Acer TM C110CTI-P-M ULV 900MHZ 512M

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Acer PDF on Carson Doctors Group

The Tabletpc (TPC), is a an actual Personal Computer (PC), that can be used as a Tablet. In other words, the user can write directly on the screen, as with a pen and paper. Tablet PCs can be thought of as a cross between notebooks and PDAs or more specifically the Pocket PCs. Some TPCs come with a keyboard and are called convertibles. The Tabletpc is designed to be light and mobile. All Tabletpcs come with XP Tablet Edition Operating System (superset of XP Pro.), that facilitates handwriting recognition, inking capabilities, voice and wireless capability. The Tablet PC puts the "personal" back in personal computing.

Introduction: 

The Tablet PC enables healthcare professionals to elevate all aspects of patient care to a whole new level of mobility. 
The Tablet PC frees the healthcare worker from their desktop as well as paper! We no longer need to balance a notebook, or turn away from the patient as we type information, or transfer paper documents to computers, or detail encounters after hours. The Tabletpc allows a wealth of information at the point of care from past history, tests, treatment and diagnosis to educational material.


I am a Chiropractic Physician, in practice in Carson, California since 1981. I became interested in computers when researching the purchase of my first office computer, an HP Vectra 286. Like many others, my ignorance was anything but bliss, as I found myself at the total mercy of a salesperson. Now, I was the patient, and the doctor, (Teacher/salesperson) was diagnosing and prescribing in a language far beyond my ability to comprehend.  We installed our practice management software and began the training of my staff.  My fledgling business was contingent on this computer and software. I decided then and there, I was not going to be at the exploitive mercy of others. I needed to become proactive and to learn this technical stuff in order to survive in an ever sophisticated world. My office has been wireless since 1999. Over the years, I have owned a half a dozen full PCs that allow pen input on a touch screen from IBM, Compaq, HP, Fujitsu and others.

SUBJECTIVE:

This unit has a Mercedes like understated elegance with grey and silver coloring. It is totally silent. It comes with a glove like protective case that is perfect for protecting it against spills, scratches and possible drools of delight ;-)  This 3.2 lb. unit is extremely compact,  especially considering that it is a convertible unit with a keyboard. I can write directly on the screen with my stylus/pen or use the keyboard. The default screen resolution is True color at 1024x768 resolution.  While I remain forever 39 years old, I do need reading glasses to visualize the icons on the taskbar at this resolution. The smaller keyboard is of course confined in comparison to a normal keyboard, but has great tactile feel. The screen twists and folds down onto the keyboard with ease and stability establishing the slate or true tablet mode. The screen quality is excellent in my office while viewing straight on.

OBJECTIVE: C110 pdf Data Sheet Web Site

Intel® Centrino^TM Mobile Technology
Ultra-Low-Voltage (ULV) Intel® Pentium® M processor 900 MHz, 1024KB L2 cache, 400Mhz System Bus
Intel® PRO/Wireless network connection 802.11b
BlueTooth ready motherboard and software (Launchmanager) but need BT PC card to utilize
IR at up to 4 Mbps. Must be enabled in BIOS, Advanced IO configuration
Intel® 855 chipset family
Price $2199.00
Processor ULV INTEL PENTIUM M PROCESSOR 900MHZ
Memory 512MB DDR SDRAM (EXPANDABLE TO 2 GB) 
Hard Drive 40GB ATA/100 HDD WITH ACER DASP (DISK ANTI-SHOCK PROTECTION), formatted with Fat32 and not NTFS. Partioned 30 Gigs and 10 Gigs. Drive D contains the initial "Ghost Load," from Acer and can be deleted.
Graphics Intel® 855GM chipset with Intel® Extreme Graphics 2 technology, up to 64MB shared video memory
VGA INTEGRATED VGA WITH DVMT TECHNOLOGY
Optical EXTERNAL 1394 FIREWIRE DVD/CD-RW (COMBO DRIVE) Standard/optional external optical drives (see models): Combo drive (8X maximum read, 8X maximum rewrite, 24X maximum record variable-speed CD-RW; 8X maximum variable-speed DVD-ROM) connected via FireWire® port. 24X maximum variable-speed CD-ROM connected via USB port 
Audio: Mono input for dictation and stereo output for listening.
No Smart Card on these new units, unless there is a PCMCIA smart card.
Network:
a. 10/100 ETHERNET,
b. 802.11B WLAN 
Modem V.92 56KBPS MODEM 
OS MICROSOFT WINDOWS XP TABLET EDITION (superset of XP Professional).
Display 10.4" XGA TFT LCD WITH DIGITIZER  Screen TFT Color Display Motion-sensitive 10.4", XGA (1024 x 768) resolution, up to 16.7 million colors: Electromagnetic digitizer behind display works with included EMR (electromagnetic resonance) stylus and pen
Auto-switch feature enables rotation of display to notebook, presentation and tablet modes. Button on LCD or menu option enables toggle between landscape and portrait orientation
Weight 3.2 LBS. 
Warranty 1 YEAR LIMITED (INCLUDES 1ST YEAR TRAVELERS) 

