Monday, November 26, 2007

Devices for Bedside Computing

We're currently evaluating several devices for mobile bedside computing including subnotebooks (Dell D420, Lenovo X61), tablets (Motion Computing LE1600), and small form factor devices (the Apple iPhone/iPod Touch, Emano-Tec MedTab ). I will write another blog entry on stationary bedside computing devices such as wall mounted thin client devices.

Our early results are that nothing on the market yet meets our ideal requirements:
8 hour battery life
Can be easily disinfected to prevent the transmission of disease
Can be dropped 5 feet without significant damage
Under 2 pounds

Here's a list of those machines which attempt to fill the niche for mobile bedside computers

Battery Life - 3 hours
Ability to disinfect - poor
Drop resistance - fair
Size/Weight - 8.3 x 11.6 x 1/ 3.0 pounds

Lenovo X61
Battery Life - 6 hours
Ability to disinfect - poor
Drop resistance - fair
Size/Weight - 8.3 x 10.5 x 1.4 / 3.6 pounds

Motion Computing C5 (Also known as the Intel Mobile Clinical Assistant)
Battery Life - 3 hours
Ability to disinfect - excellent
Drop resistance - good
Size/Weight - 10.0" x 10.0" x .95” / 3.3 pounds

Motion Computing LS800
Battery Life - 3 hours
Ability to disinfect - good
Drop resistance - good
Size/Weight - 8.94” x 6.69” x 0.87”/ 2.2 pounds

Motion Computing LE1700
Battery Life - 3 hours
Ability to disinfect - good
Drop resistance - good
Size/Weight - 11.65" x 9.64" x 0.74” / 3.3 pounds

Apple iPhone/iPod Touch
Battery Life - 3 hours
Ability to disinfect - good
Drop resistance - fair
Size/Weight - 2.4 x 4.5 x .46/ 4.8 ounces

Emano-Tec MedTab(a startup which is just entering the market)
Battery Life - 24 hours
Ability to disinfect - good
Drop resistance - good
Size/Weight - 5.5" X 7.5" X 0.5"/12 ounces

I'm personally carrying around the Dell D420 and Lenovo X61 to assess their reliability and durability.

We're piloting 5 LE1700's in our Emergency Department. The LE1700 has a 12.1" screen size compared to a 10.4" in the C5 and 8.4" i the LS800. We're testing it with a medication reconciliation application and will soon know more about its support of clinician workflow. In general, all the Motion Computing devices seem rugged, relatively easy to disinfect, and well engineered. However, battery life is limited to 3 hours, so we'll need to keep charging stations handy throughout the department.

The Emano-tec MedTab form factor and battery life are ideal. It uses an eInk display just like the recently announced Amazon Kindle. The lack of color may be a major limitation for some applications. At present, the device is not available in large quantities, so we're testing a prototype, also in our Emergency Department.

The iPod Touch is promising. A slightly larger form factor and better power management (longer life and/or hot swappable batteries) could make this an ideal medical device. Apple's attention to human interface features really shows here, but it's clearly intended to be a device for personal, not business use. We're testing it with our Emergency Department dashboard application.

Size and battery life for laptops is not as relevant if used as a Computer on Wheels on carts. We use two kinds of carts - The unpowered Ergoton StyleView and the powered Infologix SL Ultra Cart

The hardware and software development efforts of the past few years are getting us closer to the ideal mobile clinical device. At BIDMC one challenge is the difficulty involved in secure authentication. We use secure passwords (requiring capital letters, numbers, symbols, etc) which are difficult to rapidly enter via a tablet. Solutions include biometrics (we are testing Omnipass) and novel login mechanisms such as graphical authentication.

More to come as we complete our evaluation by the end of the year. I welcome any comments on other's experiences with mobile bedside computing devices.


Ileana said...

Did you try to integrate the authentication with the bar codes? It would be great if the users would just scan their bar code and login without a password or just some minimal additional authentication.

Unknown said...

There are some tablet solutions out there that are being developed especially for Hospitals.

If I remember correctly Siemens has a model, and so does phillips....hold on, lemme check engadeget....

Well, here is an Intel based one I read up on.

One thing I found interesting was a device that goes on a swing arm bedside. For the patient it can function as the TV, an internet appliace, and a way to manage their room service / food services. For the physician and nurses it converts to show vitals, EMR, the doctor can teleconference in and see the patient...

I thought that was brilliant, but I'm sure it is easier putting a tablet in a Doc/Nurses' hands than a device beside every bed.

I'd be sure whichever you go with has a way to capture images and attach them to the EMR. Would be nice for wound care assesment and such.

John Halamka said...

We require a username and password and the bar code would only provide the username, so we're looking into other technologies such as biometrics.

The Motion Computing C5/Intel Mobile Clinical Assistant includes a camera for taking clinical photos.

barakthecat said...

John, have you looked at the Nokia N series? It seems to fit the profile of devices you are evaluating. I am surprised at the battery life of the iPhone/iPod Touch, I assume the 3 hour mark is due to the constant use of the wifi.

Maybe off-topic for this forum, but how do you decide which floors get to demo/evaluate new technologies? Some of us nurses at BIDMC were discussing how other places we've seen or worked at seemed to have more electronic safety measures in place (along the lines of things you have discussed here, barcode scanning and such) than what we are using on our floor. Although reading here makes it sound like BIDMC is doing these things, just not everywhere.

Ari F. said...

Have you looked at the small Toughbooks? They're not fully ruggedized like their older brothers, but they are tested to survive small drops and get spectacular battery life. There used to be a T5 that got over 12h. I can't find the updated version of that line in the States, but the W7, R7, and Y7 still exist and get 8h.


John Halamka said...

I ordered a Toughbook for evaluation and it arrived with a cracked screen. Ironic isn't it. We found they were too expensive for large scale deployment.

stansettle said...

We're using Sig-Tec authentication software with our C5 deployment. Nurses and nursing care techs can logon and sign orders & documentation with a fingerprint instead of typing a password.

Stan E. Settle
IT Security Analyst
University of Kentucky HealthCare