless connection. Overall I try to avoid wireless (for security and speed), but then the whole point of a tablet is portability, thus it is mandatory for a tablet.
There are a number of folks who post here that use iPads. They work mainly through RDP or Logmein or such. Remote Desktop is "normal" desktop Windows so compatability is not usually an issue, but they do OK with the size, resolution and keyboard workarounds.
My suspicion is it that it will work, but.... (I do have an iPad, but not in the office)
Wendell Pediatrician in Chicago
The patient's expectation is that you have all the answers, sometimes they just don't like the answer you have for them
In my opinion, tablets will always be inferior in the exam room to a desk top computer and large screen as long as we have to record the visit in text. Tablets are only good for the ability to carry them from room to room (saves money) and take them out of your office, such as the hospital.
Since the exam room is a controlled environment, basically your production center if you were a factory, I think you need to make yourself as efficient as possible. Tablets are only good for handling chaos.
Tablets are inferior in the exam room because you have to hold them so you are looking down and using both arms throughout the visit, so the patient gets about 20% of your eye time, the data entry is much much slower, and the screen size is much smaller. That might work great with your patients that want to play on their tablets or phones during the visit, instead of looking at you.
Tablets will work great when all you need is to use them to look up data, the patient visits are AV recorded, and the computer discerns the granular data needed. Of course, doctors if they are even needed will probably be using google glass, or the walls will project the data by then.
Oh, and they drop and can get stolen.
I like a laptop cart, with a 24" monitor bolted on, that I can pull out so that the patient's face is in my line of sight just above and to the side of the monitor so I can look back and forth easily. I can type while looking at the patient. Try that on a tablet.
I suppose a hybrid system with a docking station for the tablet, monitor, keyboard and mouse in each room could save some money if you want to lug the computer from room to room. I have my MA enter data in the room, so that wouldn't help me.
I use a Sony VAIO duo 11 tablet with an 11 inch screen. Has windows 8PRO and 8 Gb of RAM. I carry the tablet from room to room. Tablet works very well, because the screen size is good. AC works well on this tablet and I think it would also on the surface PRO. Please note when AC runs on Windows 8 you do not have the ability to "pinch zoom in or out" so it will be difficult to show a parent a growth chart. That is one of my problems with AC's growth chart. Have you tried bringing a part of the growth chart in the enlarged display window? using the horizontal and vertical tabs to bring a particular chart into view is VERY slow. The tablet is on the network through wifi and speed is acceptable.
--------------------------------------------------- Raj From (mostly) sunny Port St Lucie, florida
Going to Best Buy tomorrow to play with the Surface Pro 2, hope to get a good sense of inputting data into fields, thanks all for the input so far keep it coming.
For the money, I would consider getting all in ones with touch screens running windows 7 pro, unless space limitations are critical. I have M-Tech all in ones in my rooms. I have started using the Ipad with the Parallels app for Ipad, to supplement the all in one desk top in the room. That way, I can look at imported items in the chart while having the main chart open. As others have stressed, efficiency is key. I think that we should look at our computers in the same way that we look at our other equipment. We all know that a cheap stethoscope is going to give inferior results compared to a Littman. Why make your life more difficult trying to manage a tablet?
While you are at Best Buy, I suggest that you look at the Chromebooks. at 230-280$, they are inexpensive, light, and easy to maintain. There are several RDC apps that you can install, or you can use Chrome remote desktop.
It is a different approach, but worth your consideration.
The ChromeBook powers up and is useable from sleep very quickly.
I usually find the same thing. Many physicians start off wanting tablets in the exam rooms with all of the increased mobility, but generally end up changing to a laptop with a keyboard or a desktop with a large screen; 22"-24" seems to be the preferred size range.
.... a large screen 22"-24" seems to be the preferred size range.
One of the most frequent comments from Doctors coming by the AC both at a recent PriMed event was that the screen is hard to read on a laptop.
Several to them pointed to their glasses and said they wear glassses/bifocals as do most of their peers. They want the screen easier to read.
My response was that is why you use a larger screen. Jim[mie] pointed out this weekend that he uses twin 27" screens.
During my 2010 ACUC presentation I pointed out that while the iPad was novel, it would take screen of 12-13 inches before they would be feasible to read AC easily. The manufacturers are getting there.
I agree with what you said above. 12.5 inches appears to be the minimum requirement from the providers I've talked to. I tried to convince providers to go with Chromebooks. Turns out it's just a little bit too small. (11.6 inches) There's new ultrabooks entering that price range which is good.
It's just easier for the staff and providers to use a familiar interface. Chromebooks are great devices but have limited abilities when offline. Also it's a new interface that depends on the app market. There's no access to traditional office processing software like MS Office. Printing is also a hassle for most.
