The University of California San Francisco (UCSF) Medical Center was an early adopter of the electronic health record. In 2002 the medical center began implementing IDX’s Carecast®, (now GE Healthcare’s Centricity Enterprise) and found it very useful to have a single source for patient data. The obvious next step was to add a mobility component to the equation to make it easier for clinicians to access that data at the point of care. UCSF’s initial step toward mobility was to implement computers on wheels (COWs). COWs were preferable to stationary PCs. However, UCSF soon found they came with substantial drawbacks such as expensive batteries with limited charge. Furthermore the COWs took up space in the hallways and were hazardous obstacles at the bedside in emergency situations. The COWs required a significant amount of maintenance, and, since they were shared, there was limited availability and clinicians were often frustrated with the amount of time it took to log on and off the COWs during a given shift. UCSF’s leadership realized that while COWs had helped the institution move away from a stationary system, they could not provide the level of safe, convenient, and efficient mobility UCSF needed going forward.
