Clinical Data Capture using a Pressure Sensitive Graphics Pad — APACHE Scoring in the Intensive Therapy Unit
The success or failure of any computer application rests heavily on user acceptance. The increasing power and decreasing cost and size of computer facilities have led to the widespread promotion of microcomputers in the medical field for a variety of applications. However, full realisation of the computer’s potential has yet to be made due, in part, to deficiencies in the human-computer interface (Schneiderman 1986). The standard software interface uses a QWERTY keyboard, usually combined with a series of menus. Unfortunately, this often proves unacceptable in clinical situations. Medical users (doctors and nurses) are rarely familiar with keyboards and few are skilled typists. Ergonomic constraints limit the suitability of keyboard data entry in clinical situations. Keyboards are not portable, requiring that the application be tied to a particular location, or that bulky equipment (such as a lap-portable computer) is brought into the crowded clinical environment. Shortliffe (1987), principal developer of ONCOCIN, Stanford University’s expert system for cancer therapy management, has remarked that users’ difficulties with keyboards has been one of the major hindrances for the acceptance of computer solutions for clinical problems. Mouse-driven software, light-pens and touch screens have been advocated as alternatives but these rely on the combination of a screen and QWERTY keyboard and suffer from the same lack of portability. Small hand-held terminals are available, such as the PSION Organiser (Psion, London, UK), and can be used for remote data capture. But they still have an alphanumeric keyboard and in our experience suffer from drawbacks similar to those of the QWERTY keyboard.
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