Tablets to Kill CoWs?

Published on June 4, 2012

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For several years, computers on wheels (CoWs) have been the de facto mobile computing device in many hospitals. CoWs place computing power at the point of care, which facilitates adoption of healthcare information technology.  By combining mobility, usability, and performance, CoWs increase efficiency and reduce errors with tasks such as entering patient data, gaining access to patients’ electronic medical records, reviewing lab results or radiology reports, and checking drug compatibility.

But CoWs have limitations and potential issues, including:

  • Size: CoWs can be cumbersome to move from room to room.
  • Infection risk: Moving a CoW from one patient’s room to another can raise concerns about infection risk.
  • Connection: CoWs connect to a hospital Wi-Fi® network. If the Wi-Fi radio in a CoW is not designed to operate reliably in a hospital, then connection issues may cause CoW users to lose faith in the reliability of the CoW itself.
  • Battery: A CoW computer must be recharged regularly.

Once a hospital encounters problems with reliable CoW operation, it may replace CoWs with a workstation in each hospital room. An alternative to CoWs and fixed workstations is a medical tablet computer.

In an October 2010 blog post, Dr. David Ahn says that a medical tablet provides “an ideal form factor to bridge the analog to digital transition already taking place”. Ahn argues that a tablet is preferable to a CoW or a fixed workstation in a patient room because doctors and nurses can “actively engage the patient while writing or typing on a tablet, no different than they would with a notepad or chart in front of them.” Another post on the same site argues that, if a cart is needed or desired, then a tablet can be mounted to a cart.

Unlike CoWs, medical tablets are not cumbersome, can be wiped down to lessen infection risk, and have relatively long battery lives. But tablets can have Wi-Fi connectivity issues because their Wi-Fi radios are consumer-grade and not designed to maintain a secure and reliable connection in a challenging environment such as a hospital.


Providers: Do you plan to replace CoWs with medical tablets? Why or why not?