COPENHAGEN, Denmark – Three mobile computers for nurses and hand-on caregivers built by three different manufacturers were lined up like soldiers ready to conquer new markets at the Intel (Santa Clara, California) booth at the World of Health IT (WHIT) congress held here last week.

Lightweight, rugged and washable, the three competing models from Philips Healthcare (Eindehoven, the Netherlands), Panasonic (Osaka, Japan) and Motion Computing (Austin, Texas) have one thing in common — they all have Intel microchip processors inside.

Two years ago at its Developers Forum in San Francisco, Intel released its design brief for a new mobile computing platform for healthcare professionals dubbed the mobile clinical assistant (MCA).

The unmet clinical need was to capture patient data moving at the speed of nurses on a hospital ward, zapping patient wristbands for fast identification, digitally recording vital signs, updating patient charts, tracking prescription information, taking snapshots of wound closures, and wirelessly transferring all this information to streamline workflow by avoiding double entry of data and the errors that routinely occur during the oft-hectic process.

Five months later Motion Computing was first to get to this new market when it unveiled the C5, a ruggedized, spill- and drop-tolerant tablet with an ergonomic integrated handle weighing 1.3 kilograms (2.8 pounds).

The Motion C5 features a high-resolution display screen that also is used for hand-written inputs with a digitized pen, since keyboards are banned from infection control areas, being notorious hotbeds for microbes and other pathogens.

Significantly, neither the Motion tablet nor its competitors feature the touch screens now familiar to users on portable devices, as these tactile-resistive screens use a membrane that also is a nasty source of bugs that can never be completely wiped clean without destroying the touch-sensitive function.

All three competing units run on Microsoft Windows operating systems, have docking stations equipped with wipeable keyboards, USB and peripheral plug-in ports.

The units also are loaded with the built-in data capture features specified by doctors and caregivers in the Intel design brief, including a bar code scanner, radio frequency identification (RFID) readers and an integrated digital camera.

As expected for high mobility, the units bristle with wireless connectivity features for local area networks, 3G broadband or Bluetooth and offer options for global positioning system.

Motion has sold 20,000 C5 units worldwide, more than 7,000 of them in Europe, according to Doug Litt, senior systems consultant with the company's operations based in Coventry, UK.

He said 4,000 units are being used in hospitals and primary care trusts in the UK, where the initial competition for MCAs will be most intense, with Panasonic placing 200 pre-production units at 46 National Health Service trusts for testing and promoting the endorsement of Dr. Michael Bainbridge, the clinical architect for the NHS' Connecting for Health informatics project.

The week ahead of WHIT, Panasonic gave a sneak peek of its MCA at the UK Healthcare Interoperability meeting and is now running a series of UK road shows.

Panasonic launched the CF-H1 Toughbook at the WHIT event directly across the aisle in the exhibition hall from Motion Computing, dwarfing the Texans with a much larger space and promotional events.

The only sign of Philips' entry to the MCA market at WHIT was the company's unit displayed at the Intel stand. "Philips has been coming to market for quite a while now," explained one competitor.

"Having competitors out there is helpful," said Litt gamely, citing ergonomic features he believes will create preference for the C5over the Toughbook, and a unique security feature, an optional reader for healthcare professional smart cards.

Motion also is capitalizing on its one-year head start and the installed base by holding the first MCA user conferences to share best practices and successes in areas such as bedside patient care, e-prescribing, pathology, vital signs and order communications, with presentations from Royal Salford Foundation NHS Trust, University Hospital Birmingham NHS Foundation Trust and Great Ormond Street NHS Trust (London).

"While Motion has created a market, they do not own that market," said Chris Wood, Panasonic's Healthcare Sector manager for the UK and Ireland.

"A key difference is that Panasonic is an engineering company and not an assembler of other people's components, which gives more control and consistency," he said.

Production of the CF-H1 Toughbook, to be priced at 2,000 ($2,500) plus taxes, will begin in December in Japan and units will be shipped immediately, he said, coinciding with the completion of the UK pilots.

The CF-H1 is the first MCA to use Intel's new Atom low-power processor that will create a category-leading advantage with six hours of battery life, enhanced further by the ability to hot-swap batteries.

The Atom processor also runs cooler, eliminating the need for a fan to cool the unit.

"There is clinical significance in this feature," said Wood, noting that Motion's C5 requires nurses to remove and clean the fan unit regularly during a work shift if they are moving into infection-control environments.

"Not a welcome task for busy people," he commented.

The Toughbook MCA is tested for drops from a three-foot height and can withstand the extreme conditions encountered in helicopters for vibration, humidity, altitude, and thermal shock.

It also meets or exceeds the Intel design brief requirements with built-in camera, bar code reader, and RFID reader.

Carestream unveils SuperPACS

Carestream Health (Rochester, New York) presented a sneak preview of its SuperPACS architecture that the company said it will unveil officially at the Radiological Society of North America (RSNA; Oak Brook, Illinois) conference in Chicago later this month.

Promoted at WHIT as a work-in-progress, SuperPACS is far along in its validation in Europe as a viable network for the exchange of radiology images in the Baltic Health Network and in a special project connecting specialists in the Netherlands with hospitals in the Czech Republic.

In the Nordic project, Carestream's novel SuperPACS architecture is behind the advanced functionality of R-Bay, a unique internal e-marketplace for e-health services in Europe that creates cross border brokering allowing hospitals to bid on services for remote viewing, consultation consulting and second-opinion services, enabling pan-European distribution of radiologist resources across secure networks.

R-Bay connects hospitals in Denmark and Finland with a shortage of radiologists with clinical providers in Estonia and Lithuania that have a surplus.

Confident of the technology behind the Baltic network, Claus Pedersen from Denmark's MedCom (Copenhagen) organization, which was the driving force behind the project funded by the European Union, said the partners are now developing the business case.

"We know this is a value-added service," he said, "but we do not yet know what hospitals will be willing to pay for it."

Ulf Andersson, marketing director for Carestream Health Europe North, said that in addition to the Netherlands-Czech Republic exchange and the R-Bay project, the SuperPACS technology also is driving radiology exchanges programs in Scotland and the Uppsala region of Sweden.

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