Trialling a tablet PC for remote access on the road

Originally published in GP magazine .

Written for GP magazine around 2005. This is the version I submitted - the published article may have been edited.

As part of a PCT trial I have recently been lucky enough to test a Hewlett-Packard tablet PC.

Central Cheshire PCT is progressive in its IMT strategy. They are setting up an internal network of fixed links between surgeries with centralised VOIP telephones and Exchange server (email), which will hopefully help reduce telephone costs and provide a more robust email solution. Currently clinical servers are all held locally in the practices.

The main advantage for me as a GP is that they have set up a secure remote access system that allows any number of users to access their surgery as long as it is part of the PCT network. Thus wherever I am, as long as I have a quick internet connection and a PC loaded with a piece of software called a VPN client, I can access my email and surgery.

VPN works by establishing a secure connection to a private network over the insecure internet using encryption. As part of this I have a PIN number and a key fob that generates a different six-digit number every minute that is synchronised to the server at the PCT. By typing in the appropriate passwords I can then log on to the network as if I was sitting at my desk in the surgery. The PCT have chosen to use a Citrix server solution and basically when I log on I get a window full of icons of the pieces of software that have been set up to work for me remotely.

There has been for some time a call from GPs that a mobile form of remote access would be invaluable. The remote access solution is perfect for home users with a broadband link, and indeed now that BT have upgraded my home to 2Meg I can’t tell the difference when sat at home to sat in my surgery, and a colleague from another surgery who has seen my home system said it was faster than sitting in his surgery!

The PCT IT gurus felt that now the home access was working it was worth trialling a mobile solution using a data card from Vodafone. This allows you to access the internet over the 3G network, which is as fast as broadband, or GPRS in poor signal areas, which is a lot slower.

Rather than just going for a laptop we wanted to try a tablet PC to see if they had any advantages. Tablets are very similar to small laptops but you can disconnect the screen from the keyboard and use it like a notepad. They come with a pen which not only doubles as the mouse but allows you to write on the screen.

We selected an HP TC 1100 which really surprised me. The screen is excellent, being both sharp and easily seen even outdoors. It is small and light but feels tough and robust. The battery life seems excellent and it appears to last three hours of constant use. The design is excellent and it has built-in Bluetooth, wifi and numerous ports including Ethernet and USB. The tablet came with a special office program called Microsoft Journal which allows you to create notes as if you were using a pad of A4 paper. I have found it very good for taking notes in meetings and it is much less conspicuous than typing and much easier to use than a small PDA.

At the surgery and at home I connect via wifi networks and outdoors I can use the Vodafone card. In areas without wifi or with no signal I could plug in via an Ethernet cable or even an old-fashioned modem line.

The only problem using the VPN is typing in all these PIN numbers and logging on can be a slow process, so I have found as part of the trial I don’t log on in every house. The main advantage from a clinical point of view has come in nursing and residential homes. Given a handy desk and a decent phone signal I can log on as if at my desk at the surgery. Prescriptions can even print out at the surgery for signing later; as the network just thinks of me as another user it doesn’t know I am five miles away.

I am probably going to say that from a strict remote-access-to-EMIS point of view the added advantages of the tablet probably don’t justify the extra cost over a cheaper laptop, but certainly from a personal point of view I find the tablet to be superb and the flexibility of the pen input to be great, and am thinking of getting one for myself.

Now if only I can convince the PCT that 100% of IT cost refunded means 100% of whatever I can justifiably request rather than a minimum level for all.