Microsoft Windows XP Tablet PC Edition
Customer Solution
Mental Health Provider Streamlines Incident
Reporting with Tablet PCs
Published: November 2002
Solution Overview
The New York State Office of Mental Health is deploying Tablet PCs
running Microsoft® Windows® XP Tablet PC Edition to clinical staff
responsible for managing incident reporting and investigations. Instead of
recording findings on paper to rekey later, clinicians and clinical risk
managers can carry the Tablet PCs right into the examination room, or
use them on the ward to gather information. Mobile access to OMH’s
incident management and reporting system ensures that users efficiently
and accurately collect incident findings and that incident information is
saved as soon as it is collected.
Customer Profile
The Office of Mental Health
(OMH) oversees New York
State’s mental health system and
directly operates 28 psychiatric
centers, serving both inpatients
and outpatients.
Business Situation
OMH wanted to improve clinical
and administrative workflow
processes by exploiting the
benefits of mobile computing and
wireless technology.
Solution
individuals each year. The Office of Mental Health (OMH) operates 28 psychiatric centers across
In a pilot project, the Tablet PC,
running Microsoft® Windows® XP
Tablet PC Edition, is streamlining
the clinical risk management–
incident process in psychiatric
hospitals.
the state, serving both inpatients and outpatients. It also regulates, certifies, and oversees more
Potential Benefits
than 2,500 programs that are operated by local governments and nonprofit agencies.

The Office of Mental Health has a complex and diverse computing infrastructure that must meet

the information technology needs of dispersed hospitals, outpatient clinics, local patient providers,

Situation
New York State has a large, multifaceted mental health system that serves more than 500,000
and a mobile workforce. OMH has a production wireless computing environment consisting of a
mixture of 802.11 (primarily at the Central Office) and CDPD devices.

OMH is constantly reevaluating and piloting new technologies with the ultimate goal of improving
patient care, and it strives to maintain a flexible infrastructure that easily accommodates new
technologies. To that end, OMH had tested deploying personal digital assistants (PDAs) to field
clinicians so they could download patient, clinical, and medical records. However, the agency
quickly found that PDAs offered less functionality than it required.
When OMH heard about Tablet PCs running the Microsoft® Windows® XP Tablet PC Edition
operating system, it decided to use the Tablet PC to evaluate the latest evolution of the notebook
PC as a platform for mobile patient care applications. This time the agency would be working
with Microsoft’s most advanced desktop operating system, plus additional features to enable penbased computing in a lightweight “Slate Tablet PC” form factor that weighs less than three
pounds. “The Tablet PC is not just a PDA replacement,” says Mark Mitchell, Programmer, OMH.
“It provides the full power and functionality of a regular business notebook PC that can be used
on the ward, at the office, or at home.”

