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Curbside Consult with Dr. Jayne 5/18/15

May 18, 2015 News 15 Comments

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Dr. Jayne Adapts to New IT (and Lives to Tell the Tale)

Sometimes it’s important for those of us in healthcare IT to eat our own proverbial dog food. This week was one of those times, when I decided to buy a new laptop before heading out on a locum tenens gig. Although I did plenty of research and thought about it for several months before I took the plunge, I had some unexpected surprises. Much like EHRs, it had plenty of “undocumented functionality” to keep me guessing.

At my previous employer, we had three choices for end-user devices: standardized desktop PC, standardized laptop, or standardized convertible tablet PC. Regardless of which you selected, the desktop images were pretty much the same. I’ve always opted for the latter because it worked well for me in clinical settings. I liked to use it basically as a touch-screen laptop, so I could free text easily while navigating through EHR screens. Our hardware refresh cycle was typically 4+ years, so it had been a while since I had anything new. Additionally, we were still using Windows 7 and I had not yet had the adventure that is Windows 8.

While shopping for my new hardware, I worried that I had become out of touch with consumer electronics because I had been insulated in the IT silo of Big Health System. That became a reality when it finally arrived on Friday afternoon. I have to say, Dell does a snazzy job with their packaging. The new laptop came in a glossy box with full-color photographic images on it. I was worried that my new device was heavier than anticipated, but discovered that a good chunk of the weight was the decorator-quality box. The real shock, though, came when I tried to start setting it up.

First, I guess you can’t do anything anymore without being online. Despite having purchased full versions of several applications along with the PC, it wanted me to go online to download updates before I could do anything. I had heard a lot about the Windows 8 interface so I was prepared to not have my familiar landmarks. I was not prepared, though for how clicky it is just to navigate to items that previously lived in the start menu. Rumor has it that Microsoft is bringing back the start menu with Windows 10, and I daresay I’ll probably be looking forward to it.

I spent a good hour downloading non-Internet Explorer browsers and configuring links and bookmarks just the way I like them, not to mention the general appearance and settings items. The new keyboard has a totally different feel than what I am used to and I knew there would be a learning curve, so I decided to start slowly with some online shopping. Running skirts on sale, y’all. Get ‘em while they’re hot! I placed my order and felt I was doing well getting used to the new touchpad when I had a big surprise – apparently this model is now touch screen! When I originally researched it a few months ago, they offered it in two versions – with and without. Now, apparently, they only offer it with the touch screen and I didn’t notice when I bought it since it was the same price as what I had researched before.

Although cool, it made me wonder whether the privacy filter I purchased would work with it. Especially now that I travel a fair amount, I don’t need people reading my work on the plane. I wanted to get things organized before I had to leave town, so I left that as a project for another day. I started moving files over from my old machine. I was feeling pretty good on the new keyboard and only typing gibberish now and then, so decided to do some real work. I’ve been working on a textbook chapter for a couple of months and emailing back and forth with a collaborator. We’ve had some bad experiences with Google Docs (which everyone and their cousin seems to use for collaboration), so we do our revisions old-school, emailing them back and forth after each update. I couldn’t open the most recent document from my partner and the laptop threw some ridiculous out of memory error at me despite the fact that Chrome was the only thing running.

I ended up having to download the document on another laptop and move it via USB, so I was already aggravated and distracted. Then, while I was trying to write, I kept getting emails from Gmail alerting me that my various accounts had been signed into from new IP addresses and new browsers. I plowed through some edits then got ready to save. Unfortunately, it stuck my draft not in the good old Documents folder as I had specified, but in some AppData/Roaming folder, which apparently is a hidden folder in file explorer. Not cool.

The last straw was when I got the email from Dropbox announcing that it had somehow (and seemingly without my permission) mated with Microsoft Office Online. Seriously? By this point I was ready to go online to my local school district and start looking for community education courses to help me navigate this mess. I’m really a pretty basic user at home – word processing, email, Internet, accounting software, spreadsheets, Twitter, and the occasional Facebook. I don’t do any multimedia or gaming and don’t like storing data in the cloud unless I really have to, hence the Dropbox account. (Yes, I’m a bit of a curmudgeon that way.)

But here I was with my applications melding in a way I didn’t understand or know how to control without doing a bunch of research or calling the teenager across the street. I decided to give up on the textbook and start writing Curbside Consult. Mind you, I’ve had this computer less than 72 hours and have barely used it. I was looking forward to some straightforward word processing and what happens next? The “I” key decides to stick. The screen instantly fills with the letter I and I’m prying it up with my fingernails to get it to stop. I tried for a good 15 minutes to get it to work right and no luck. Apparently the key has three modes: stick and type a thousand letters, stick and type nothing, or depress and type nothing.

By this point I was ready to throw in the towel and returned to my lowly HP with 2 GB of RAM that I bought in 2009. It’s slow and cantankerous, but has all its vowels and consonants in fine order. As for the new one, it’ll have to wait until I get back in town and am ready to deal with it. If nothing else though, I have a new appreciation for what physicians feel like when we throw new hardware or a new operating system at them without adequate orientation and training.

What’s your take on Windows 8? Email me.

Email Dr. Jayne

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Currently there are "15 comments" on this Article:

  1. HATE IT. I have had mine for more than a year and still have trouble getting to things that I could easily find before in the start menu and I don’t even use half the junk they put on the main screen. I’m with you sister… Curmudgeons unite! Glad it is not just me.

