Choosing the right laptop for your EHR

NOTE: choosing an laptop for daily use with your EHR is different than choosing a laptop you plan to travel with frequently.  Our review below is solely focused on what makes sense in the office for use with an EHR.

It has been our experience that there are 3 camps when it comes to how a medical practice wants to deal with their EHR and how the physician(s) will access the EHR while with patients.

  1. Have desktop PC’s in every room
  2. Use a tablet (iPad/Windows/Android)
  3. Use a laptop

A PC In Every Room

Having PC’s in every room is generally considered the most straight forward method.

It will generally cost more as each room requires a PC.

Additionally, it will generally create a login/logout version of Twister.  This not-completely-smooth process of having the nurse/technician login to the PC, then when the physician arrives, logout.  Now the physician logs in and the cycle continues.

Pros: Straight forward, generally the easiest, lease complex method

Cons: more expensive, multiple login/logout can become frustrating

Tablets

The use of “pure” tablets (iPad/Windows Slate/Android tablets) will continue to grow, but there are many established EHRs that are not yet compatible with the tablets operating systems. As this progresses, we will address these in more detail.

Laptops

Right now, many physicians like the idea of a laptop to carry around.

It can cut down on costs, but more so it can streamline events.

With a laptop the Doc can bounce from room to room and the nurse doesn’t need to log out of a computer. This ability really does streamline things.

What is really great right now are the “convertible” laptops.

These are laptops that can act as either a tablet or a laptop.

This is nice as it can be used to point and tap, but when some speedy typing is needed, the keyboard is right there.

Many physicians are still more comfortable using the keyboard for input rather than their finger or a pen-pointer.

The Battery Life Issue

One of the major challenges with laptops, though, is battery life.

Even when “tweaking” the settings to minimize battery use, getting a laptop to last beyond 4 hours is quite a challenge.

In our experience, we have used laptops from the major manufacturers and what it interesting is the lack of real options.

Because battery life is a major issue, you either need to have extra plugs in many rooms, or the ability to add batteries.

A third option is to have an external battery charging station so somewhere around lunch you can swap out batteries.

This can work well, but realize there are some challenges with these external battery charging stations.

In fact, let’s get down to the nitty gritty.

Top Down

First, I believe that a convertible laptop is the way to go.

This format give you options.

The one option you will not have, though is size. 13” convertible laptops is it. If you must have a larger screen you’ll need to either get a large heavy laptop OR get a docking station with an additional monitor attached.

We’ve used convertible laptop models from Fujitsu, HP and Lenova.

Lenova Laptops

The Lenova laptops are great machines, but the additional battery area is problematic.
The Lenova external battery charger is clumsy.
It requires too much fumbling and in fact we had issues with the connector to the battery breaking as the physician got frustrated with the device.

HP Laptops

HP has a rather nice external battery charging cradle.
Though it does get “built up” as you put the proper battery attachment on the base, this only needs to be accomplished once.
This then allows you to “drop” your battery on the charger.
Keeping one battery on the charger and another in the device works quite well.

Fujitsu Lifebook

The Lifebook T-900 (now a T-901 is out, but we have not laid hands on it yet) is our current favorite device.
The Lifebook has a “multi-function bay” that comes with a cd drive in it.
You can remove that drive and add a second battery.
This does make the laptop a bit heavier, but it will last you all day.

Another nice thing about the lifebook is the ability to use it as a “normal” laptop, or in tablet mode you can use just your finger (if you get the optional display which is only $100). All of the other laptops require you to use a stylus for table input.

Pros: many options, additional batteries

Cons: With 2 batteries will be heavier than the others

Durabilty has not been an issue with any of the laptops mentioned, but it would be smart to get the “drop” insurance.
Carrying something around all day like this is just asking for trouble.

The other smart thing to do is to ensure the entire hard drive of the laptop is encrypted. Only encrypting a portion of the drive is asking for trouble.

Not encrypting a laptop because you “don’t store PHI” on it is also asking for trouble as there is always the risk of accidentally putting PHI on a computer that you use daily for patient records.

Finally, back that thing up.  If you are not backing up, you will be brought to tears in the future.

Again, tablets are going through a major ramp-up right now.  They are going to be a huge part of the way physicians work in the future.  As EHRs adapt, and more tablets come out, we’ll give our 2 cents.