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Electronic Medical Records on Palm WebOS
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Old 03/01/2009, 04:21 PM   #1 (permalink)
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Doctors are one of the main customers of Palm.

I was doing my charts on IE today when i suddenly thought...

Our medical records are essentially run on a browser, and are essentilly web apps since i really dont have to install any other applications to run it. It runs on JAVA as well. It does require Microsoft .NET 2.0 though and activeX.

Wonder how difficult it would be to port EHR onto webOS. If we can run them on a Pre, or better, on a Foleo-like device that we can carry around the hospital, that would be a KILLER app. No need for charts anymore!

Doctors what do you think? ANy programmers who can shed light?
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Old 03/01/2009, 07:22 PM   #2 (permalink)
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Seems that many hospitals are way ahead of yours.... search around and see what gov't hospitals are doing....

Far as webos... anything is possible if the resources are thrown at it... contact the builder of application and see what they say....

Would be interesting to see if Palm actually makes it with this OS... people tend to forget that if the pre does not do well, palm could fold... no company wants to devote resources into a failed product.

If I were building phone apps, I would aim for Win, apple, google OS, and Symbian.... not in that order.... then again, a nice app that could work no matter the os would be even better... but hey, wishful thinking on my part... maybe....
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Old 03/01/2009, 10:43 PM   #3 (permalink)
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Interesting topic considering I'm an application coordinator for the nation's leading health care provider with the most "connected" EHR system so far. With my experience, I think it wouldn't be a problem at all porting over the system to WebOS but the only red tape I see would be all the security standards for HIPAA. Technically I think it would be simple but it would be a matter of making sure patient records are secure. We allow our doctors to chart from their homes on their personal PCs but we use very strict RSA security standards to even connect to our servers.
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Old 03/01/2009, 11:30 PM   #4 (permalink)
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With my experience, I think it wouldn't be a problem at all porting over the system to WebOS but the only red tape I see would be all the security standards for HIPAA. Technically I think it would be simple but it would be a matter of making sure patient records are secure. We allow our doctors to chart from their homes on their personal PCs but we use very strict RSA security standards to even connect to our servers.
If my hospital allows doctors to look thru medical records with a simple username and password, then i dont see a very big issue with that on webOS HIPAA wise.

The other hospital that i work in on the other hand uses a Cisco VPN to access records from the outside and i imagine that shouldn't be very difficult to make on webOS.

I think the main hurdles software wise is the .NET framework and ActiveX controls. Then again that other hospital i was mentioning really wasnt using .NET and ActiveX at all, and just uses any browser (firefox and IE at least).

I hope someone from Palm is listening. I really do believe that the medical field is an audience Palm should be listening to. It could potentially, if all else fails, be the ONLY user base that will keep the company alive.
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Old 03/02/2009, 01:38 AM   #5 (permalink)
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I hope someone from Palm is listening. I really do believe that the medical field is an audience Palm should be listening to. It could potentially, if all else fails, be the ONLY user base that will keep the company alive.
I absolutely agree! I think this user base should definitely play a big factor considering how there is an initiative to promote EHR across the country now. I saw the iPhone commercial that showed an app that you can view MRIs - that was pretty impressive. I think Palm should be able to see all the potential here...
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Old 03/02/2009, 05:50 PM   #6 (permalink)
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I absolutely agree! I think this user base should definitely play a big factor considering how there is an initiative to promote EHR across the country now. I saw the iPhone commercial that showed an app that you can view MRIs - that was pretty impressive. I think Palm should be able to see all the potential here...
No, the medical field won't "save palm."

It is unfortunate, but I can say that out of the 100s of medical professionals I see everyday, I noticed only two with a Palm device... obviously, if "sold" a device more would come onboard... but I'm thinking something larger like a netbook... small, light, but with a larger screen.

Can't imagine trying to view images on an iphone, good luck with that. Give me a large flat screen... better yet, most want no less than two -- but want four -- so they can really see what is going on.
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Old 03/02/2009, 08:16 PM   #7 (permalink)
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What were the other 98 using?
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Old 03/03/2009, 07:56 AM   #8 (permalink)
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Interesting topic considering I'm an application coordinator for the nation's leading health care provider with the most "connected" EHR system so far. With my experience, I think it wouldn't be a problem at all porting over the system to WebOS but the only red tape I see would be all the security standards for HIPAA. Technically I think it would be simple but it would be a matter of making sure patient records are secure. We allow our doctors to chart from their homes on their personal PCs but we use very strict RSA security standards to even connect to our servers.
I have to agree, Red Tape will be the big roadblock. I am not even sure HiPaa is the biggest roadblock. Hospitals tend to be very set in their ways. I work for a company that I bet supplies some of the applications you coordinate. Right now I can name several of our applications that would require very little tweaking to be usable on WebOS. Using a WebOS based device to access patient information is really no different than what I can do with a secured laptop. It would either need to be completely server based and rely on a VPN connection or if the hospital needs records to be local to the device, it would need some sort of hardware based security (like biometrics or something) I am not too clear of security possibilities of the Pre, but my gut says that it is not the most secure device.
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Old 03/03/2009, 08:04 AM   #9 (permalink)
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No, the medical field won't "save palm."

