Computer Consult

By Robert Lowes

HIPAA update and other computer news

• A privacy filter on your monitor helps you comply with HIPAA regs.

• The Toughbook tablet PC can take a beating.

• The military will begin transitioning to an accessible-anywhere EMR this year.

Every now and then, this column becomes a buffet table of helpful news items on trends in health care computing. This spread covers hardware, software, and—can we ever hide from it?—HIPAA.

Why a practice Web site?

Most physicians apparently aren't convinced that they need to cater to Internet users. Only 34 percent of practitioners have Web sites, according to Manhattan Research, which studies computer technology in health care.

However, 140 million American adults now surf the Web, either from home, work, a library, or some other location, based on a recent survey by Harris Interactive. And an estimated three-quarters of them log on to find health information. Manhattan Research reports that one-fifth of such e-patients say they'd switch to a new doctor simply because he had a Web site.

HIPAA-compliant monitors

Ever worry about patients peeking at a computer monitor at the reception desk and reading about somebody else's medical problems? It's a privacy violation under the Health Insurance Portability and Accountability Act. The law's new standard on computer security requires physicians to implement safeguards that will frustrate prying eyes.

One solution is to buy office furniture that recesses the computer monitor beneath the work surface. The computer operator looks down to view the screen, and a peeping Tom has to practically stand over her to read what's there.

A less expensive fix is to equip monitors with slip-on privacy filters. The filters make data visible to someone directly in front of the monitor, but the screen looks either blurred or completely dark to a person off to the side. Some filters also reduce glare and radiation. The extensive product line from 3M includes "shades" for regular desktop monitors, flat panels, and notebook computers. You can shop for these items at the Web sites for Office Depot ( www.officedepot.com) or Staples ( www.staples.com). Expect to pay anywhere from $100 to $400 per filter.

Tablets that can take a hit

Tablet computers are becoming the rage in medicine, but some practitioners remain skeptical. What if you drop one on the floor? Have you lost a $2,000 investment?

That depends on what you drop. For years, military personnel and workers in rough-and-tumble industries such as construction and mining have used portable computers that have been "ruggedized" to keep operating after a nasty nosedive. Magnesium alloy cases and shock-mounted hard drives (some set in gel) account for their durability. Such devices are also sealed to withstand moisture—even submersion.

Now companies that make these die-hard computers are hawking them to physicians. Panasonic sells a line of so-called Toughbook devices, including a notebook that converts to a tablet. Surprisingly, it weighs only about a pound more than two leading conventional tablets—the Fujitsu Stylistic ST4000 and the Acer TravelMate C100—but at $3,200, the Toughbook portable is considerably more expensive.

If rugged tablets exceed your budget, you might consider a protective carrying case that stays on your tablet while you use it. Acer and Fujitsu sell them for $100 or so. An X-shaped strap in back lets you hold the device with one hand. The case also comes with a shoulder strap.

The military's new EMR

The bandwagon for paperless health care got a lot more crowded recently when the Department of Defense unveiled plans to deploy a full-scale electronic medical record system. The move affects 12,000 military physicians and 8.7 million patients, including active and retired military personnel, their families, and diplomats. Implementation begins this year and is expected to take five years to complete.

Uniformed caregivers will use the new system to document patient encounters, but the DOD's digital vision is bolder than that. The Pentagon foresees battlefield scenarios in which a medic will look up a wounded soldier's medical history on a laptop to check for medication allergies. The EMR system's massive database also should help physicians uncover a pattern of symptoms among casualties that might point to biological or chemical weapons.

The conversion to the EMR is the latest stage in a computerization process that began 10 years ago, when the DOD adopted computerized physician order entry and eliminated prescription pads. Other functions were gradually automated. However, even when they were digitized, patient records weren't always handy, because they resided in computer networks of individual military hospitals, says Navy Commander Robert Wah, an ob/gyn who serves as deputy director of information management for the DOD's health services wing. "We generally had to transfer them from hospital to hospital," says Wah. With the new system, military physicians theoretically will be able to access any record from anywhere in the world. However, on the battlefield, says Wah, they will generally avoid wireless connections to the EMR database for security reasons and instead rely on portable computers loaded with a limited number of records.

The author, who is based in St. Louis, is a Senior Editor of Medical Economics.

 

Robert Lowes. Computer Consult: HIPAA update and other computer news. Medical Economics May 9, 2003;80:30.