ASSESSMENT:

Initial Experience:

The device was well-packed and everything was easy to find. In addition to the usual hardware, some nice touches were a set of plug adapters if I ever want to take this unit abroad. There were two manuals one for Applications and the other a Users Guide. Both manuals had a front and back cover that was an exact picture of the Acer computer from the top and bottom (cute). My unit came with a DVD RW that comes with an external power supply (very compact), needed to power the DVD, and connects to my internal Firewire—very fast. No complaints with speed while watching a movie or installing Office 2003. I try and copy any DVD or CD to my hard drive if I intend to use them regularly. I synced my wireless Ipaq 54xx, to my TPC, in the cradle, via Infrared and wirelessly. I attached a USB 20 gig Pocketec hard drive just to make sure it works. I will attempt to boot from this portable hard drive later. I use it as a backup for all my computers.

I did have a little trouble finding where and how to activate my Acer's wireless radio, not that I was in a hurry mind you  ;-) There was no reference in the quick start and I had to actually resort to “Reading the Manual ;-)”

Once I figured out how to turn on the Wi-fi, I connected to my office Orinoco Access Point and was up on DSL and connected to my office LAN. I went home for lunch the same day and connected to my Linksys Access Point and desktop. No problems. (Wi-Fi is enabled in Bios, software or buttons on the unit, very easy).
I am now using a Linksys G Access Point as of August 2003 in mixed mode.

I found the C110Ti to be solidly built and "tight." It certainly didn't feel as though anything would fall off. Changing from the notebook mode to the tablet mode was easy and everything seated and locked as expected. I found the system of detents easy to use and well thought out.

It came with two pens. I like the idea of always having one "in" the machine and one in my pocket. If you lose these pens, the touch screen aspect won't work.

Pros

* Centrino improvements such as new CPU and chipset,1MB On-die L2 cache,400 MHz System Bus  (prior cache was 512 and bus of 133!)
* Great structure and function form factor for mobility
* Trackpad excellent
* Speed of processor crisp and fast in memory hungry applications like Office.
* Screen pivot mechanism solid, stable and easy to operate. (read the directions).
* Large Office 2003 applications are fast
* Screen is very nice straight on, and best used in a non glare room. Process intensive fish 3d screen saver looks great- a reflection of the video card with 64 shared megs of memory and screen.
* 2 Pens come with the unit
* nice protective case
* internal fire-wire screams, plenty of external ports
* Built in Wi-fi
* Convertible architecture with keyboard and slate-why compromise?

Cons (the only real con here is the battery life)

* Battery life is unspectacular at around 3 hours.  (this Centrino unit is essentially getting a faster processor more ram, greater cache and a new Wifi, with the same portable battery life). I get 2 hours and 55 minutes  of battery with full Wifi on, no hibernation and charting patients across a LAN. My battery reads 6 % after 2 hours and 55 minutes when a forced hibernation occurs.  I now have a second battery. I really don't need the second battery if I connect to power when I am not with patients. The unit charges very fast. I can get a full charge in one hour.
* The screen has limited viewing ability from angles; good for HIPAA privacy, bad for DVD watching except by yourself. Straight on it is excellent, who wants to share anyway ;-) Glare can be an issue. I have used the Acer under my office fluorescent lights and regular bulbs with clarity. However, outside or other conditions will vary.
* 10.4 screen will take some getting used to (compared to my 19 and 21," desktops); that said, the form factor is right (portability and manipulability are essential to this type of device). 12" would be nicer but not if heavier.
* no extra battery if shipped to the United States but apparently in Australia you get an extra battery! I wonder if the ACLU is aware of this;-)
* Latch: The latch is a little quirky. The latch has a dual purpose, to close and lock the clamshell and lock the slate mode. Just be careful and follow directions when closing the latch. Make sure you slide the latch all the way to the right side (Tablet mode) or to the left side (closing the unit in normal mode) so the locking device is fully extended to lock it down to the base unit.