It is unfortunate, but I can say that out of the 100s of medical professionals I see everyday, I noticed only two with a Palm device... obviously, if "sold" a device more would come onboard... but I'm thinking something larger like a netbook... small, light, but with a larger screen.

Can't imagine trying to view images on an iphone, good luck with that. Give me a large flat screen... better yet, most want no less than two -- but want four -- so they can really see what is going on.
I don't think the Pre would be the device, but I know a lot of hospitals that use Tablet PCs and I think WebOS would scale nicely to that format. And I personally think that the WebOS could make medical usage much easier. I am imagining applications that I support working on WebOS and I think it would be brilliant - if implemented correctly.
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Old 03/03/2009, 05:35 PM   #10 (permalink)
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I don't think the Pre would be the device, but I know a lot of hospitals that use Tablet PCs and I think WebOS would scale nicely to that format. And I personally think that the WebOS could make medical usage much easier. I am imagining applications that I support working on WebOS and I think it would be brilliant - if implemented correctly.
WebOS on a different device... hmm... now you might be talking... actually, put it on multiple devices and let docs decide what will work for them...

For us I don't know of one "application" that is installed on a local computer... almost everything is performed on the net within our intranet...

But anyway... you bring up a good point, in the broader sense, I don't think people really care what is being used... not that they don't care, but they don't want to need to care.... they only want the device (hardware/OS) to work. Going to be interesting to see if google pushes their OS... and money toward this goal.
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Old 03/03/2009, 09:38 PM   #11 (permalink)
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WebOS on a different device... hmm... now you might be talking... actually, put it on multiple devices and let docs decide what will work for them...

For us I don't know of one "application" that is installed on a local computer... almost everything is performed on the net within our intranet...

But anyway... you bring up a good point, in the broader sense, I don't think people really care what is being used... not that they don't care, but they don't want to need to care.... they only want the device (hardware/OS) to work. Going to be interesting to see if google pushes their OS... and money toward this goal.
I think the Healthcare Tech companies will drive what is being used. I know IBM and Google are trying to break into the Healthcare Tech business(and try to grab some money form this stimulus bill) but I don't think they have the depth of some of the more established companies. (ok, so I am biased but thats another story)
So it would really be up to Cerner, Picsys, or McKesson (among the others) to choose a device for which to format their content. Like you said, everything is performed on the intranet...so the days of fat clients are numbered.
I hate to say it, but from what I have seen, Microsoft has a huge head start, BUT With Android and WebOS being so scalable, I would hope that these companies would tweak their software to work with WebKit.
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Old 03/03/2009, 11:02 PM   #12 (permalink)
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I was in clinic today doing my charts on a tablet PC...

Its just soooooo SLOW!!!!

If Palm can make WebOS in a tablet device that is as snappy as Palm Garnett OS and INSTANT ON.... that will get the attention of many medical bosses.

Integration of software and hardware... there's just so much potential with that in EHR.
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Old 03/04/2009, 06:40 AM   #13 (permalink)
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I was in clinic today doing my charts on a tablet PC...

Its just soooooo SLOW!!!!

If Palm can make WebOS in a tablet device that is as snappy as Palm Garnett OS and INSTANT ON.... that will get the attention of many medical bosses.

Integration of software and hardware... there's just so much potential with that in EHR.
BINGO
We are on the same page.

I was on-site at a hospital that is 100% electronic last year. This is the most amazing hospital I have ever visited. I was there for 2 weeks. Literally the biggest pain I saw in operations was MS WINDOWS being shoved onto these laptops and portable systems. I am not a hater on Windows, but there are just some things that shouldn't be done. I sit back and imagine all of these applications (most of them are web based with some Ajax...every now and then there was a fat client) being run on an efficient system made for being portable. Imagine a Provider's busy day being enhanced by a system that stays out of your way rather than requires extra brain cells just to use it.
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Old 03/04/2009, 06:13 PM   #14 (permalink)
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BINGO
We are on the same page.

I was on-site at a hospital that is 100% electronic last year. This is the most amazing hospital I have ever visited. I was there for 2 weeks. Literally the biggest pain I saw in operations was MS WINDOWS being shoved onto these laptops and portable systems. I am not a hater on Windows, but there are just some things that shouldn't be done. I sit back and imagine all of these applications (most of them are web based with some Ajax...every now and then there was a fat client) being run on an efficient system made for being portable. Imagine a Provider's busy day being enhanced by a system that stays out of your way rather than requires extra brain cells just to use it.
Actually, what I've seen is not an issue with windows, but an issue with the hardware....

For the most part, MS is in the background and no one ever knows they are using it unless a wireless connection drops... lol
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Old 03/04/2009, 07:24 PM   #15 (permalink)
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Actually, what I've seen is not an issue with windows, but an issue with the hardware....

