Capt. Jay Sumerlin of Lakewood Fire District Number 2 in Pierce County, Wash., says mobile patient-care applications can help save lives.
Jan 15 2009
Mobility

Tale of the Tablet

These mobile devices are versatile enough to run government applications as varied as health care, inspections and transportation.

These mobile devices are versatile enough to run government applications as varied as health care, inspections and transportation.

These days, mobile computing isn’t just about notebooks. Tablets, which accept handwritten input from a stylus, are ideal devices for environments in which using a mouse or keyboard is impractical, such as public safety, transportation and inspections.

Public-sector organizations are increasingly deploying mobile devices of all types, according to Meghan Cook, program manager at the Center for Technology in Government at the State University of New York in Albany. Manufacturers such as HP, Fujitsu, General Dynamics Itronix, Lenovo, Motion Computing and Panasonic offer a variety of tablet computer models.

Cook, who has been studying the use of mobile devices in government since 2006, says that there are a range of factors that influence how well mobile devices “fit” into government work. “Mobile devices have the potential to improve productivity and increase worker satisfaction, depending on the nature of work, governing policies, management practices and individual skills,” she says.

In Lakewood Fire District Number 2, tablets promise to significantly improve patient care. The emergency medical service technicians in that district of Pierce County, Wash., were scheduled at press time to begin using a tablet PC-based mobile patient care application. For Capt. Jay Sumerlin, the application is about more than just automating what traditionally had been paper-based data collection.

“This mobile patient care application could save lives,” says Sumerlin. He began installing 13 Motion Computing F5 tablets in Pierce County’s emergency vehicles in January. The F5s run an EMS application from ESO Solutions and have integrated barcode and radio frequency identification readers to help users avoid medical errors, such as administering the wrong medication.

The tablets connect to the test equipment the paramedics use in the field, such as blood pressure cuffs and cardiac monitors, allowing specialists at the hospital to pull up the incident report while the patient is still in the ambulance. “If I’m in the field and I have someone who is having a heart attack, a cardiologist can look at my report while I am still at the person’s house,” says Sumerlin.

In a critical-care setting, every second counts. Speeding up services delivered to the patient is a huge win, agrees Marc Holland, program director for Health Industry Insights.

“Emergency services personnel usually have little or no information on the patient being treated,” says Holland. “The potential to upload patient data from the hospital or other provider promotes better outcomes.”

Integrated Devices

Of course, not every tablet application involves a life-or-death scenario. In Kent, Ohio, the Portage Area Regional Transportation Authority (PARTA) installed 60 Panasonic Toughbook 19 computers throughout its public bus system. The Toughbook notebooks swivel to convert to tablet PCs.

Bryan Smith, PARTA director of planning, says the agency chose the Toughbook devices because they incorporate a GPS and cell phone along with the screen and CPU in one unit.

“We did not want to have to install separate things — all with separate wires — on a bus,” says Smith. And while these devices are not formally classified as “rugged,” they can tolerate the extremes of heat and cold that city buses must withstand.

The tablets have been most useful for door-to-door routes, when the passenger calls for a ride. In the past, the driver would record the destination and passenger information on a paper manifest, and that data would later be logged into a computer system at headquarters. Now, the driver simply taps the tablet’s screen to enter passenger data. On fixed routes, the driver taps the screen to indicate how many passengers got on the bus, and the system records the time and GPS location of boarding. And, drivers can push an “emergency” button on the tablet if they run into trouble on the route. So far, PARTA hasn’t had any problems with bus drivers using the tablets while they are driving.

Tablet Trade-Offs

In perusing tablet choices, buyers often have to weigh the available features and make trade-offs. Jeffrey S. Williams of the Virginia Department of Social Services in Richmond has long experience in that regard. In 2003, when the department first looked to outfit its 120 child- and adult-care facility inspectors with tablets, Williams and his team tried to figure out which model would best serve their needs.

“We looked at a slate without the keyboard and a clamshell, which looks like a laptop, but the screen folds back on itself,” says Williams, licensing administrator. Originally, the department went with a slate model because it weighed only about four pounds. The inspectors appreciated its low weight, but the 9-inch screen was too small.

Their next choice was a clamshell model. This type of design was a better fit because they could use the touch screen or convert it to a keyboard and use it more like a notebook. Either way, the tablet is light enough and sturdy enough to be used in the field.

It is unlikely that tablet PCs will outnumber notebooks in government — or elsewhere — any time soon. But in the meantime, government agencies are taking tablets to places notebooks fear to tread.

Notable Dates

The roots of today’s tablet PCs reach back further than you would think.

  • 1888: Patent granted to Elisha Gray on electrical stylus device for capturing handwriting.
  • 1915: Patent on handwriting recognition user interface with a stylus.
  • 1942: Patent on touch screen for handwriting input.
  • 1968: Alan Kay proposes the Dynabook device before joining Xerox PARC, but the device is never constructed.
  • 1982: Pencept markets a general-purpose computer terminal that uses a tablet and handwriting recognition instead of a keyboard and mouse.
  • 1989: GRiD Systems releases the GRiDPad tablet PC.
  • 1993: IBM introduces the ThinkPad portable tablet computer.
  • 2001: Microsoft demonstrates the first public prototype of a PC running the Tablet PC version of the Windows operating system.
  • 2006: Windows Vista includes functionality of the special Tablet PC edition of Windows XP.

Tablets Aid EMS

Emergency medical services (EMS) is one of the last nonautomated frontiers of medical care.

Most paramedics have to make do with a clipboard and handwritten notes when they are called to a scene. And if the patient is comatose or doesn’t speak English, the situation is even more complicated. There is no way to know if the patient is allergic to any medications or has any complicating conditions. Such ignorance can be fatal.

The ability to access patient information on a mobile device in the ambulance will revolutionize emergency care, according to Marc Holland, program director for Health Industry Insights. “This will really help reduce medical errors. If paramedics can access the patient’s records, they won’t give him medication he’s allergic to in the ambulance. This is a major advance.”

But a serious obstacle stands in the way of this vision: The mobile EMS application must interface with hospital and medical care providers’ systems, and that won’t be easy to resolve. There are also major information security concerns, in addition to a general lack of funding. The potential for this technology remains promising, however, even with the many wrinkles that remain to be worked out.

Rick Dahms

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