One of the most common questions physicians ask is what type of hardware should they purchase for their practice and EMR. But hardware should not drive the choice of software. The first and most important piece of advice is to talk to your EMR vendor to determine the technical requirements of their system and any recommendations they have regarding hardware for your practice. There are a wide range of choices to consider when selecting hardware depending on your practice and how much mobility you require in terms of your computing requirements.
Laptops vs. Desktops
One of the benefits of desktop computers is that they are relatively inexpensive and can be fixed securely in specific areas. In comparison to laptops and other mobile devices, they are more difficult to steal. It is also easier to replace keyboards or monitors if they are damaged. How should you position your computers in the exam room to ensure maximum interaction with your patients? Read this blog post for guidance on integrating computers for maximum patient benefit. In addition, you should consider the layout and integration of computers from the perspective of ergonomics and human factors in order to avoid medical conditions commonly faced by computer-dependent workers — such as eye strain from long hours looking at a computer monitor or carpal tunnel syndrome from repetitive strain injuries. Fortunately, most physicians are quite mobile in their practices and seldom work in a single position for extended periods of time.
Another resource section on CanadianEMR is medical office configurations with images of practices that have implemented EMRs including example layouts. Different individuals may have different preferences regarding the hardware that works best. For example, exam rooms may be assigned to each physician, in which case there may be the ability to customize specific rooms for special needs. The downside of too much customization is that it becomes more difficult to replace equipment or keep office furniture interchangeable, if items need to be replaced. Laptops are available in a number of formats ranging from the new light ultrabooks, Macbooks, more traditional laptops, or those that have touchscreens such as the HP ProBook Notebook and the Toshiba convertible laptops. Touchscreen laptops allow users to combine screen selection in addition to using a keyboard or touchpad. However, you should check and confirm that the laptops will offer decent battery life. There is nothing more frustrating than a computer that shuts down midway through a shift because the battery has died.
Tablet Computers & Mobile Devices
The prevalence of tablets such as Apple’s iPad and the Samsung Galaxy tablet have created a lot of excitement amongst healthcare providers. The iPad is the undisputed leader in healthcare, particularly with the recent release of the high resolution retina display. Tablets are relatively inexpensive and provide a comfortable and more natural mechanism to document encounters due to the form factor. When considering this type of device you will need to check with your EMR vendor to ensure they are supported and whether they offer full or limited functionality.
Many clinicians also like the ability to use smartphones such as the iPhone or Samsung Galaxy series phones to access certain parts of their EMR. If you use a web-based EMR that requires a browser plus a username and password you may not require additional apps or functionality. However, your view will be limited due to the small screen size. Devices such as the Samsung Galaxy Note are larger phones that are beginning to bridge the gap with traditional tablets. If you use mobile devices to access clinical information, make sure that you lock your device(s) and have an ability to “remote wipe” them in the event that your device is lost or stolen. Expect to see different sized devices in the next 12 months as tablets begin to service different sectors of the market. For example, although the traditional iPad is too large to carry in one’s coat pocket or hold with a single hand, devices that provide screens in the range of 7"–8" are going to become more popular. As with everything mobile, the device is important, but the App ecosystem is increasingly becoming the determining factor. Software is driving the hardware selection. Now, where have I heard that before?
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