Digital Pens Technology beginning to accommodate users

by David Orenstein free-lance writer

Electronic medical records, practice management software, and electronic prescribing haven’t displaced or necessarily reduced the paper in your office because paper is comfortable and familiar. Rather than trying to replace it, some technology companies simply want to enhance it.

The newest, highest-profile effort is the Logitech “io” pen. The gadget is a pen that writes with real ink but also digitally captures every point, line, and stroke for later transfer to a computer. At the least, this would allow you to keep an electronic copy of what you write (i.e., prescriptions, chart notes, calendar items) without having to scan it. In addition, companies such as Triple i/Cliniforms and Mi-Co have been developing paper forms and software that promise to automatically create electronic medical records from simple pen and paper writing.

Triple i/Cliniforms is researching both io-enhanced prescription pads and patient record forms. The goal is to go beyond making an easy electronic copy of the documents by also capturing clinical data, according to Vice President of Business Development Tom McCabe. Because filling out forms with ink is so familiar to patients, he says, the advent of digital pens opens the door to patients filling out their own electronic records when they fill out simple forms.

Here’s how it could work: When a new patient comes into the practice, the receptionist hands him a patient history form and an io to fill it out, mostly by checking boxes. When the patient is finished, the receptionist synchronizes the pen with the computer like a PDA, and an electronic medical record is born. The computer has turned the patient’s handwriting into text and the checked boxes into industry-standard HL-7 medical data.

The io pen makes this story possible. The io pen is a good product that makes digitizing writing easy, but several factors make it less than a cinch to be a success.

Because the io accommodates a sophisticated optical sensor, a rechargeable battery, memory, and some electronics (as well as ink), it is larger than a usual pen—7 inches long and 1 inch in diameter. The pen is quite light and ergonomic, but undeniably awkward in a shirt pocket.

A bigger issue is that it relies on special paper to do its voodoo. The pen keeps accurate track of its movements across each page by reading specific patterns of dots printed on the page. The technology, developed by the Swedish company Anoto, works well and the dot patterns barely are perceivable. As you’d expect, such paper is more expensive and less widely available than the plain kind. A package of three spiral-bound, 80-sheet notebooks with Anoto-compatible paper retails for $22. That may seem rather steep after you’ve paid between $125 and $150 for the pen. Further, because of the reliance on special paper, the uses of the pen are limited by the kinds of forms that vendors supply.

By and large, the io pen and underlying Anoto technology do not base their appeal on handwriting recognition, which is good because the recognition is passable but not great. The pen will recognize only capital letters neatly printed on specific parts of the paper. Part of setting up the pen is teaching it to recognize your capital letters. It is not clear how well any software can recognize the distinct handwritings of every patient who passes through your office.

Despite the drawbacks, the io pen represents an important and laudable technology development philosophy: It is better to accommodate the preferences of users than to try to force change down their throats. Perhaps the pen is mightier than the keyboard.


David Orenstein is a technology and business writer in Silicon Valley. To learn more about a technology topic in Computing Care, e-mail him at davealli@comcast.net.