The Integrative Stream

Health Wonk Review

Managed Care Matters has the
first edition of the Health Wonk Review, a new biweekly carnival of blog posts on health care policy. Hopefully this will pick up some steam: it’s a worthwhile project.

Thinkpad X41 Tablet Mini Review

Now that I’ve been using it for a few months, I have some slightly more developed thoughts on the various merits and demerits of the IBM (Lenovo) ThinkPad X41 Tablet. As blog readers may recall, I picked up this particular piece of black plastic back in October, promised to write about it in more detail, and then never did. That, by the way, is why these things are called blogs.

I’ve been very happy with the machine itself, with one notable exception and a few small ones. On the plus side, general performance has been very good, and battery life, with the eight-cell extended battery, is excellent: I can usually get four hours or more of active work. Dialing up the power-saving functions gets further. The X41 is also extremely light, which is a real benefit over its predecessor. And like most ThinkPads I’ve used, the keyboard is excellent. I’m typing on it right now. I’ve also become a convert to the new style trackpoint device, which is made out of a software rubber rather than a pencil eraser. The only striking design flaw is the positioning of the fingerprint scanner, which is extremely hard to use when the system is in laptop mode, and upside down in tablet mode, at least in the orientation I tend to use. A higher resolution screen would have been nice, too, since the 1024×768 display can be cramped. More pixels would also allow smaller handwriting in tablet mode.

The big exception, though, is the bootup time, and the other X41 owners I know all agree. Going from power-on to actually using the machine takes a minute or more, and that’s with a gigabyte of RAM. So I generally avoid turning it all the way off and use the Hibernate function instead. This works fine for a while, after which I start having WiFi problems and need to reboot all the way.

I didn’t originally pick up the docking station, but I went out an got it later, since the base X41 doesn’t include a DVD drive. Carrying the docking station around when travelling is a pain in the neck, although the system comes with software that lets you mirror a few DVDs (or a lot of CDs) to the hard drive. The dock station is fine, although it doesn’t have a DVI out connector (which isn’t a big deal) and doesn’t have separate mouse and keyboard connectors (which is). The lack of separate connectors means I can’t tie the X41 into my keyboard/monitor/mouse sharing arrangement at home.

Of course, the real issue is whether or not the tablet functionality has changed my work patterns. I bought the computer mostly because my situation had changed: I didn’t need a large screen, software development workhorse computer anymore, I needed something small, portable, and good for note taking and the occasional spreadsheet. Tablet mode is great for sitting in lectures, since it allows unobtrusive (and quiet) digital note taking. The propensity for distraction is a little lower, too, since the pen moderates the speed at which you can, for instance, write email. You can still web surf to your heart’s content, though.

Tellingly, though, I’m currently sitting at a desk surrounded by paper printouts, all of which are covered with notes, and all of which are sitting on my desktop in electronic form. The problems are density and random access. The tablet PC pen writes more thickly than its 79 cent equivalent, so you can’t squeeze as much in the margin, at least if you want to keep it readable. Again, this is where a higher resolution display, even at the same physical size, would be a real improvement. And it’s still easier for me to flip through a printout of a journal article or business plan than it is to scroll. So the pen usually comes out for quick notes, small sketches, and lectures.

Bottom line, though, is that I like the machine even if I’m not getting everything I’d like from the tablet functionality. I’m certainly using it enough to justify the cost, although I bought it mine through MIT and thus paid a little less than at Lenovo’s web site.

Effective Delegation

As I continue to weather out the blizzard by catching up on the blogosphere, I’ve come across Thinking Faster’s guide to Delegating for Fun and Profit. Simple and easy to absorb, as is all the business advice that people actually manage to remember.

Update 2/13: For a two sentence post, this one had a surprising number of typographical errors.

Procedure Price Escalation

And as I continue this morning’s round of the medical blogs, Kevin, M.D., discusses the decline of the physical exam in favor of more clinically clear-cut diagnostics. Lawsuit survivability is a big part of this, and it’s certainly affecting health care costs. Comments on the post vary from interesting to fairly simplistic.

Earlier this week I was at a talk given by Harvard’s David Cutler, focusing on the relative importance of medicine in healthcare. The topic sounds a little odd, but it’s if you think about it, it’s not: only in the last thirty to fifty years have medical advances been the main driver of increased life expectancies. They played a role prior to that, but public health and rising economic conditions played a much larger one. Sewers were, perhaps, the statins of their day. And when you look at things in this context, those extra years of life expectancy are getting a lot more expensive.

Danish Cartoons and Global Medicine

MedPundit writes of boycotts of European drugs in countries angered by the now-infamous Mohammed cartoons. Patients suffer.

Medical Digital Divide

The Boston Globe reports on the rising gap between IT-haves and IT-have-nots. A good explanation of why electronic health record adoption has been as low as it has been.

Back from New Zealand

Just a quick note to say that I’m back from my adventure in New Zealand. A great country, very much worth visiting pretty much regardless of your particular interests.

I spent my last week on the ground driving through the South Island, visiting a couple of key spots and jumping out of an airplane in the vicinity of Queenstown. This is probably the best interview preparation money can buy; after leaping from a moving plane at 12,000 feet, there is really no way for a man or woman in a suit to be all that intimidating.

And, of course, it’s interview season. After getting back to Boston on Sunday morning I almost immediately turned around and started prospecting for jobs, averaging a little more than one interview every two days. The process has wreaked havoc on my schedule, and is going to make my dry cleaner a very wealthy man.