For the most part, MS is in the background and no one ever knows they are using it unless a wireless connection drops... lol
Are you running single apps at a time? Are they running full screen?

Are you all using DHCP or assigned IP for your wireless?
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Old 03/06/2009, 10:27 AM   #16 (permalink)
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Hi folks,

Not to dampen your ambitions of EMR's in the palm (or Palm) of your hand, but I think you're all a bit overambitious. I've used several EMR's in several offices and hospitals. A physician needs to be able to look at a large window of info all at once in order to get anything understood and done. Whether it's xray images, consultation reports, lists of medications, summaries of visits, or whatever, it requires decent screen real estate. Works tolerably on a 10-12" tablet, works better on 15-20" desktop screen. Just doesn't work on the 2 1/4" screen of Treo or the 3" screen of Tungsten series, doesn't work on iPhone. You can make the font & type-size really small to fit more on a small screen, but it still isn't enough. And I don't want to just look at a list of 16 medicines. I also need to see the patients allergies on a med screen so that I know what other medicines not to give. I also need to see patients medical conditions so at a glance I understand which meds are used for what diseases, and look for discrepancies when meds don't have diseases listed, or diseases don't have meds listed.

As a longtime Dragon Naturally Speaking medical user, I had given some thought to using a UMPC (ultra mobile personal computer), basically a full powered Windows PC with a very high resolution but small screen (Sony has one). But despite having very good eyes, there's no way one can see all the necessary info on an EMR page on a tiny screen.

Thus I see basically no likelihood of running EMR's on webOS/Pre, iPhone, or anything else.

-- Josh (Dr. Josh)

Last edited by steinbej; 03/06/2009 at 10:37 AM.
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Old 03/06/2009, 10:53 AM   #17 (permalink)
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Hi folks,

Not to dampen your ambitions of EMR's in the palm (or Palm) of your hand, but I think you're all a bit overambitious. I've used several EMR's in several offices and hospitals. A physician needs to be able to look at a large window of info all at once in order to get anything understood and done. Whether it's xray images, consultation reports, lists of medications, summaries of visits, or whatever, it requires decent screen real estate. Works tolerably on a 10-12" tablet, works better on 15-20" desktop screen. Just doesn't work on the 2 1/4" screen of Treo or the 3" screen of Tungsten series, doesn't work on iPhone. You can make the font & type-size really small to fit more on a small screen, but it still isn't enough. And I don't want to just look at a list of 16 medicines. I also need to see the patients allergies on a med screen so that I know what other medicines not to give. I also need to see patients medical conditions so at a glance I understand which meds are used for what diseases, and look for discrepancies when meds don't have diseases listed, or diseases don't have meds listed.

As a longtime Dragon Naturally Speaking medical user, I had given some thought to using a UMPC (ultra mobile personal computer), basically a full powered Windows PC with a very high resolution but small screen (Sony has one). But despite having very good eyes, there's no way one can see all the necessary info on an EMR page on a tiny screen.

Thus I see basically no likelihood of running EMR's on webOS/Pre, iPhone, or anything else.

-- Josh (Dr. Josh)
You make great points, but I don't think anyone here expects much serious work to be done on a phone sized device.
I think we presuming that A Tablet is the smallest size useable.
In fact, Most of the hospitals I support make significant use of tablet pcs right now. Periop staff love that sized device.
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Old 03/08/2009, 11:16 PM   #18 (permalink)
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Just out of curiosity, what apps do people typically use on their WM or POS devices? Know a couple of folks studying Medicine, and I'm wondering if there's anything that would be useful to them.

Couple of qualifiers here: They're still students, and unlikely to graduate for a few more years yet, and I'm down in New Zealand (as are they), so anything that's geared explicitly for the United States is going to be less than useful.
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Old 03/10/2009, 03:03 PM   #19 (permalink)
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Originally Posted by steinbej View Post
Hi folks,

As a longtime Dragon Naturally Speaking medical user, I had given some thought to using a UMPC (ultra mobile personal computer), basically a full powered Windows PC with a very high resolution but small screen (Sony has one). But despite having very good eyes, there's no way one can see all the necessary info on an EMR page on a tiny screen.

Thus I see basically no likelihood of running EMR's on webOS/Pre, iPhone, or anything else.

-- Josh (Dr. Josh)
I don't work in your field of business, but don't forget, that if you are using say a touch screen tablet, and you can flick your "windows" sideways out of view, it probably wouldn't take to long to get used to the lack of screen real estate, I know you can do this now using alt/tab but I am always amazed at the number of people who either don't know to do this or can 'deal' with this concept when looking for, or comparing data.

Me I would LOVE a 10" tablet lying around my house with WEB/OS on it.
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Old 03/15/2009, 07:23 PM   #20 (permalink)
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What about Charge capture. I have been using Palm Treos now for about 3 yrs for billing during rounds and procedures. When I get to the office I print out the billing sheets via BT and give it to my manager. All E&M and ICD/cpt codes all done.
I know there are cumbersome Winmob applications for this out there already and have tried all of them.
Would love to be able to bill and eRx with the WebOS.
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