I'm hoping that Apple went to 64 bit processors so they can make larger iPads. A 15 inch retina would be so nice for surfing on the couch at home.
If you could save a fraction of a minute on making the note for every patient you see, then invest in making yourself as efficient as possible so you can give that time back to the patient, yourself, or another patient. You are selling your time, and it is very valuable. To me it's like trying to do professional level production with consumer level tools.
I remember trying to make an Apple Newton work in the exam room.
Personally, I have settled on Lenovo x200 or 220T tablets. Tried a bunch of things, different tablets, different desktops.
I use a combination of handwriting and typing, I like to move all around the room, depending on the patient. The screen is big enough to see AC well, and small enough not to be intrusive. I can set it on my lap while sitting and interviewing the patient, or set it on the desk while standing and examining, then go back and forth to make entries. Handwriting recognition works well and is more natural for me than typing -- I can interview and take notes that way. If I try to type what they say, it's more like taking transcription, and it is more intrusive and less efficient for data collection.
I don't like the fixed position of a desktop, plus it takes a lot more room.
The wireless works very well in my environment -- if I put the machine in an UltraBase, wired to server, it is a little faster, but doesn't really make that much difference.
My nurse makes a lot of the initial entries on her own tablet, then forwards the chart to me. I forward it back to her if there is post-vist work to do.
no doubt younger doctors who grew up with computers (and their younger patients) have different needs and expectations. Which is why I started this with "personally."
I too use the Lenovo X220 - that is probably the smallest screen that I can use and see practically. If it came in a 15 inch screen that would be ideal. I also love the finger-controlled cursor button that decreases hand movement and makes me feel more efficient. I too sit it on my lap while typing and looking at the patient, and place it in a table during examinations. With a desktop in the room I would have to turn away from the patient too much. I have a separate desktop in my office, but at home I plug the Lenovo into a 24 inch screen and use LogMeIn ignition.
Theo A. Stephens, MD Internal Medicine, Baltimore, MD
I'm hoping that Apple went to 64 bit processors so they can make larger iPads. A 15 inch retina would be so nice for surfing on the couch at home.
Because Samsung owns the glass market for devices, watch what they are doing in the marketplace. Their Chromebooks are just the beginning. The flexible displays are next, and then will come larger form factors.
Originally Posted by DanWatrous
If you could save a fraction of a minute on making the note for every patient you see, then invest in making yourself as efficient as possible so you can give that time back to the patient, yourself, or another patient. You are selling your time, and it is very valuable. To me it's like trying to do professional level production with consumer level tools.
I predict that the next 2-3 years will be watershed years as Doctors concentrate on their businesses and make decisions. The majority of the conversations this last weekend were concerning practice business structures, going non-par with Govt payers, opting out completely, or going to hybrid/split practices.
Originally Posted by DanWatrous
I remember trying to make an Apple Newton work in the exam room.
In storage I have my two Newtons that I developed on - all that we tried to do with Hypercard. Back then becoming an Apple developer was a whole process.
It's good to see so many Lenovo fans on the board. The X220/230 remains my number one recommendation for an ultraportable laptop. The Premium IPS display works quite well and the keyboard is legendary.
Well I did go with the Surface Pro 2, like that it is a full version of Windows 8.1 professional, figured it was time I delved into touch screen functionality. Screen size is right at the borderline hurray for bifocals. Been practicing with the pen this may become my preferred input method. Now have to decide do I load AC 6.6.1 on it and all my office computers or stay with 6.3, a chore for the weekend. Likely will just go for 6.6.1 will leave a few updates re: the experience and is it an improvement in flow.
Well I did go with the Surface Pro 2, like that it is a full version of Windows 8.1 professional, figured it was time I delved into touch screen functionality. Screen size is right at the borderline hurray for bifocals. Been practicing with the pen this may become my preferred input method. Now have to decide do I load AC 6.6.1 on it and all my office computers or stay with 6.3, a chore for the weekend. Likely will just go for 6.6.1 will leave a few updates re: the experience and is it an improvement in flow.
