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Using Hand Writing (HW) Recognition with Charting Plus EMR, on a TabletPC:
Tablet PCs (TPCs) are great for EMRs. They can be, just plain friendly. On a TPC, the EMR presents as a piece of paper. Instead of a mouse you use a pen! Are you getting my drift?
Tabletpcs are mobile computer that can run any EMR that a desktop PC can run. This fact is why I have been using Tablet type personal computers for well over a decade. I hate to date myself, but I think it was 1986 when I had my first Convertible Grid. At a very basic level the difference is a stylus replaces the mouse. The stylus can be much more friendly and intuitive with an EMR. Additionally, new TPCs have built in voice and handwriting recognition as well as inking that recognizes whatever you write!
I thought I would write a very short compendium, not on Medinotes as an EMR, but simply implementing Medinotes Charting Plus, on a TPC. As a background, I have been enamored with the hyperlink concept of any EMR, for many reasons but especially since it facilitates stylus input, with a simple point and click method. Medinotes sweetens the concept by being extremely customizable. One of the best features of Charting Plus is the ability to customize. The software functions like an EMR development tool, providing custom screens around the database structure, thus allowing one to create their own EMR.
Charting Plus uses hyperlinked text, that when clicked on, opens a dialog box or list box that allow a user to rapidly click on customized answers that concatenate to compose a complete sentence! The result is that the user reads the typed soap note and the clicks on only the portions that need change! This means a user can rapidly make robust changes by clicking on hyperlinked text e.g. A male patient of 50, presents with low back pain that is moderate and constant....... In this simple scenario when you click on the underlined hypertext, a list box pops up with custom answers that are changeable and reflected in the chart note. The notes reflect a "What you see is what you get" philosophy (WYSIWYG). All of the exam charting is done from one screen. There is no need to switch between screens to enter each section of information. The note is laid out as you write it.
The best way to store data and introduce Hand Writing (HW) is within a "Dialog Box." Dialog boxes are boxes that pop up for user input when a user clicks on hyperlinked text. When the dialog box opens up, you simply click on your desired choice or start writing in the box and your handwriting will be converted to text. (See above picture). You don't have to use the Tablet Input Panel (TIP), as in the picture. You can write directly into the dialog box and your writing will be converted to text. Accuracy is excellent (98%) as you are seldom writing more than a few words or a sentence.
Just to cover all my bases, in my templates I created a custom object called, "Free Text." I created a Free Text object for each individual heading of SOAP. Now, when I want to enter text with handwriting recognition, I simply click on the hyperlink appropriately called, "Free Text." One advantage of this method is, that I can enter text that is not necessarily related to the existing information. For example, if the patient was to verbalize something pertinent but not directly related to the existing chart note, I could write it directly into my free text box. (Example, I am treating a simple musculoskeletal condition when the patient verbalizes he has HIV). Additionally, TPC users can use the Tablet Input Panel (TIP) that comes with the TPC or use third party handwriting recognition, such as Pen Office.
 Click to enlarge. I need to emphasize, that you do NOT need to use a keyboard with Medinotes, even though my pictures have the TIP present.
Charting Plus, like most programs, allows the stylus to function like a mouse. In Charting Plus, a user can configure the stylus to use one click or a double click to open hyperlinked text sentences. Calling up the properties box (equivalent of right mouse button click), is not needed in the chart note proper and is therefore not available. This right mouse button/equivalent feature, is available elsewhere in the program, where the user can utilize it for a host of options, such as copy new note from old note, etc.
The combination of entering text into a dialog or free text box makes navigating and using Medinotes with HW very quick, friendly and intuitive on a TPC. The program is setup with radio buttons and check boxes to obviate typing or handwriting, but HW is very easy, when and if needed. When Charting Plus adds an inking field/object to its database, it may be par none.
Medinotes claims to be, "The best EMR value on the market," and it very well may be. It is certainly easy to use on a Tabletpc once you understand the logic!
Caveat: Charting Plus stores information in two ways: as data and as text. Charting Plus stores the data as objects and the entire note as a text file. You may add free-text to the chart, in the note window itself, but since this is stored as text and not data it will be more difficult to use this information for data analysis.
Addendum: While this scenario pertains to HW, the user could substitute Voice Recognition (VR) instead of HW.
For more information contact: http://www.medinotes.com
C.M.Wilkerson, D.C.
Carson Doctors Group
www.digital-doc.com
Editor-in-Chief
MedicalTabletpc
Disclaimer: I have no financial interest in Medinotes.
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