There are several reasons I chose the Acer:

I skipped purchasing the first generation of Tabletpcs because I was unable to have hands on experience with each available model prior to purchasing. It took nearly six months, but I did use HP, Toshiba and Motion, all fine Tablets depending on your needs. However, I felt that I needed a powerful convertible with Wi-fi and as light as possible. The Acer Centrino is the undisputed winner for me, in May of 2003.

1. First with Centrino:

By mid May 2003, I had hands on experience with most of the Tabletpcs and new what I wanted. Acer was first on the market with the Centrino.
The Centrino technology was made from the ground up for mobility. This chipset was not a dumbed down version of a more powerful chipset, designed to save power.

Centrino Technology is comprised of 3 products:
- Intel® Pentium® M processor
- Intel® 855 Chipset Family
- Intel® PRO/Wireless 2100 network connection

2. Personal attention:

I logged onto Acer's site and contacted a local representative who was kind enough to go out of his way and actually come to my office to show me the Tabletpc!

3. Finally, decent CPU Power. The 900 MHz rated by Intel at the equivalent of 1.4 MHz,  has gusto, especially with 1024KB L2 cache and wider 400 MHz bus. The XP OS needs 512 Megs of Ram and that is standard on this unit and upgradeable to 2 Gigs. The first generation of Acers had a 256, RAM ceiling, which was a definite pass for me.

4. Form factor: I chose the convertible because I want to chart in my treatment rooms and don’t have time to run back to my office and hook up a keyboard if needed. A keyboard is sometimes necessary, in my opinion, when charting patients. (even though we live in a point and click world ;-).  As a "clamshell" device, the screen would also be protected when not in use. While the screen isn't the largest at 10.4", the combination of screen, weight and keyboard make my choice easy.

5. Handwriting: What really impressed me is when I scribbled in "osteopathlogy, necrosis and hemoglobin" and the recognition engine wrote it correctly. Actually, this feature is part of the OS not Acer but it worked on the Acer better than on other models I tested.

5. Keyboard: Personally, this is a must for me with patient histories. I don't have time to run back to a docking station. Why have to "compromise" when both "slate" and keyboard could be had as a convertible? And there's a perfectly good track pad, as well.

7. Inclusion of a CD drive. While I can get away without it, by connecting to a LAN CD, it is a true convenience at times. Acer did the right thing offering a choice of with and without an optical drive. The C110TCi version comes with the drive. Optionally, you can purchase without it.

8. Screen: Excellent, even when compared to my 19" LCD desktop. The TPC screen is dimmed by default when on the battery, as in this picture.
 

9. Advent of robust Electronic Medical Applications (EMR) that can be utilized and optimized for Point and Click on a TPC

Desktop machines lack portability. Palm and PocketPC platforms are just too small and underpowered. For me, a TabletPC is better than a Desktop PC, a PocketPC (PPC), or any Handheld PC, at least for EMR, simply because it is a mobile yet robust communicating tool, with the caveat that it does not fit in your pocket. As a long time PDA user, that is a genuine compromise for me. For better or worse, it is all about compromise.

The TabletPC demonstrates critical "visual real-estate," and is readily networkable with other LAN PCs. Real time voice dictation is built in to the OS as well as handwriting recognition in various forms from Journal to Write Anywhere to Tablet Input Panel and even third party applications like Pen Office and RitePen. Whatever you can do with a pen and paper or a desktop PC, you can do with a Tabletpc! Forget navigating horizontally, vertically and diagonally with a mouse; move directly and intuitively to the target with a stylus/pen! Additionally, when networked, other staff can input data besides yourself, in "real time," enabling a Triage Approach to patient care. For example, a historian can prepare the history and ROS, the front desk the demographics, a nurse the vitals, all prior to the doctor examining the patient. Then, the doctor digitizes the exam findings and chart note. (IMO, this is best started with a protocol template that is easily customizable, rapidly inserted and easy to change with hyperlinks to exam findings/tests and appropriate drop down list boxes, etc.) All information is readily viewable, obviating the need to scroll, pan and or change screens as on a Personal Digital Assistant (PDA). Of paramount importance, the entire chart note (SOAP) is visible for review, on a single screen, an important factor in a harried and hurried setting. For patient education, the larger viewing area is obviously better than a PDAs 3.5" screen, and when wirelessly connected to the internet with DSL, you have a very potent mobile educational tool, where screen shots and patient hand outs are easily printed from the point of care, to a network printer. Point of care communication with the entire networked staff is easily accomplished with "robust office applications," not feasible on a PDA.

