--- shiv sastry <[EMAIL PROTECTED]> wrote:

> It clips on to a pad, and you write on paper. A
> copy automatically goes into 
> the gizmo (displayed on the screen as you
> write) to be downloaded later.

OK, it is a handwriting-capture device that is
purely a supplement to current record system.
That makes sense and is a small step forward.

> Incidentally there was this news report about a
> bloke who used a pen scanner 
> to scan his exam question paper and sent it
> over a cell phone to cheat-mates. 
> Apparently this company will sell such pen
> scanners as well - but that is 
> less useful to me than this gizmo - for which I
> see loads of possibilities.

Scanning medical documents can be temporary
solution when moving from paper to electronic
medical records. It creates extra work and hence
cannot be a standard way to input into the
electronic medical record.

> I foresee a day when each patient's bedside
> will have a (wireless) clipboard 
> with electronic paper - a screen on which you
> write like ordinary paper while 
> what you write gets transferred to a central
> memory as you write. With my 
> hands in gloves I can request a nurse or
> assistant to hold up the chart so I 
> can look for some detail or other - perhaps an
> investigation report that can 
> be called up at the touch of a button (as can
> be done now by the turn of a 
> page). Even better than paper - I should be
> able to see X rays and scans on 
> the board - an act that is now physically more
> unwieldy with paper, requiring 
> the extraction of scans from envelopes and/or
> moving to a separate viewing 
> area.

Imaging is the least of the problems in terms of
electronic compatibility. Almost all new imaging
machines produce digital images (that can be
printed on paper or film if needed) and hence can
be moved around on electronic networks. For
imaging it is a problem of having a hospital
network in place not a problem of data capture.
Just the opposite is the problem in the case of
patient notes. As far as I know there is no good
way for electronic capture of patient notes.
Handwriting capture (like your mobile e-note) is
the least intrusive but is unprocessable by
machines in any intelligent fashion. Handwriting
to text conversion may help but is still very
error-prone in the medical domain. Speech to text
capture is fast but does not work in the nosiy
clinical workplace. In most places where
physicians record their notes the conversion to
text is done by human transcriptionists. The
current default is to have the doctors, nurses,
etc type in their notes at a terminal. However,
this usually disrupts the clinical workflow since
you cannot type while on rounds. Also, there is
an insidious problem with the current system of
electronic notes. People tend to copy, paste and
modify their previous notes rather than type in a
note de novo. Ultimately you have zillion lines
of text that you have to parse to extract the
salient clinical features that defeats the very
purpose of cinical notes. This may be a
US-specific problem where documenting eveything
is given undue importance. 

shyam


 
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