iPad, Layout-Based Forms, and Scrolling

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  • Brian Elcock

    Brian Elcock - 2011-08-04


    I am helping support a few mental health clinics. We have developed several layout-based forms for their practice, including things like progress notes. When you use these forms, each "section" is initially collapsed and can then be expanded by toggling the checkbox.

    The problem I'm hearing about is that the clinicians who are using iPads during these sessions are having a hard time with this functionality. Apparently when you click on the checkbox, the frame does not expand and does not allow you to scroll down.

    My questions are:

    1. Has anyone else encountered this? If so, how do you work around it?

    2. Is it possible to have the layout-based forms be expanded by default? I'm wondering that if the sections are not expanded via javascript (like with the checkboxes) if the iPad browser would then see that as area that it needs to allow scrolling in?

    Any help/insight would be greatly appreciated.


  • Rod Roark

    Rod Roark - 2011-08-04

    Sounds like some kind of browser bug.  But you can write custom logic (PHP and JavaScript) for specific layout-based forms as plug-in modules.  See sites/default/LBF/ for some examples.  I'll help to answer questions for anyone who already has programming experience, and perhaps that can be the start of some documentation!


  • Kevin Yeh

    Kevin Yeh - 2011-08-05

    LBF uses jquery 1.3.2 and fancybox 1.2.6 both of which are pretty old.  I wonder if upgrading would address iPad (and possibly other browser) problems.

  • Brian Elcock

    Brian Elcock - 2011-08-05

    Thank you for both of the replies.

    I did some research and found that this is a common complaint with iPads and frames. Apparently the technique of using 2 fingers to scroll within a frame is pretty touchy on the device. I'll have them try that tomorrow and see if it helps.

    I'd also like to figure out for myself what Rod suggested. Hopefully I'll get some time to do that soon.

    Thanks again.

  • Mark A

    Mark A - 2011-08-05

    This is also an issue with browsers based on the Android OS.  I just placed an order for an Acer 10" tablet to use with OpenEMR.  It comes with Android 3.0.  When it arrives next week, I will be checking to see if this problem persists.

  • Alfonso

    Alfonso - 2011-08-05

    I just went through this on two sites.  One with Ipads the other with Android Tablets.
    Adroid OS Browser had frames issues.
    Dolphin did not work well either.  At times it just went blank.
    FireFox was so bad I did not even look into why.  It also went blank randomly.
    Opera was the one we finally went with.  It worked smoothly
    The only issues on iPads we found so far was anything associated with flash (and you know how that goes or doesn't).
    FYI: MAC Tiger and Leopard  did just fine.
    Hope this helps.

    Next step printing from Android and iPad…???


  • Brian Elcock

    Brian Elcock - 2011-10-14


    Just wanted to follow up and ask about your experience with the Android-based tablets? Also, how has the printing been? We have found that the iPad does not print the scripts out like would happen on a PC.


  • Mark A

    Mark A - 2011-10-20

    Regarding Android based devices: I am using an Acer A500 running Android 3.2  There are still some browser/frames issues, but for the most part it works well.  The built-in browser and Opera Mobile seem to work the best.  Firefox Mobile is one of the worst.

    Regarding printing, for now, Android devices only print through Google's Cloud Print, or similar service.  I've heard it said that for a small OS, designed for mobile devices, they don't want the overhead of trying to support multiple printers the way a full-sized OS does.  I'm not sure if I believe that or not.

    You can buy a printer that is Cloud Print enabled, and print to it directly, or you can use a legacy printer connected to a Mac or Windows PC.  A Linux version is not officially available, though I've seen some reports of Linux hack-arounds being available.

  • Brian Elcock

    Brian Elcock - 2011-10-20


    Thank you for the information.

