Medical Clinical Assistants
Medical Clinical Assistants or MCAs are a young form of computing device. They are essentially fully featured PCs which can be carried about. Unlike laptops, they do not fold out. You get a touchscreen embedded in a smooth contoured, white computer, and not a lot else.
Most of these devices lack hard drives, and boot from the hospital's main network. This is a precaution against would-be thieves, as if you take them out of the hospital, they don't work. The idea behind them, is to eliminate paper from the medical process. Rather than taking notes on paper, they are taken on an MCA. This means of course that within minutes, the information taken, is available to medical professionals working on the patient's case whether elsewhere in the hospital, or halfway around the world. It also means that typing up medical notes should become a thing of the past, limiting who sees sensitive data.
Many varieties of MCA have been produced over the past couple of years, and it can be interesting to track their evolution over even such a short time span. Regardless of manufacturer, all share features in common: wireless connectivity, no ports, a smooth white contoured finish, and the ability to be bashed into a wall or run over by a bed with no apparent damage.
One of the first mobile clinical assistants to hit the market, was the Philips MCA in 2006. Created as a partnership between Philips and Intel, this relatively primitive wireless data input unit was designed to be held in one hand, and interacted with by a stylus in the other.
Designed with a then-easy to read 10.4 inch XGA touch-screen, the device had every manner of wireless connectivity it was possible for it to have: RFID and barcode scanning, Bluetooth, wireless LAN connectivity and a digital camera. The hope was to create a platform which would connect to every conceivable wireless network a hospital might possess, and to supplement note taking with actual images on-file.
The idea worked, as this little device spawned an industry.
Its medical grade compliance allowed usage in many clinical areas, including intensive care units and surgery theatres.
In addition, it served to positively identify medical personnel as records could be called up to show the patient.
This was to become an increasing role of such devices.
ProScribe was an early MCA or Medical Clinical Assistant device, created by Philips in 2006. It was designed as a medical tablet PC, that could be taken anywhere inside the hospital, rested on one arm or a bed whilst notes were entered in via a touchscreen, whilst maintaining a continuous wi-fi link to the hospital itself. The Scribe could also be docked at a nurse's station or doctor's desk to commune data through wired channels, and to recharge.
Physicians visiting patients on the ward could use ProScribe to prescribe medication or make laboratory appointments on the spot. The moment the data was entered, under the doctor's secure login of course, it was transmitted to the nearest hotspot, and back to the central computer system. Within a minute, the request was logged at the pharmacy or diagnosis room, eliminating unnecessary delays.
Nurses typically used the display to enter blood pressure, temperature and other relevant data into an electronic patient record at the patient's bedside. Again, there and then, the data was part of the patient's central medical records. EMR, PACS and other patient files and applications were supported, although they could not be called forth on the limited capabilities of this model.
Created in 2007, then updated several times throughout 2008, the C5 remains on the market at time of writing. This MCA or Medical Clinical Assistant device was the brainchild of a partnership between Intel and Motion Computing.
At the time of launch Intel stated it would be shipping units worldwide to "enable nurses to spend more time with patients, do their jobs on the move while remaining connected, and manage the administration of medications."
To develop the MCA, Intel conducted a broad range of pilot studies in hospitals worldwide, including El Camino Hospital in Northern California, Salford Royal NHS Foundation Trust in the United Kingdom, and Changi General Hospital in Singapore.
Unlike previous units, the C5 incorporates a carry handle moulded straight into the case itself, so the unit could be carried around like a briefcase, rather than being awkwardly pinned under an arm. This design feature has been copied by almost every MCA since the C5.
Also unlike previous models, weight was a concern, and the unit was designed with being carried all day in mind - it was stripped of anything pointless, and featured custom chipsets. Like one of the models before it, the C5 is fanless. This means there are no holes in the case for airflow, and thus it can be immersed in liquid and keep running.
MedTab was created in 2007 by Emano Tec, Inc. it has the notable distinction to date of being the only Medical Clinical Assistant device or MCA, that's not a clinical white for easy cleaning. Instead, the case is jet black.
The company announced it, by boasting that the device could be thrown down onto concrete with force, and survive a drop of three feet, without damage. It also weighed in at less than one lb, and had a 12-hour battery life on a full charge. Integrated GPS allowed the devices to be tracked.
Notably, it lacked a camera, so unlike its competitors, no images of the patient's illness or injury could be taken. Additionally, it was very small, small enough to be slipped into a coat pocket, which meant it was far more likely to be stolen than any of its competitors. Also unlike them, the MedTab had data ports. Audio ports and an internal fan meant the device had holes in the case, so unlike all of its competitors, it could not be immersed in water, and did not qualify for high sanitation environments.
MedTab continues to be sold. To our knowledge, not one single hospital has shown interest. Looking at the competing units, it is not hard to see why.
The Toughbook H1 was created by Panasonic at the end of 2008. Very much alive and kicking, this Medical Clinical Assistant device or MCA, is a sturdy bedside point of care computer for hospitals. A Panasonic-designed software utility can be programmed to remind users to wipe the unit down at defined intervals. The utility automatically records a successful cleaning for the hospital's permanent records.
The device features Intel's Atom processor, which requires no external ventilation, no fan, and a completely watertight case. You could probably dump it in a bucket of water. Whilst not recommended, the computer would almost certainly keep working. It possesses a grip moulded into the case itself, on top, for easy carrying and is as lightweight as possible. It also has a secondary grip on the back, to support your hand whilst you hold it - hold the main grip and the socondary, spongy grip rests against the back of your palm. This design feature greatly increases comfort.
It has all the features expected of a modern MCA: integrated 2.0 megapixel auto-focus camera on the rear to photograph the illness or injury, integrated keyboard in the touchscreen, bluetooth connectivity to medical devices, integrated active RFID to identify patients and medical staff, as well as medications and equipment. Integrated barcode reader for inventory and stocktaking.
MediClient Panel PC
European developers finally weighed in with the arrival of MediClient at the end of 2008, and it could not have been more of a disappointment.
Unlike most of its competitors, MediClient does not have a convenient carry handle moulded into it. Instead, it is more designed to be carried under one arm on short distances rather than carried about all day, or frequently passed around a busy lab. No camera being present is a serious omission, as are the lack of BlueTooth and RFID technologies. There is not even the option of a barcode reader.
What it does have, are mediocre capabilities. Scalable up to the Intel Celeron M processor with 1.0 GHz, the cost-optimized Kontron MediClient 104 features up to 1024 MB of RAM and a Compact Flash socket plus an optional 2.5 inch HDD for data storage. Windows CE or Linux being the operating systems of choice.
Like most such devices, it is fanless, with no case holes, allowing it to be accidentally immersed in water without complaint.However, the flash port is not fully water resistant, and fluid leaks into the unit through that. To top it off, the display is only capable of 800 x 600.
released early 2009 by TabletKiosk, integrates so many of the features of the
devices that came before it. It is a Medical Clinical Assistant device or MCA.
It was designed as a medical tablet PC, that could be taken anywhere inside
the hospital, rested on one arm or a bed whilst notes are entered in via a touchscreen,
whilst maintaining a continuous wi-fi link to the hospital itself.
It is rated to survive drops of up to four feet, and rated to survive immersion in alcohol.