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Thoughts, comments, news, and reflections about healthcare IT from Microsoft's worldwide health senior director Bill Crounse, MD, on how information technology can improve healthcare delivery and services around the world.

Is the perfect computing device for clinicians not a “device” at all?

Is the perfect computing device for clinicians not a “device” at all?

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As you might expect considering my profession and where I work, clinicians frequently ask me, “What kind of computer is best for clinicians?” My answer typically goes something like this. “Well, it depends. If I’m out to dinner with my wife and on call, it’s my smartphone. If I’m in the clinic running room to room, I would likely prefer a tablet. If I’m in my back office doing reports or research, I’d likely dock my tablet and work with a traditional monitor, mouse and keyboard. If I’m teaching or doing a presentation at grand rounds, I’d like to use a really big screen such as a projection system or PixelSense giant touch-screen. So, I guess what I’m really saying is that the best computer for a clinician really depends on what the doctor or nurse is doing and where. Basically, no matter what device you pick up, you just want to access the information you need and do your work.”

imageThat pretty much describes where we are today and, as I’ve written before here on HealthBlog, I think there are some excellent devices on the market right now that will provide a satisfying experience in today’s clinical environment. This includes devices such as our laptop replacement tablet, the Surface Pro 3, and other options from a wide array of manufacturers. But that’s today. What about tomorrow?

Yesterday, I participated in a meeting with some of my Microsoft colleagues from our product and business groups. The purpose of the meeting was to reflect on the current status of devices for clinical computing and then dive into a discussion about the future. Let me share with you what I shared with the team. An idealized future of clinical computing and clinical workflow would be one with no discernable dependence on devices at all. What did I mean by that?

Think about what clinicians do. First, we tend to be highly mobile. Healthcare professionals move around a lot and need solutions that move with them. Second, patient care involves much more than just consuming and entering data, although I’m sure many of my colleagues would say they feel more like data entry clerks than healthcare professionals these days. Yes, we consume and document lots of information, but we also use our hands, touch our patients, and examine them with instruments. We do procedures that often get messy or require a sterile field. We may be wearing gloves. It’s a highly variable environment that doesn’t always accommodate computers, keyboards and other devices. Thus, the perfect future device for a clinician is likely to be no device at all.

imageThis brings us into an era of what is often referred to as ubiquitous computing and ambient intelligence. You can already see evidence of this with giant, gesture-based touchscreens built into walls and rooms that listen for our commands. You get a feeling for the future when we talk about the “Internet of Things”, machine learning, cloud-based neural networks, and wearable sensors. That doesn’t rule out devices entirely. The “device” might be something built into your clothing, worn on your wrist, or clipped to your lapel. It might sometimes be a heads-up display in the glasses or contact lenses you wear.

When I described all this to my colleagues and why I thought it simply was essential for the future of clinical computing and clinical workflow, one of them said to me, “It sounds like you are describing Cortana for healthcare.”  I thought about that for a few seconds and said, “Yes, I think that is exactly what I’m describing!”

Maybe I watched too much Star Trek growing up, but I believe clinical computing of the future requires an omnipresent virtual assistant like Cortana. She (or he or it) will be everywhere we go. She will be a cross between our personal assistant and a brilliant clinical colleague. She will access information, provide guidance, take notes, schedule appointments, make a call, do research, and basically be our wing-man. She will be in the exam room, in our back office, in our car, and in our living room at home.  And it’s not just healthcare professionals who will have access to this kind of technology. It will be every one of us in both our personal and professional lives.

That, my friends is the future of clinical computing, and it’s a future that is closer than you might think.

OK. For now go out and buy yourself a great tablet. You need one. But someday we’ll look back in the review mirror and today’s tablets will appear as antiquated as the electric typewriter.

Bill Crounse, MD            Senior Director, Worldwide Health               Microsoft 

  • I see it more of a smart environment that gives the user the illusion of using a single device. We have been experimenting with Bluetooth low energy beacons as a low cost and quick way to give our not so smart environment (in this context) some added dimension for data gathering. Its yielded some interesting results. But nothing like when we can have a seem less confluence of multiple mature technologies. Internet of things, smart environments, and ehr being the big ones.

  • Interesting post Dr. Bill. I agree that this is where medicine, and many other professions, are moving in the future.  We are beyond simply having access to data, it is now having access to the right data at the right time.  With so much of it in so many different places we need help in finding it just-in-time.  Machine learning and AI do not replace professionals like physicians, they just ease their burden a little.

    Thanks for a thought provoking post.

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