    My biggest problem at the moment is printing the subscriptions. Some Android-based devices won't even allow me to select the prescription in the lightbox overlay. In fact, I only found one device that would. I spent about 2 hours at Best Buy last night trying all of their devices. The one device that did allow me to select the checkbox and then click the "Print PDF" button didn't do anything once I clicked the "Print PDF" button. So I don't know if it was generated and downloaded somewhere on the device . . . or what. But it appears that this is something that won't work at the moment.

    We were thinking of using a newer ePrint-capable printer, but that still requires you to email the actual document. At least that's my understanding. But perhaps you have the ability to set up that printer as the default printer and it is just sent "to the cloud" automagically?

    As before, I'd love to hear about anyone else's experience. We've pretty much ruled out the iPad. We're actually looking at some Windows-based devices now. I was hoping that the Android devices would work, but I can't get one to function well enough to be able to recommend to my clinic.

    Thanks again for the reply. Good to hear of others' experiences.


  • Palmdoc

    Palmdoc - 2012-04-07

    Sorry to dig up this thread but I think mobile support would be important, particularly with tablets. I notice there's an Android app in closed beta but in the meantime is there a working mobile front-end?

  • Penguin8R

    Penguin8R - 2012-04-09

    iPads actually work quite well, the printing issue can be solved for $10 with a handy little program called FingerPrint that runs on a Windows or Mac desktop.

  • Kevin Yeh

    Kevin Yeh - 2012-04-11

    What I've discovered is that some of the pages add another layer of frames to the mix.  The calendar and the encounter summary are specific examples.  Because of this it seems that on tablets/phone where the gesture to scroll is done with a finger (rather than an explicit scroll bar on the desktop) the scroll events don't make it down the event chain to the element you actually want to scroll.

    So, if you access a large LBF (or even a standard form like vitals) from the menu items in the frame itself in an encounter summary you can't scroll.  However, if you access the form from the left navigation visit forms menu, the form doesn't get loaded in two frames and can scroll correctly.

    On iPad in Safari, it seems that frames just get expanded to their maximum size and scrolling events get handled at the full view port level rather than for each individual frame, so it's less of an issue.

  • Roger Gietzen

    Roger Gietzen - 2013-01-07

    Tablet/smartphone question:
    This seems like the best thread for my question.  I am considering using OpenEMR, for my one doctor, home based clinic.  I hope to use my mac as the server.  I would like to use a tablet for the actual patient encounters.  My hopes are to use the programs that recognize handwriting and can insert them as text, with the tablet.  I don't own a tablet yet, but my first choice would be a Samsung galaxy product.
    Also I'm a one man show.  So I'm hoping to use a smartphone to schedule patients, look up medical records, create documents and send in e-Rx's.  I don't own one of these yet either, but would choose the Galaxy S III.
    Do any of you here, have experience with this type of usage? 

  • Kevin Yeh

    Kevin Yeh - 2013-01-07

    I don't own one, but I've been interested in the Galaxy Note II Phablet.  I think its larger form factor and S-pen would make for a better OpenEMR experience than the Galaxy SIII.  In my mind there wouldn't be too much advantage in owning both a phone and a tablet verus simply having a Note II.  The resolution of the current pen enabled galaxy tabs is 1280x800 vs 1280x720 of the Note II. Essentially the same amount of information can be presented on both devices at any given time.  However the smaller text size on the Note II may be an issue depending on your degree of age related presbyopia.

    One caveat. The OpenEMR community does not have adequate resources to dedicate to tablet/smartphone specific versions of the software, and while we do our best to address issue that arise on those platforms, the priority is always placed on the desktop browser experience.

    Honestly, I suspect you will miss having the keyboard and mouse.  If you truly want handwriting recognition, I would suggest a Windows 7 laptop with a Wacom digitizer like the ThinkPad X230T for your "primary usage" scenario.  I realize this may be blasphemous since you said you want to use a Mac as your server. 