Update Have been using the Surface Pro 2 for 10 days now in the office with AC 6.6.1 Here are some early observations/thoughts: Yes it is borderline size however with bifocals and the capacitance pen is very workable, I have put in a request to get AC written to take advantage of touch screen technology this would then be sweet. Maybe will try to email the CEO directly about this. It is quick with good battery life and as I get more familiar with Windows 8.1 and 'gestures' believe I will become 'ready' to leave Windows 7 behind. I do have the detachable keyboard which I use as primary input method, the write to text function works well but seems like I've just become a better typist so rarely write on it as input method. Anyway back to seeing patients feel free to ask a question here or email me kobylarzmd@yahoo.com
getting AC written to respond to touch screen gestures is what I asked Mr Squire about; just sent him email today hope he thinks there is a competative sales advantage and also that it's not a huge code writing dilemma
No response yet from Mr Squire wonder where on his pile of emails my request for writing AC to be Windows 8.1 and touch screen/gesture compatible ended up? probably not high on the list, maybe didn't get his correct email address; if anyone is at Pri-Med NY this weekend and hitting the AC booth today(Saturday) please ask about Tablets and touch screen functionality being written into AC. In the meanwhile still like the tablet over the laptop I had been bringing into the exam room.
This is a bit removed from my usual conversation on the forums but I'm considering getting my wife the Microsoft Surface Pro 2 with 128GB for Christmas. How do you feel about the overall/general speed of the tablet if I may ask? Is the removable keyboard comfortable to work with or average to clumsy? The touchscreen, is it very intuitive and streamline with no bottlenecks or hang ups? I haven't had the time to handle or play with one of the units as of yet.
Tom here is my response to your Surface Pro 2 questions. Let me start by saying this is my first experience in using a touch screen computer and my 'insistence/closed mind' on having a full windows operating system for compatibility concerns made my shopping experience limited to the Surface Pro 2 so that after playing with it for 10 mins at the store I felt comfortable it was worth the go. Been using it for 2 full weeks in the office in the exam rooms for Amazing Charts/patient charting; it connects wirelessly to the server database and I can appreciate no obvious lag and think it is actually quicker than the laptop I had been using. I also use it to connect to the internet while in the exam room to look up hospital/lab information again quick to connect only hangup is the hospital website traffic(they need better server capacity) and that the hospital software not optimized for Windows 8/touch screen/gesture technology. That being said AC not really Windows 8.1 optimized either still waiting for a response from Mr Squire on that one would love to be able to expand the fields in the chart but it still doesn't seem much of a problem viewing the fields. Choosing a field with finger action or the capacitance pen can be tricky if the tabs are small and next to each other; the problem is that the screen starts to read the signal from the pen once the tip is about 1 inch away from the screen so that at times the wrong tab gets selected,that was more of a problem week 1, my pen accuracy has improved and I now keep the point of the pen shielded with one of my fingers as I approach the screen so this week think I have no tab 'errors'. Using the Metro interface just takes some time(and not a lot of time really), i.e. what do I have to do to get to the programs, close programs, switch between open programs etc. I used the online guide from Microsoft and if I wasn't using the device predominantly in the office for AC/patient charting think I'd use the Metro interface more. I put AC on the desktop portion of Windows 8.1 so I mostly live on the desktop though switching between desktop and Metro is very fast, I think I could put AC on the Metro interface just haven't tried yet. The keyboard/cover works well, there are 2 options for keyboards one is a smooth surface keyboard, the other one is more traditional with individual keys the latter is the one I have works well even the little mouse pad. I thought I was going to be using the writing on screen function for input but the keyboard is faster. One 'bug' that has occurred twice in the past 2 weeks is "delayed wake up from sleep" when opening the device from being closed; usually this requires a short push of the on button to 'wake' it from sleep but once required a 10 sec push and once required a reconnect to power supply. I open and close it about 50 times a day so not very frequent a bug. My reading into it seems to indicate there was a video driver change from Windows 8 to 8.1 that is the culprit, could roll back the driver but I understand it is a known issue and will be addressed so I'll just wait for the update. Hope this gives some insight.
Having seen JamesNT's (aka Mr Microsoft) at our Laramie conference, it looks fairly awesome. He seems quite satisfied with it, and probably will chime in with information.
This guys original signature was "Danny". I did not recall a Danny at the conference, so I think he snuck a quick one on us!!!!!!! He must have changed his signature in the interim.
Yeah, we picked it up. This guy is kind of a smart spammer. I noticed the post and figured it was spam, but due to his knowledge of the conference (and James), I wondered who it was. Jimmie, I asked a couple of others who were at the conference, and Donna pointed out that the post is an exact copy of her post (the second one in the thread). That is why I say he is "smart". Bert has him on his list of people to be banned...
He has made three posts in three months. He's not selling shoes. Yeah, I fell for his Casino deal, but other than that, he's rather harmless. If he posts one more time, I'll get him.
Oh, yeah, I did take away the signature. Sorry, Tom.
I was only amused. If he wants some clicks on his casino site he'd have better luck on a different type of venue. The only thing to worry about these type of spammers is sometimes they will go though and gather all email addresses inside of member profiles/signatures and some will put up links that when clicked will launch viruses.
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