This webinar discusses selecting the right hardware for an electronic medical record (EMR)-based practice. It outlines key questions to consider regarding devices for different settings and dealing with small spaces. The presentation then describes the hardware configuration of a family practice that has used a full EMR since 2002, including desktops, servers, printers, and strategies to avoid downtime. The presentation warns against some potential pitfalls and concludes with a hardware wish list and recommendations for a successful hardware purchase.

1. Webinar – How to Select the Right
Hardware for an EMR-based Practice
December 6, 2011
Funding to support this Webinar has been provided by Hewlett-
Packard

2. Webinar – How to Select the Right
Hardware for an EMR-based Practice
December 6, 2011
Funding to support this Webinar has been provided by Hewlett-
Packard

3. Background
• With the growth in range of computers and
additional hardware, how should you select
the right devices for front office, back office
and clinicians?
• Are you adapting an existing medical office
to an EMR or building a new office?

4. Questions to Consider
• Understanding the pros and cons of tablets,
laptops and desktop computers.
– What is available?
– which form factor is best for each practice setting?
• Dealing with small spaces – what solutions work
best?
• Are wireless devices an option in a small
medical practice?
• Managing printers and scanners.
– Should you centralize printers or have a printer in
each examination room?
– How many scanners are sufficient and what are the
minimum specifications one should expect?

5. Dr. Mark Dermer

6. Central Ottawa
Family Health Organization
• 11 family physicians, 5.9 FTE
• 4 nurses, 3.1 FTE
• Full Electronic Medical Record (EMR) since
2002
• 4,300 sq ft office
– 12 exam rooms
– 16 healthcare provider desks
– 8 administrative workstations

9. Hardware Configuration
• Local server
– Redundant array of independent disks (RAID)
– Uninterruptible power supply (UPS)
– External backup with cartridges taken off-site daily
– 3 “switches”, 60 ports, to distribute data to stations
• 36 workstations, all desktops
– 22” monitors mounted on full ergonomic arms
– Exam room and provider stations have laser printers
– Washable keyboards and mice
• One network printer (50 page/minute)
• Two scanners
• Internet firewall with virtual private network (VPN)

10. Avoiding Downtime
• RAID disks in server
– 4 disks, each simultaneously storing all data
• Spares
– Workstation
– Printers
– Hard drives
– Switch
– Firewall
– Monitors, keyboards, mice
• UPS
– Server
– Phone system
– Single workstation with inkjet printer

11. What We Don’t Have and Why
• Laptops
– Twice the price of equal-powered desktops
– Small screens and keyboards
– Poor pointing devices
• Tablets
– Tiny screens
– Terrible keyboards
• Wireless networks
– Security risk
• Inkjet printers
– Total cost of ownership higher than laser
© Mark Dermer, 2003

12. Recommended Approach
to Hardware Purchasing
• Recognize the value of physician time
• View the purchase as an investment in
productivity, not an office supply expense
• Err on the side of overpowering the computer
• Never compromise on the user interface
– Monitor and arm
– Keyboard and drawer
– Mouse or other pointing device
– Chair
• Use lease financing to turn a large purchase
into a stable monthly expense

13. Common Pitfalls
• Technical instead of functional specifications
– Don’t get bogged down in GHz and GB
– Focus on speed of user experience
• Blind acceptance of software vendor specifications
– Vendors motivated to avoid “sticker shock” by suggesting
lower cost/lower performance hardware
– Also may suggest inefficient sharing of workstations and
peripherals
• Confusing ease of initial use with ease of durable
use
• False economizing
– Cheap but inefficient
– Cheap but costly consummables

14. Hardware Wish List
• Check-in and checkout kiosks
• Interfaces to medical devices
– Digital thermometer
– BP machines
– Scale
– PFT machine
• Tablets for patients to view and verify data
• Proximity IDs to ease sign-in/sign-out
• Digital voice infrastructure for transcription
© Mark Dermer, 2003

15. Chris Mertens

16. 16

17. 17

18. 18

19. 19

20. 20

21. Questions & Discussion

22. Webinar – How to Select the Right
Hardware for an EMR-based Practice
December 6, 2011
Funding to support this Webinar has been provided by Hewlett-
Packard