HIMSS coverage: This pen is mightier than the cord

February 14, 2003

A new approach to retaining the old habits of physicians who are averse to data entry was exhibited this week at the Healthcare Information and Management Systems Society meeting.The approach tries to overcome physicians' resistance by letting them do

A new approach to retaining the old habits of physicians who are averse to data entry was exhibited this week at the Healthcare Information and Management Systems Society meeting.

The approach tries to overcome physicians' resistance by letting them do what they normally do, which is checking off boxes on forms or writing on paper, said Philip Cohen, Ph.D., founder and chief technical officer of Natural Interaction Systems, a startup company in Portland that is a spinoff of Oregon Health and Science University. An estimated 50% of U.S. physicians' offices are entirely paper-based.

The solution is an electronic gadget that looks and writes like a standard pen, but is also a computer with a camera/sensor embedded in the tip. The device wirelessly transmits everything the physician writes, checks, or symbolizes directly from special "smart" paper to the hospital information system.

Perhaps the single greatest challenge that consistently confronts every
clinical system developer is how to engage clinicians in direct data
entry, a 1991 Institute of Medicine report warned.

Physicians are accustomed to using paper charts and paper ordering systems.

The pen's base technology comes from a Swedish company called Anoto. On top of it, Cohen has layered recognition technologies that can also be coupled with speech recognition.

According to Cohen, the system has every advantage of both paper and digital systems, and the smart paper provides a ready backup.

"We're targeting two markets, military and medical," he said.

The system's durability and flexibility have attracted the Defense Advanced Research Products Agency and the U.S. Army, two organizations that can be an even tougher sell than physicians.

"It's been hard to digitize the Army because infantry soldiers carry paper maps, not computers," Cohen said.

The Army's mantra is that a paper map with a bullet hole is still a map, but a computer with a hole is a stone.

"You can put a hole or tear the smart paper in half and tape it back together and it still works," Cohen said.

The pen, which can transmit to any computer from up to 30 feet, will begin U.S. beta testing at Oregon Health and Science University in March.