Monday, February 28, 2011

The Pen is Mightier than the Keyboard

There were some pretty innovative solutions being demonstrated at the 2011 HIMSS Conference. One of the most interesting demonstrations I saw was at the NextGen booth on the new NextPen. Roy Feague Vice President, Development at NextGen Healthcare showed me some the uses for the pen and explained future plans for its development. "There are really only three modes of communication being used in healthcare: typing, voice and writing. We have done a good job at capturing data from typing and voice recognition, but up until now we've done a poor job of capturing writing," said Roy. "This will extend the reach of the EHR quite a bit. Anybody who can hold a pen can become a data contributor to the EHR, including patients."

The immediate use case available now is to allow patients to complete intake forms while waiting to be seen. Future plans include allowing clinicians to enter data into forms that will be captured as discrete data elements within the EHR templates. This could be handy to help those practices using NextGen that may have some clinicians struggling moving to digital from paper. But capturing patient demographics and other patient provided information prior to rooming is an immediate win, saving time and increasing accuracy.

Using laser printers and ordinary copy paper (although the results are definitely best with a color laser printer - I would not recommend using back and white), NextGen prints an intricate algorithm of barely discernible dots on the background of the page. Printing this dot pattern on the paper makes it possible for the NextPen's built-in camera to detect pen strokes and record handwriting that can then be stored and sent digitally. Every small area of the pattern has a unique combination of dots with different positions. When the user writes on the digital paper, the digital pen captures information about what the user writes and where, by registering the pattern close to the pen tip.

A tiny camera in the pen’s tip captures everything as it is written or drawn. The camera automatically takes digital snapshots of the dot pattern on the paper at a rate of between 50 and 100 images per second. Every snapshot contains enough data to enable the pen’s image microprocessor to determine the exact position of the digital pen, what it writes or draws, and what form is being used. Then the pen is placed in a USB docking station, the data is approved, and NextPen automatically fills the structured data fields into the EHR. An image of the form can also be captured and automatically attached to the patient’s record. Saving the image would create an ideal situation for signatures and drawings, while also keeping an exact record of the data entered.

Here is a brief video demonstrating the pen:


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