Wacom Interactive Pen Displays
Many clinicians long ago accepted mice and keyboards as necessary parts of their work environment, however despite over twenty years of mainstream use, they have not proven suitable for all clinicians or all clinical environments.
While digital pen solutions have been available for many years, the software and hardware technology has matured significantly in recent times and many vendors are re-doubling their marketing efforts in the health sector. With a range of interactive pen displays (IPD), Wacom is one such vendor.
As it is the model Wacom is targeting at clinicians, I chose to evaluate the 15 inch DTI-520 (larger models are also available from Wacom including the 17 inch DTU-710 and the flagship 21.3 inch Cintiq 21U).
Setting up the DTI-520 was only marginally more complex than connecting a traditional monitor. In addition to the power and VGA monitor cables, a USB connection is made between the display and the computer. USB ports on either side of the display allow a keyboard, mouse or other devices to be connected.
Once the supplied software driver is installed, the IPD functions as both a pen-based input device and a monitor.
An additional VGA port on the DTI-520 allows the video signal to pass through to a second monitor. As this device is also marketed as an interactive whiteboard solution, it is likely this feature was included to allow a projector to be easily connected and used as a digital whiteboard.
In a clinical environment, this port could be used to allow the patient to view the doctors screen on a second monitor for demonstration or other purposes.
Unlike a traditional monitor, the DTI-520 would typically be placed almost horizontally on the clinicians desk. An adjustable stand allows the angle to be changed from almost horizontal to almost vertical. Alternatively, the unit can be mounted on a retractable arm to allow a full range of movement.
For navigation purposes, the pen is used in much the same way as a mouse. Tapping on the screen with the pen simulates a left mouse click and a programmable index finger button is used for the right.
As someone who has used keyboards and mice for over 20 years, transitioning to the pen driven system was an interesting experience. The concept of physically interacting with a monitor did take some adjusting to and initially I found myself reaching for my keyboard to perform well-practiced shortcut combinations. Fortunately I was able to retrain myself quickly and within fifteen minutes the new ergonomics felt natural and efficient.
Wacom doesnt ship handwriting recognition software with its IPDs, instead relying on popular third party solutions to extend the usefulness of the product. Interested to see how each platform would deal with my terrible handwriting, I spent equal time with the IPD connected to computers running WIndows XP machine and MacOS X.
Most users of Wacoms IPD utilise the handwriting functionality included in Microsoft Office 2003. Most medical practices are likely to have this software already and should only be required to follow a simple activation procedure to get it to work. Once configured, the user simply writes into an input panel, which then attempts to recognise and insert the text into the active text area. Depending on the program the user is interacting with, drawings can also be inserted in a similar manner.
Despite the software not being able to learn or be trained (this is a feature of the soon to be released Microsoft Vista), I found the recognition to be acceptable initially, improving alongside my familiarity with the solution. To the delight of practice staff world wide, this software may actually improve clinician handwriting!
MacOS X has handwriting recognition software built into the operating system, which can be configured using the InkWell System Preference (these options will only be visible when an IPD or graphics tablet is connected).
Despite being an early innovator in the field with the powerful but long defunked Newton PDA, Apples handwriting recognition didnt impress me as much as the Microsoft offering. The gesture system (which allows special symbols to be interpreted as commands) did allow corrections to be made easily, but the general accuracy of the software hampered my efficiency.
While thoroughly testing specific clinical packages wasnt a realistic goal in the brief time we had to play with the Wacom IPD, we did experiment with several popular solutions. In most cases text input could be achieved, however I felt that all packages would benefit from tighter integration with this and other digital pen solutions.
When not being used for handwriting recognition, the Wacom pen simulates a mouse meaning sketches and diagrams can be created in any clinical drawing module.
The prospect of learning to type has proven to be a disincentive to computerisation for many clinicians. While writing instruments have been around since the days of the caveman, present day techno-troglodytes have been let down by a lack of viable digital pen solutions.
The impending release of Microsoft Vista will give proponents of the pen something to cheer about, though ultimately the success of such devices in health will be heavily contingent on the levels of integration clinical software vendors are willing to provide. While a keyboard cant be completely jettisoned, Wacoms IPD does provide an excellent hardware platform for desk bound clinicians that prefer pen based input.
Posted in Australian eHealth