Streamlines the incidentreporting process
Eliminates paper and the need
to rekey data
Enables anytime, anywhere
access to OMH’s incident
management and reporting
system
Enables electronic input of
data as soon as it is collected
Provides management with a
current picture of incidents as
they occur
Software and Services
Microsoft® Windows® XP Tablet
PC Edition
Microsoft Office XP
Oracle 8i
Microsoft Visual Studio®
Microsoft Consulting Services
Hardware
Fujitsu Stylistic Series 4000
Tablet PC
Cisco Aironet 350 Wireless LAN
Adapter
The Office of Mental Health chose the clinical risk management–incident process for the RAP
project. Historically, staff had followed a paper-based incident reporting process. Recently, OMH
created a proprietary, Microsoft Visual Basic®–based application called the New York State
“The mobility and versatility
Incident Management & Reporting SystemTM SM (NIMRSTM SM), to replace the paper-based
of the Tablet PC may well
process and to facilitate the reporting, tracking, and analysis of incidents that endanger the safety
provide us with a valuable
and well being of patients. However, the absence of a suitable mobile computing platform for the
new tool to improve patient
NIMRS application has meant that staff must still rely in part on paper recoding. “The Tablet PC
project enables us to realize the paperless potential of NIMRS and opens possibilities for further
development,” says Jayne Van Bramer, Director of the Bureau of Quality Management.
Staff first record incidents on a paper form that is reviewed by several levels of staff before being
entered into NIMRS. In conducting investigations of incidents, clinical risk managers rely on their
handwritten notes, which are later typed into a document. “Typing data into a desktop computer
while conducting an examination or interview would be intrusive to the process and is not
practical. This plus the lack of wireless connectivity on the wards limited the mobility needed by
staff to use NIMRS in the way it was intended—dynamically and in real time,” says Cindy
Sherwood-Judd, Mental Health Program Specialist.
Clinical risk managers, responsible for determining if a follow-up investigation is required, had
also been using pen and paper during interviews and while taking statements from witnesses.
Delays in getting the data into NIMRS meant that there were also delays in making that
information available to other staff with appropriate security rights to access the data remotely.
Solution
The Office of Mental Health deployed the Fujitsu Stylistic Tablet PC to two user groups in a proofof-concept project to assess the potential benefits of loading NIMRS onto a tool that nurses,
clinicians, and clinical risk managers can carry and use anywhere on the OMH wards. The
agency chose two wards in a juvenile facility and a ward for high-risk patients in an adult facility.
“In order to take full advantage of the built-in wireless access and mobility of the Tablet PC, OMH
set up these wards with 802.11b access points secured with Virtual Private Network encryption
between the Tablet PCs and the wired, private network,” says Mark Bilanski, Data
Communications Specialist. “In addition, to boost the wireless connectivity range we installed
Aironet 350 Wireless LAN Adapters.”
The first user group, including doctors and nurses, accesses NIMRS on shared units. The second
group, the clinical risk managers, have access to NIMRS and Microsoft Office XP Professional,
using the Tablet PC as a general productivity tool to carry to meetings, record minutes, send and
receive e-mail, and take statements from witnesses. The pilot is still ongoing and OMH is
assessing its results.
Working with Microsoft Consulting Services, OMH is extending NIMRS with pen and ink
capabilities by using the customized ink control in combination with the full inking application
programming interface that comes with Microsoft Windows XP Tablet PC Edition. As a first step,
Tablet PC users are taking advantage of the handwriting recognition engine to allow them to write
directly on the Input Panel at the bottom of the screen for automatic conversion into text within the
appropriate NIMRS narrative field. User groups are pleased to see improvements in handwriting
recognition and look forward to further technological refinements.
care.”
Chip Felton
Chief Information Officer
New York State Office of Mental
Health
“We were able to port our existing application quickly and easily to the Tablet environment using
Windows XP Tablet PC Edition, ” says Chip Felton, Chief Information Officer, New York State
Office of Mental Health. “The custom software controls added to supply ink to the NIMRS
“We were able to port our
narrative fields seamlessly interact with the Visual Basic COM layer and minimally intrude into the
existing application quickly
established production code base.”
Benefits
“The mobility, power, and ease of use offered by the Tablet PC are key to developing a paperless
risk management system and improving quality assurance,” says Nancy Gutterman, Director of
Application Development and MIS. “We expect to streamline the incident management workflow
and facilitate incident investigations.”
Improving Information Gathering
Nurses responding to an incident on a ward can take the Tablet PC with them into the
examination room and enter initial findings directly into NIMRS. Similarly, physicians, many of
whom are used to writing notes during examinations, can also enter their findings using the
stylus.
“The Tablet PC can help staff to easily access NIMRS when they need it—while dealing with the
immediate aftermath of an incident. Its ease of use and portability mean that the Tablet PC will
help staff gather information quickly and easily using a familiar input tool,” says Gutterman.
“NIMRS has built-in business rules that ensure that staff follow the proper procedure and fill out
the requisite information. Now that the staff have access to NIMRS on the Tablet PC, we believe
information will be gathered more efficiently,” says Van Bramer.
Streamlining Incident Management
Other staff members, including the ward administrator and the team leader, are involved in
completing the incident form in NIMRS before it reaches the clinical risk manager. In the past, this
meant that pieces of paper and files were handed from one person to the next. Using the Tablet
PC eliminates the paper-based steps and provides the added benefit of no longer requiring a data
entry clerk or nurse to rekey the data into NIMRS. Now, every time a person enters information
into the incident report on the Tablet PC, that data is automatically saved into the NIMRS
database.
“With full implementation of the Tablet PC and a wireless LAN environment, we would have a
cumulative, real-time dynamic record of the incident management process available to
management with the requisite security,” says Gutterman. “So, for instance, when executive staff
arrive in the morning and want to see what incidents, if any, have occurred overnight, they could
simply run a report in NIMRS and know that the information is current and up-to-date.”
The Tablet PC also makes the NIMRS data available to clinical risk managers when they conduct
ancillary investigations subsequent to the incident. Using the Tablet PC, risk managers can draw
upon the NIMRS data during follow-up interviews with witnesses and use the inking capability for
taking notes during interviews, as well as for taking notes at Incident Review Committee
meetings. “Using the Microsoft Windows Journal note-taking utility, clinical risk managers no
longer have to rekey minutes and type a separate committee word-processing document,” says
Van Bramer. “The Tablet PC provides an easy way to ensure a more comprehensive summary
of findings within NIMRS.”
and easily to the Tablet
environment using Windows
XP Tablet PC Edition.”
Chip Felton
Chief Information Officer
New York State Office of Mental
Health
Future Plans
The Office of Mental Health plans to further ink-enable NIMRS to facilitate medical examinations
and information gathering on the ward. For example, physicians could draw an image of a body to
more accurately delineate his or her findings, and when the narrative fields in NIMRS are inkenabled, users can write directly on the form.
Other plans include ink enabling a separate application, called Special Investigations, for clinical
risk managers to use for incidents that warrant intensive review. The project will involve the same
Clinical Risk Managers. Instead of needing to commit the details of critical investigative steps to
memory or having to consult a investigations manual, users will be prompted to follow the
requisite policies and procedures by using the application loaded on the Tablet PC, gathering
information in real time and collecting witness statements using the inking capability.
The Office of Mental Health is also working with county mental health authorities in a third pilot.
Clinicians will carry Tablet PCs, loaded with four ink-enabled assessment forms and a
calendaring function, to help them coordinate services and create individual care plans for
individuals living in the community who require intensive mental health services. The pilot will
assess the utility of the Tablet PC platform and the ink-enabled assessments to facilitate care
coordination by field-based clinicians.
“We look to technology to improve the provision of health care services,” says CIO Felton. “The
mobility and versatility of the Tablet PC provide us with a valuable new tool that may assist us in
many areas of patient care.”
Microsoft Windows XP Tablet PC Edition provides a more versatile computing experience,
enabling you to use your PC in more places and more ways.
For more information about Windows XP Tablet PC Edition, go to:
http://www.microsoft.com/windowsxp/tabletpc/
For More Information
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http://www.microsoft.com/
For more information about the New York State Office of Mental Health products and services, visit the Web
site at: http://www.omh.state.ny.us/
© 2002 Microsoft Corporation. All rights reserved.
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