Part 2: Does Microsoft know what they've got with this thing?
Part 3: The (possible) future of medicine, and the Microsoft Surface Pro
What makes you so
special?
As some may know, I had the rare opportunity to go to the
exclusive release event for the Microsoft Surface 2 and Surface Pro 2. How in
the heck was I invited to something like that? Or, in the words of a family
member after I told them I was going, “What makes you so special?” It actually goes back a couple of years to when I
first heard of something called the Surface Pro. Within seconds I knew that it
was THE device that could solve so many Health Care IT problems physicians
encounter throughout our days.
The biggest problem I have seen for physicians (and many
other health care workers) is the need to login and logout every time we sit at
a new workstation. No problem if you sit at one desk all day long. Login once
and logout once. However, I, and most physicians, have no “home base” desk.
Even if we do, we are at that desk rarely most days and not at all some days.
The way most hospitals are setup, there are computers all over the hospital
that sit there, turned on, waiting for me to login. The rest of the day, they
might get used by someone else, but often they are sitting there doing nothing.
My guess is that the ratio of computers to physicians is somewhere between 3 to
1 and 7 to 1. Even in clinic, I have a computer in the physician workroom to
look up patient info. Then, less than 15 feet away are another 5 to 10
computers in each patient room that I login and out of sometimes as often as
every 10 minutes. When you take into account the many places a surgeon works in
just one day, the login and out reps become exhausting and frustrating.
Why login and logout so many times? The main reason in
health information privacy for our patients. A big problem with this is that
when only one goal is the main focus of everything that is done in a hospital, everything
else falls by the wayside. We often say that patient safety is first. However,
I think that safety actually suffers at the hands of compliance with privacy
requirements. There are no free lunches and increasing focus on one goal must
cause others to suffer when people are involved. People have limited time,
energy and resources. Enough microeconomic philosophy, though. Back to
technology.
To solve the problem I’m describing, physicians are trying
to implement mobile-health solutions, such as phones and tablet-computers. Mobile devices have the added benefits of
bringing your user-experience along with you, including your personal/work
files, and access to social media. Early on, lots of docs brought their iPads
in from home, threw them in front of the hospital IT person and said (or begged)
“Make it work.” After many hours of frustration, much capitulation to functional
compromise, third-party work-arounds, squinting to see the shrunken interface, and
after attempting to precisely interact with the finger-unfriendly menus, many
physicians got some things to work. However, it was more of a “show my coworker
what it can (finally) do” and less of a “use it all day to improve my life”
kind of functionality.
Enter the Surface Pro
Way back in 2010, I started hearing about something that
instantly grabbed my attention. A tablet computer that could run a full version
of Windows and also do some other stuff that seemed very cool too. I already
had the opportunity to trial an HP slate/tablet computer running Windows XP for
a couple of months. Even though it had a short battery life and Windows XP was
clearly NOT optimized for touch interaction, I loved that I could throw a full
windows device in my pocket. That HP slate had a 7 inch screen and a USB plug.
Even though I already had an iPad, I carried that HP slate with me at all
times. I loved that it could fit in my white-coat pocket and even better, into
my scrub pants back pocket!
That device also showed me that to truly solve the problems
encountered by a physician trying to use electronic medical records (EMRs) and
other programs we interact with throughout the day, the solution had to be a
FULL windows device, not Android/Mac running a Citrix Remote session and,
unfortunately, not Windows RT. Being able to carry a full Windows machine in my
pocket was going to be an essential part of my quest to make the physician’s
digital life simpler, more efficient, and even more emotionally fulfilling. So,
I reluctantly gave that HP back after the trial period and went back to my
iPad, which I soon realized was little more than a big phone, minus the ability
to use it as a phone. Yes, content consumption was great and slick, but content
modification and creation was frustrating.
As more details leaked about this new Surface device and the
differences between the “RT” and “Pro” versions became clear, I knew that my
future computer would be a Surface Pro. What made the Microsoft offering so
much better than the ones from other brands like Dell, Lenovo, ASUS, Acer, and
Sony was that it was the smallest and lightest, while still retaining a ton of
power and function. Yes, I know a 12 inch screen is more pleasant to look at
than a 10.6 inch screen. But I don’t want to carry that 12 (or 13) inch screen
around on my person all day!
Along the same vein, the ability to easily remove the
keyboard was a huge plus since I wanted to be able to customize the portability
of my device, depending on my particular workflow at that moment. All the
creative ways to protect the keyboard while still letting your hold your
touchscreen laptop like a tablet would be too heavy and cumbersome for
physicians to carry when the keyboard is not needed. So goodbye Lenovo Yoga and
Dell Duo.
The last feature that really sold me on the Surface Pro was
the digitizer pen. As a physician, especially as a resident in training, we
read a lot of articles published in scholarly journals and then present them
for discussion. We also like to keep noteworthy articles for future reference
and sharing. I was always frustrated on my iPad when I could read an article,
but couldn’t write comments in the margins, or underline anything. Sure, I could
try to zoom in a lot and then make some annotations by drawing with my finger.
Try to do that for a few minutes and let me know how it goes.
That reminds me of another gripe I had with my iPad: the
lack of a file system. I know, iFans are going to say that it’s a feature, not
a bug to not have a file system because it protects you from viruses. I keep my
Windows Defender updated and I don’t open suspicious-looking attachments. Since
I haven’t had an issue with a virus in over 10 years, the marginal benefits Apple
expounds are not worth the tradeoffs. I love being able to modify a file in one
program, the open it in another, then copy it to/from a thumb-drive or do
whatever else my geek mind wants to do with it. Yes, I have my files in the
cloud, and yes I know how to use that little arrow-box in my iPad apps, and
yes, I know that iTunes can keep track of my files while slicing, dicing, and
making julienne fries. But I hate being tethered to solutions outside of the
device I have in my hands at that moment.
But, back to the digitizer pen. Being able to read a journal
article, then underline, make comments and draw pictures right onto the PDF
document is life-altering. I know I’m easily amused, but I know people that
aren’t and they also think this is really, really cool.
Ok, so then I knew that I wanted a Microsoft Surface Pro.
The only problem was being patient enough to wait for it. A number of
competitor Windows 8 Convertible Tablets (as they came to be known) started
hitting the market around 2011. I had to resist the strong urge to get one of
them while I waited patiently.
And wait I did. And waited.
Other residents, knowing that I was the in-house tech geek
kept asking why I was still schlepping around my old Panasonic Toughbook and
when this newfangled Microsoft Surface thingy was going to come out. I can’t
remember how many delays there were in the release, but I almost lost the faith
when the Surface “RT” was released and I heard that the Surface Pro was not
coming out for many more moons!
Finally, the day finally arrived and for the first time in
my life, I went out to buy a new computer product on the day it was released,
arriving before the local Best Buy even opened. I never buy ANYTHING retail. My
wife and I are the ultimate deal-finders and regularly scour slickdeals.net and
steepandcheap.com. We used to laugh at people that bought tech on the first day
it came out, full price, and even waited in line for the privilege. But for
this piece of tech, I knew it was going to be worth it.
And I was right.
Part 2: Does Microsoft know what they've got with this thing?
Part 3: The (possible) future of medicine, and the Microsoft Surface Pro