PLAN:

I have owned multiple TabletPC in the past, including Fujitsu Lifebook, Grid Convertible, Fujitsu Stylistic, IBM 360-P, Dauphin Orasis. Pound for pound, this Acer is the unequivocal best! This 3 lb., true color, pen convertible unit, enables me to execute a patient encounter with all the added benefits of a Windows XP OS, handwriting recognition, Voice, Office Professional Software, and robust applications. The Acer Tablet PC puts the "personal" back in personal computing.

The idea of a truly portable device which would help me manage my patients by documenting patient encounters, "at the point of care," has been a goal since the first time I used my office computer in the front room of my office. This is it.

USE SO FAR

So what have I done so far? Primarily, a lot of familiarization-play. I've created some templates for patient management (Prescription pad, initial histories, progress notes, exercise diagrams, patient instructions, educational pictures) in the Journal and my Word processor. I've starting taking images of X-Rays for inclusion in patient "files." I've even "scanned in" x-rays, CT scans and MRI. I have scanned in Workmans Compensation authorization forms that I can write directly on my TabletPC and print to the front desk, on the spot. The fun part is that I can do some image processing and annotation right on the Acer. A doctor could make his own subscription pad in Journal, write directly on it and print it to a network printer! I've found that Adobe PhotoShop Elements 2 works well on this little Acer, a pleasant surprise, since my normal desktop with Photo Shop, is a 3.06 Hyperthreaded box with a gig or Rambus Ram and dual Raid hard drive with a 256 meg ATI 9800 Radeon video card.

Windows Journal: Microsoft’s software application for taking notes by hand. Basically the program simply recognizes your inking strokes just exactly as you write. Windows Journal lets users write notes in their own handwriting in the same way that people write notes with pen and paper. However, because the ink is an actual data object and not just a picture or image file, users can convert their handwriting into text. Users can also draw and include graphic files such as pictures or other images in their notes. Think of this program as a piece of paper that you can write or draw on. You can erase your writing and even convert your inking into text. You can print (Journal Note Writer is the virtual printer for the Journal application. ) other documents to Journal and then they become Journal documents that you can write on top of and manipulate in a custom fashion.

Sticky Notes:

Windows XP Tablet PC Edition also includes the Sticky Notes utility. Sticky Notes allow users to jot down short notes and place them on the desktop in a simple and easily accessible manner. Users can also record information and save this recorded information as a Sticky Note. A Sticky Note attached to your desktop keeps quick reminders easily accessible. You don't have to open a program—you see important messages right on your desktop.

Wi-Fi high-speed IEEE 802.11b (11 Mbit/s) connection (not BlueTooth), I can roam my entire office 2500 sq.feet connect to a Linksys WRT54G router/Access Point. Simultaneously, other staff members, can complete (share) the insurance information and patient matriculation, while I am in the patient file, entering exam and soap findings.

I can send and receive email (Outlook) and print to the front desk before the patient leaves the treatment room. I am in constant contact with my entire staff with Outlook's intra office mail.

Handwriting: Write Anywhere and the Tablet Input Panel (TIP) are two methods of input that come with all Tabletpcs. Write anywhere, does exactly what it says. The user can write anywhere on the TabletPC. With TIP, the user employs a panel that displays lines to write on and access to a handy virtual keyboard as well.
I installed a third party application called Pen Office (www.phatware.com) and can write directly on the screen and the program will convert my handwriting or print into text! Pen Commander lets me make macros that I can use for memorized text insertion. This feature alone is a reason to have Pen Office. I installed the medical dictionary as well. The Tablet PC recognition engine comes preconfigured and can't be changed to understand a specific user's input. Dedicated users will adjust their handwriting to achieve better results. From my experience, the native handwriting recognition of the TabletPC in Write Anywhere or the Tablet Input Panel (TIP), is superior to Pen Office, which may or may not be related to the increased depth of the Pen Office dictionary. I have noticed that written medical terms are recognized more accurately with Pen Office; no doubt because of the specific installed medical dictionary. For example, "radiculitis," is readily recognized with Pen Office and not with the native TIP or Write Anywhere.
Parascript Pen&Internet's RiteMail is another third party application and electronic-ink application for Palm OS, Pocket PC, and Windows that allows you to send handwritten notes and drawings to IMAP, POP3, and SMTP e-mail accounts. On a Tablet PC, riteMail can coexist with Windows XP for Tablet OS, though it is not integrated with the Tablet handwriting recognition technology.

