Guest Spot: A Touch of Class...A New Paradigm in Clinical Computing

Contributed by: Kam Shams, The Shams Group

Computing in healthcare has made steady progress over the last four decades. Innovative hardware and software have both evolved to meet the growing needs of a complex healthcare environment.

Despite this progress, one area that has been particularly challenging is clinical computing. Success now looks a lot like a slice of Swiss cheese, peppered with high degree of dissatisfaction amongst nurses and physicians. This greatly impacts clinician time and effort.

With ‘Meaningful Use’ on the horizon and its emphasis on clinical IT usage, it is fundamental for hospitals to ask themselves the following critical questions:

• What has been the clinical computing experience in the organization over the last decade?
• Are nurses, clinicians and physicians content with the current clinical computing environment?
• What type of software, hardware and user interface will ensure ‘Meaningful Use’ and enhance clinical computing?

KEY BOARD TO MOUSE TO TOUCH

Let’s briefly look at the history of healthcare computing to understand why we’ve had good success in financial, administrative and ancillary areas and also why clinical computing has been a challenge but is soon to change.

In the 1970’s, applications using terminal & keyboard technology started appearing in hospitals around the country in the administrative and financial departments.  In the 1990’s, personal computers with mouse technology coupled with graphical user interface became prevalent.  Both of these paradigms (keyboard centricity and mouse centricity) worked well for desktop driven users who primarily worked in a stationary environment. However, clinical users on the floor have always lived in a mobile environment. For these powerhouses, keyboard centric computing equated to a ball-and-chain tying them to a desktop or a COW (computer on wheels) and altering their duties from being patient centric to data centric. Moving to mouse driven applications provided some improvement but not enough to replace the productivity and ease of use they had in a mobile and paper/pen driven environment.  What they lacked was mobility and an intuitive and natural user interface that could replace paper and pen in a meaningful manner for the digital world.

HIGH TECH – HIGH TOUCH

All of this started to change in 2008 when Apple rolled out the Iphone followed by the iPad with multi-touch capability in 2010.  The touch screen interface, which we experience at ATMs, airports, and information kiosks, has now become available to masses as a relatively inexpensive computing device classified as a PDA (personal digital assistant) and tablet.

This new technology paradigm called multi-touch responds to multiple inputs by multiple fingers—even multiple users—all at the same time which has transformed the way we interact with computers. How? For example, take your thumb and index finger and push the tips of them together, place them on the tablet and drag them apart while touching the screen to  make the screen appear larger. Amazing! These complex gestures that can be performed with our fingers allow for so much more than point and click technology.

Now imagine a patient walking into your clinic or hospital and is given an iPad that acts as a mobile kiosk to review, verify and speed up the registration process. Once the patient is admitted to the unit, physicians and clinics can make rounds via TSG’s Physician/Provider Portal and CPOE application via the iPad to review clinical chart, place orders and discuss with patients their clinical progress, disease management options etc.   Case Managers and Discharge planning can also conduct their work via iPad. All of this and more is possible today with TSG’s True Safari-based iPad application suite.

Touch-based navigation is now available for clinical decision support, CPOE and much more.   When nurses and physicians can use their fingers to do what they want just like they do with a paper interface at a patient’s bedside or in the lounge, you have success in your hands!

Innovative healthcare vendors whose software platforms are built on ‘open technology’ have been able to respond quickly by delivering native Apple Safari support for the IPHONE and iPad which provides a true and easy to use interface for effective clinical computing.  ‘More importantly, these vendors will be able to ride the tremendous wave of progress and innovations that the multi-touch paradigm has started.

The world of clinical computing is at the beginning of a new paradigm where a ‘touch’ will be at the core of ‘Meaningful Use’.

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Kam Shams is Chairman of The Shams Group (TSG), a leader in browser-based portal applications for Medication Order Management, CPOE, Physician EMR, Legal EHR, Business Intelligence and Community Integration Solutions. Kam has been a visionary and innovator in the IT and Healthcare industry for 30+ years. Kam is a featured speaker at healthcare conferences around the country for his vast experience in integrating clinical systems and designing/implementing clinical and financial decision support systems.