Daniel L. Johnson wrote: > My own experience, rather limited I must say, is that getting *to* the > data-recording step with IT can be rather cumbersome, even if the actual > typing is easy. A "smart" system will pop up the entry fields when > needed, but making it "smart" may be quite an undertaking indeed.
Very true, I think. Although it sounds very 21st Century, I think that wearable computers and voice recognition, combined with wireless networking may provide the answer. Oh, it is the 21st Century already! This article recognised the potential in healthcare a few years ago: http://linuxgazette.net/issue87/lodato.html Combine a headset-mounted display (based on devices like these: http://www.kopin.com/products/index_cyberdisplay.html ) with a headset-mounted microphone, connected to a wireless networked wearable computer based on a a PDA-style XScale low power processor (running Linux). The whole thing acts as a voice-activated thin client, communicating with the main hospital systems via wireless networking. All feasible with existing, off-the-shelf technology. A few years of R&D and it could be made fairly unobtrusive, so that the wearable devices don't interfer too much with human-to-human interaction. Replaces phone and pager while in the hospital, of course. Interestingly, the sorts of screen displays and data entry "forms" best suited to such head-mounted display devices are not complex GUIs, but rather very simple text-mode "terminal" displays, remarkably like the screens used by VistA (not the VistA CPRS GUI) - very simple, fast and efficient to enter data and navigate with single keypresses (which would equate to single word commands). So, combine VistA on the back-end with a wearable display connected to a Sharp Zaurus (see http://www.zaurususergroup.org/modules.php?op=modload&name=News&file=article&sid=77&mode=thread&order=0&thold=0 ) or similar wearable PDA running Linux and IBM ViaVoice for Linux... Obviously a hospital full of staff all walking around muttering to themselves would take some getting used to - or would it? A year of so ago I accompanied my better half for a gastroscopy in a gatroenterologist's private rooms (clinic). He was wearing a Bluetooth hands-free earpiece and microphone, and dictated findings hands-free as he twiddled the knobs of the scope. With the fairly constrained vocabulary of endoscopy reporting, and a system trained to his voice, the printed report of the procedure was ready, error-free, for us to take back to our GP before the consultation had finished. If he had had encrypted email, he could have sent it directly to our GP's EMR. he said the system meant that there was more time for him to discuss the findings with the patient rather than spending time writing them down to be typed up later, and had paid for itself in a few months due to a reduction in the need for typists. Tim C