Tips to improve handwriting recognition: First of all, allow me to dissolve the myth that the Tabletpc learns your handwriting like voice recognition software learns your voice. The Tablet PC does not learn your handwriting. Instead, you have to learn how to write in a way that will be recognized by the Tablet PC which is quite easy.

Write large with at least a 12 size font and write more straight up than slanted. This is the most important tip of all and can make the difference between frustration and ease.
Calibrate the tablet PC pen and screen
Hold the tablet pen in the same way that you hold a pen or pencil when writing on paper
Hold the pen near the tip and rest your hand on the screen
Write using cursive letters in a straight line
Avoid printing all uppercase letters
Write legibly, at a constant speed with even spacing between letters and words
Write uppercase letters larger than lowercase letters
Avoid empty spaces and letters
Avoid adding additional words, diagrams, or drawings within existing handwriting in a note
Open Journal and write a common word or phrase several times, such as "The patient presents with a chief complaint of neck and low back pain."
Next, select the words and convert to text in Journal. Did it recognize each of the sets incorrectly? Did it interpret the same word or letter incorrectly each time?
If the recognizer converted the phrases incorrectly at different places, then look to see if you wrote the letters the same way each time.
If the recognizer converted the same word incorrectly for all attempts, then try to modify how you formed that particular letter or word.

With Voice Dictation built into the OS, I can verbalize into Office Applications, using voice to communicate with others.  I use other dictation software (Dragon Dictate) to verbalize information and commands directly into my other application of choice. (con: generally the noisier the computer the more artifact noise resulting in less quality. This is a factor with CPU cooling fans). An external microphone is optimal.

I have a "shared," DSL modem that I wirelessly link with, that allows me to roam my office and surf the web at DSL broadband speeds! Medscape, Merck, Epocrates, National Library of Medicine and other resources are a click away. I use my own website as a reference tool, showing my patients pictures and other educational material while on line. At their request, a printout of what I have just shown them awaits their arrival at the front desk. Optionally, they can go home, get on the internet, pull up my URL and print what they want. Matriculation and history forms are available on line for technically advanced patients.

Performance:

Faxing: When reports are ready to be sent, I need only to print to my integrated phone and faxing software or my networked shared printer.

Hibernation: Hibernation can be an issue. I once had a Tabletpc that would go into hibernation and terminate my LAN and Wifi connection, mandating a cold reboot! Thankfully, no such issues exist with the Acer. Because of this issue, I insisted on buying from a vendor that would allow me to return my unit if need be. Many vendors will not!

Final Word: So far I couldn't be happier. For me, this unit is, structure/form/mobility and view-ability, at its best.

The new world of technology belongs to the DMV, and that is NOT the Department of Motor Vehicles, but instead: Digital, Mobile, and Virtual.
 

Wish List, applicable to all Tabletpcs:

1. Lighter than 3 lbs.
2. Longer Battery life
3. Clearly viewable screen inside and outside
4. 12 " screen (assuming the presently impossible equation of bigger equals lighter)
5. Better wi-fi configuring software. Apparently the configuring software is in the XP OS, not developed by the Vendor or Intel.
6. End users need an expedient and economical way to charge a second battery. Buying a separate charger and battery is just too economically steep.
7. A stand, while not a necessity, is needed, in slate only models when using keyboard.

Acer PDF on Carson Doctors Group

C.M.Wilkerson, D.C.
Carson Doctors Group
Mail:  digitaldoc@digital-doc.com
Web: www.digital-doc.com
(This email address is protected by EarthLink Spamblocker. Please watch your inbox for Allowed Sender Request Form).

I am presently testing various EMR packages on this specific hardware platform.