Digital Pens Ease EMR Pain

Susan Nunziata, Director of Editorial | 10/23/2013 | 23 comments

Susan Nunziata
What if you could have all of the benefits of electronic medical records while giving your patients and your staff the pen-and-paper experience to which they're accustomed?

Major healthcare operations have CIOs working to deliver sophisticated EMR solutions to their organizations, but small physician practices may be struggling to keep up with meaningful use requirements. This is especially true when it comes to the plethora of forms patients must fill out before their first encounter with a doctor.

Dr. Larry Gordon, chief software architect and CEO of the Saas-based EMR vendor Waiting Room Solutions, told us he wanted a way to keep doctors, staff members, and patients well within their comfort zones while helping them move forward with EMR efforts. Among the goals he highlighted:

  • Allowing patients to input data that can be captured digitally before the encounter with the physician
  • Helping physicians and other clinicial staff members chart in a comfortable, forms-based manner
  • Managing human resources by giving people a form they're used to seeing

In essence, the goal was to manage change by making changes feel as familiar as possible to users. Enter stage left: the digital pen. Specifically, Waiting Room Solutions implemented a joint solution from Shareable Ink and Anoto that the companies describe like so:

The digital pen is Bluetooth enabled and has a tiny digital camera under the tip of the pen that takes pictures at 70 times per second as the user writes. When medical staff fills out paper forms, the handwritten information is recorded onto a chip in the digital pen. When the form is completed, the data in the pen is transferred via a USB docking station or through Bluetooth transmission.

OK, I know the tech-savvy touchscreen lovers among you may be shaking your heads. Many of you may consider digital pens the least sexy technology development ever. Before you scoff, consider this. Adobe is expected to introduce a digital pen in 2014. Evernote and 3M are working on a Post-It note that is compatible with digital pens, and the UK Food Standards Agency is using the Anoto digital pen to inspect 3,000 dairy farms.

I ask you this: When was the last time you accompanied an elderly relative to the doctor's office? In my experience, many patients who are on the far side of the digital divide would feel a lot more comfortable using pen-based technology.

Waiting Room Solutions' clients are likely to agree. "There's a comfort level using a digital pen. With a computer or even a tablet, you need to somehow index the patient and then have a little bit of tutorial," Gordon said. "The digital form is almost immediate. You don't have to train the patient at the moment of encounter. It enhances ease of use during a very busy situation."

On the physician side of the equation, a lot of doctor-patient encounters don't go according to a standard format that can be handled by checking off boxes on a form, he said.

For example, a dizzziness exam may have particular elements that are more easily charted using a digital pen. Depending on the clinical format or the user, the pen format can be an alternative to charting with a computer. The best thing about the digital pen from the user's side is somebody can start entering structured data using paper-based notes. For older physicians who aren't tech savvy, they're able to achieve meaningful use criteria by the pen form.

Even tech-savvy practitioners can benefit from not needing to haul around a tablet or access a computer.

Using the digital pen, you can chart multiple encounters at the same time. You'll see that in a recovery room, where a nurse may be charting three patients at the same time. They don't need to go back to a computer to chart the patients. They have all the advantages of structured data entry and having the flexibility of being at the bedside.

Here's how it works: When a form is filled out, the digital pen is synched wirelessly or sits in a cradle. The data goes back to a Shareable Link server, which sends to Waiting Room Solutions the PDF representation of the form and the ink pattern that goes on top of that. The Waiting Room Solutions EMR system maintains the PDF representation, and because data fields have been mapped as XML, that information goes directly into the patient's chart.

Any security concerns about transmitting data from the digital to the SaaS-based Waiting Room Solutions database have been addressed. "We're certified for meaningful use and for privacy and security standards, including 256-bit AES encryption, and all encryptions to the web happen through secure socket layer. Data is encrypted and can only be de-encrypted when it hits our server."

What do you think? Are digital pens the future of EMR systems? Can you envision other scenarios in your own enterprise where a digital pen could help you bridge the paper/electronic divide? What would it take for your IT department to consider such a solution?

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— Susan Nunziata, Circle me on Google+ Follow me on TwitterVisit my LinkedIn pageLike EnterpriseEfficiency on Facebook, Director of Editorial,

View Comments: Newest First | Oldest First | Threaded View
Page 1 / 3   >   >>
Susan Nunziata   Digital Pens Ease EMR Pain   11/12/2013 1:39:15 PM
Re: PT
@Joe: LOL LOL. Please send us the photos of your new shingles when you're done. 

Joe Stanganelli   Digital Pens Ease EMR Pain   11/7/2013 3:22:17 AM
Re: PT
I, on the other hand, had to overcome a frequent urge to, when  in a store selling everyday notebooks/composition books for super cheap (under $1), buy one in every color.

Of course, since I discovered the ultra-cheap 17-cent ones in Wal-Mart, and since I already have a lot of notebooks, I don't do that anymore.  Now when I see those sales, I shrug -- because I know if I ever need more notebooks, I can go to Wal-Mart and buy enough to shingle a house.
Susan Nunziata   Digital Pens Ease EMR Pain   11/6/2013 1:08:39 PM
Re: PT
@Joe: yep, they do run sales a couple times a year. Other than that, I tend to browse there as if I am visiting a Museum of Pretty Paper. I can look, even touch, just can't buy. 
Joe Stanganelli   Digital Pens Ease EMR Pain   11/1/2013 12:57:39 PM
Re: PT
I will admit Papyrus has some really nice business card offerings -- but the prices are crazy.  I had mine done at a local shop for a reasonable amount on similar-quality stock.
Susan Nunziata   Digital Pens Ease EMR Pain   10/31/2013 1:40:32 AM
Re: Digital pens
@tekedge: It is alarming how many physician's practices have yet to be updated. I assume this is due in part to lack of funding and in part to a reluctance to change. Paper forms are pretty much standard in almost all physican's offices I have been to in recent years, I've not yet encountered a truly paperless physicians office.

Hospitals would do well to offer educational opportunities to the independent physicians who have rights to practice at those facilities. a little knowledge sharing can go a long way.
Susan Nunziata   Digital Pens Ease EMR Pain   10/31/2013 1:23:08 AM
Re: PT
@Joe: I hear that. I happen to be a big fan of nice paper. It's a little indulgence that makes me happy. Though I have learned that I must never enter a Papyrus or Kate's Papiere store if I have my credit cards in my wallet, or damage will be done.
tekedge   Digital Pens Ease EMR Pain   10/30/2013 10:22:21 AM
Digital pens
Change is inevitable. So I agree whatever makes the patient comfortable to deal with this change and get on to EMR. Many big hospitals have already gone paperless so change is happening fast, so we need to find solutions to get everyone on board
Joe Stanganelli   Digital Pens Ease EMR Pain   10/29/2013 1:57:34 AM
Re: PT
@Susan: Ah, I'm too cheap for that.  These days I mostly rely on freebies and 17-cent notebooks from Wal-Mart.
Susan Nunziata   Digital Pens Ease EMR Pain   10/28/2013 11:51:42 PM
Re: PT
@Joe: Yes, those are always appreciated. I've become a big fan of the Arc customizable notebook system that Staples sells, check it out when you have a chance. They make a tiny notebook with refillable pages that is just perfect to have handy for a conference.
singlemud   Digital Pens Ease EMR Pain   10/28/2013 1:19:14 PM
Re: PT
that is a good point, I ever used the digial pen, the accuracy and the feeling bothers me sometime.
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