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Meaningful Health Care Informatics Blog

Mar 13 2011   11:03PM GMT

Can mobile devices replace COWS (computers on wheels)?

Posted by: RedaChouffani
android, COWS, iPad, tablets, XOOM

During a recent hospital visit, I noticed a set of commonly used mobile computers, referred to as COWS (computers on wheels), moving around the halls of the cardiology floor. These very useful, and mobile, PCs were being used to document patient care and track inventory.

The COWS were made simply of a Wyse station that had wireless connectivity to a Citrix Presentation server, mounted on a moving platform, which had batteries connected to the bottom of it. These units were being rolled in front of the patient rooms, where the nurses would then scan a patient’s bracelet to ensure their identity, giving them the ability to track and verify medications and decrease chance of error.

But if the functionality needed from these units is simply the need to have connectivity to a terminal server, could a VMware platform for VDI (Virtual Desktop) or a Citrix server or tablet device do the trick instead, while possibly providing added value?

The following are some of the functionality and features that tablets might have over thin clients that are available on the COW units:

· Mobility: In the sense that when patients are receiving visitors and you can’t drag the COWS in the room, a tablet can be undocked and then taken to the patient’s bedside to read their bracelet or tag to confirm their identity and collect data.

· Battery life: Currently COWS require more power than a tablet device. In several of the new tablets, the battery life extends on average six to eight hours.

· Versatile: A tablet can be used to capture vitals by simply connecting through Bluetooth or wireless connectivity to some of the medical equipment. It can also assist hospitals reduce operational costs by reducing some of the paper based data entry.

The truth is that we can’t simply just venture off and assume these devices can replace the current COWS. In theory, they have a lot to offer, but one must take careful steps in evaluating this technology. There are still areas that need to be defined, such as securing these devices, as well as ensuring that their value has actual ROI for the hospitals that are using them. We must also understand the limitation of these tablets, which will become clearer as we continue down the road toward mobile health and remote patient monitoring.

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Donok  |   Mar 15, 2011  2:33 PM (GMT)

What you miss here is the ergnomics that the COWS provide. If I am going to scan where is my scanner on an IPAD? If I am going to connect to a USB where is my USB and what am I supposed to do while it synchs, just stand there with an IPAD in my hands? The COW free’s up my hands so I can do what I am supposed to do, take care of the patient and not stand there with an IPAD in my hands. FYI, there is no place to put he device in your average pt room when you actually need your hands free to touch the patient. So until the IPAD can levitate I don’t think it will repace the COW.


Davidangwin  |   Mar 15, 2011  2:46 PM (GMT)

Reda, theres no reason why an iPad or Android tablet couldn’t be used, or a laptop form factor mobile thin client. I work for Wyse and we have customers using any of these to connect to a virtual or published desktop, but it’s a case of getting the best fit for the task. Sometimes a full size keyboard, mouse/trackpad and decent size screen just make it easier.


RedaChouffani  |   Mar 21, 2011  7:02 AM (GMT)

You have raised some very important points. Clearly it would not be something that a tablet device can be a productive substitute right away. I do want to hear your thoughts on whether or not future bluetooth enabled device would help some of the device connectivity (bar code scanners and such). I do agree that synchronizing the data would be a nightmare, but as VMWare just recently released support for the iOS it may be a good alternative to use that in order to avoid any data exchange delays. I have also seen Wyse PocketCloud product being used. I do appreciate your comments and feedback on this.


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