  2. One new device and losing it–eating dog food indeed. Welcome to the brave new world for mere mortals. Consider the average person laboring in the modern life where everything is services and everyone is an information worker who will literally have to deal with scores of devices and interfaces daily, all of which are constantly being updated and theoretically upgraded. Just the account numbers and passwords alone are mind numbing and that is before the real problem solving can begin. To whit: the stuck I key–was it a software or a hardware thing? No question lots of folks share your pain. . .daily.

  3. Why do companies even buy these things? Look at that start screen picture; “games”, “music”, “store”, “camera”. This is a computer for kids hanging out at the mall, not for serious people doing serious things.

  4. I owned a Windows 8 laptop for roughly 4 months before posting it to Craigslist and buying a Macbook. I haven’t used a Mac OS since the ’80s but that was one of the better decisions I’ve ever made. It’s weird, it just…….works. All the time! Crazy. I’m a convert.

  5. Fix all that is wrong with your Win8.1 experience by downloading Start8 by Stardock for $4.99. It will give you back your Win7 type Desktop and your Start Menu, and it’s the best solution for fixing your issues with the new laptop and will make you much more productive. I’ve installed it on all three of my devices that I use for Win8.1 and it has never disappointed. Staring at those big colored tiles is intimidating and trying to find routine things when they used to be so readily available is a big frustration, but there are some very good online articles in PCWorld Magazine site about how to use Win8 effectively. Give it a chance and it’ll be a much better experience. Wishing you luck!

  6. I noticed that in this week’s edition there is a small image of you. I think many women in the HIT space would be interested in hearing how and what necessitated adding an image of yourself to your Curbside Consult, though I could probably hazard a few guesses.

  7. This post is indicative of the larger problem in the Health IT space. Users are reluctant to embrace change – why not try peeking your head out from underneat a rock once or twice a decade and change won’t be so hard. I won’t say that Windows 8.1 isn’t without flaws, but the majority of the whining in this post is likely attribuatble to user error or someone who’s 50+ who is terrified of technology. In an age where I can SMS my coffee maker in the morning to start brewing, start my car from my smart phone and adjust the climate control in my home from half a world away we’re at a point where the internet of things is here, and here to stay. “you can’t do anything without being online” isn’t a new concept and its not a bad concept either, but maybe that’s the view in healthcare where there are still attitudes that connectedness and sharing information may blow someones competitive advantage.

    Posts like these remind me why its seems like a losing battle to try and advance tech in the healhtcare space. Users who have no desire or aptitude to learn and embrace new tools, a generation of technology leaders who think innovation is implementing Epic. A leading HIT blog like histalk should be embarrassed to post this.

  8. Shame on you Cynical. Your comment misses the boat on so many levels. First off, it was incredibly rude. You should be capable of stating your opinions without belittling others. Furthermore, I’m sure most readers of HIStalk all share some degree of frustration over the people that we lead and support when it comes to technology. Change can be difficult. When the change is an improvement, when its intuitive, when it helpful, then change can be pretty easy. When the change makes a process harder, when its poorly designed, not helpful, or poorly presented, then there is a lot of pushback.

    I would be very cautious before lecturing Dr. Jayne on “embracing change”. I’m quite sure that Dr. Jayne has more experience in this area than most.

    Cynical, I wouldn’t be using the conversion to Win 8.1 as an analogy to attitudes towards embracing change. Windows 8.1 is largely not intuitive and makes easy things harder. Yes, this is my opinion, and that of the majority of computer users. Win 8.1 has been a flop within the enterprise space, across all industries that come to mind. Its not just Healthcare. Win 8.1 has a high learning curve. Windows 8.1 is a great example of a project that was rolled out prematurely. Its a good cautionary tale of making sure that your project is ready before you push it out to your staff, customers, patients, etc.

    Jayne, if you are ever able to unpry your “i” key, you will eventually learn Windows 8.1. Sadly, you will need to use google and youtube to figure out some “features”. All enterprises are hoping that imminent release of Windows 10 will fix the interface issues. Until then, many of us are enjoying our newly purchased macs.

  9. @Cynical I couldnt agree more, I have worked in roughly 120 different physician offices throughout the nation and have been absolutely floored regarding physician and staff overall tech knowledge. I have seen literally everything from not knowing how to check email to fully being unable to turn on a computer without someone else pressing the button. I personally feel that the transition to higher levels of technology not only increase patient care, but also allow providers and their staff to have a much easier workday.
    I am fully behind the switch to more technology in healthcare, the offices that fall behind the times in technology deserve to remain in the dirt. If you knew your doctor couldn’t sit down and figure out how to operate a computer, would you still go to them?

  10. Windows 8 is an uncomfortable melding of a traditional desktop UI (keyboard and mouse) with a touch oriented UI. The internet is alive with commentary about this fact and has been for the last 2 years.

    I’ll assume you want the desktop. Once you find the desktop, the next step is to tame the Metro apps links. For the most part you won’t want to run the Metro apps. They don’t run in window, and you lose all your landmarks when they run. Therefore change the file associations away from those Metro apps.

    In the meantime, you are going to get periodically dumped into a Metro app from time to time. It’s disorienting! However all the old key shortcuts still work, so I recommend [Alt-F4] as your lifeline. That immediately closes the Metro app and puts you back in the desktop.

    Windows 10, based upon many previews, seems set to perform a much better job of reconciling the 2 worlds (desktop & touch).

    The stuck key is of course a hardware problem. Nothing but repair or replacement is going to correct that.







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