    If you haven't worked with OpenEMR before, I think jumping right in to the tablet experience may be difficult. I'd suggest that a more reasonable approach would be to try out the desktop experience first, install it on your Mac or play with the demo http://www.open-emr.org/wiki/index.php/OpenEMR_Demo . Then once you are comfortable, go to a mobile phone store and try some devices out.

  • Roger Gietzen

    Roger Gietzen - 2013-01-07

    I have thought about the Galaxy Note II.  I might reconsider.  It is just a bit bulky for carrying everywhere in my pocket.  Since I am a one man show and travel, I always want to be able to access records and respond to my patients.  So I will always need to carry a device.  The S III is smaller.
    Handwriting recognition is just a cool option, not crucial to me.  I was just curious where OpenEMR stood with these devices.
    I posted a similar question on the fb page, and the responder there suggested a start a new thread here, requesting smartphone/tablet software work.  They seemed to think it might be doable and a good time to think about it. 
    Before doing so, I wanted to understand what issues where open with those devices.  I was told that you can use them, but things just were not too smooth yet.
    BTW, I am going to go ahead and install the OpenEMR and play around with it.  It sounds like it meets my immediate needs.  In fact I already tried installing it.  But as a non-IT guy, it exceeded my skills.  I will be hiring a local to help.
    If OpenEMR seems like a good fit for me, after playing around with it AND there seems to be a real need to improve the mobile experience, I would love to directly financially support that work.  I love open source projects and I think the mobile compatibility is a huge feature that may "make or break" a potential new EMR user from choosing the product.

  • Roger Gietzen

    Roger Gietzen - 2013-01-07

    Another thought.  My "clinic flow" plan was to use both my mac laptop and potentially a tablet.  The tablet would allow me to complete the free text portions of the EMR, while I sit with the patient (this improves efficiency and accuracy) and while I go do my home visits.  But then I would us switch to the computer for the rest of the functions.
    As I said before, the tablet would just be the frosting on the cake.  Not crucial.  Here in the USA, it does appear that most new EMR users do employ tablet/ipad in such way.

  • Kevin Yeh

    Kevin Yeh - 2013-01-07

    I doubt that you will be happy with "free texting" on any tablet regardless of platform due to handwriting recognition accuracy issues.  Unless you are a "hunt and peck" keyboardist, typing will likely be a better experience.

    I've had some ideas about implementing capture of handwritten documentation as "images" into the workflow, in order to maintain full fidelity of information that a clinician jots down.  That way one could blindly scribble notes to oneself while still maintaining eye contact with the patient.  You would do your own handwriting recognition later. 

    Where did you get stuck on the installation?  We might be able to help you out here.

  • Roger Gietzen

    Roger Gietzen - 2013-01-07

    I appreciate your feedback.  I am employed at another clinic now that uses EMR (cerner based).  There I scribble a minimal amount of notes when I'm with the patient and after the visit is over, I go to the computer and use a speech recognition system to make the note.  It seems like a waste of time, but it does work. 
    I type pretty fast, but for big notes, I must say that transcription software is nice.  In fact, I already have similar software on this mac (just never used it yet).  That may be the best way for me to use this system too.
    I can ditch the handwriting recognition idea. It just seemed like a solution.
    As far as installation.  I got stuck installing the Open Source database software on my mac.  If I understand correctly, I need to use my mac as a server.  I was able to install MySQL and do some code related work (like uncommenting some lines, etc), but when I moved on to php I got stuck.  It wouldn't let me uncomment a line or add a required file.
    And then I started to look at the rest of the installation procedure and realized it was all greek to me, LOL.  I spent a bunch of time googling solutions, but never got the php thing up and running.
    I look forward to your help. I won't be at my computer til the end of the day today.  Thanks again.

  • Kevin Yeh

    Kevin Yeh - 2013-01-07

    None of the most prolific OpenEMR contributors routinely use OSX, so in the long run, I think you are far better off trying to run a virtual server on your mac instead of directly using OSX as your server.  Apple seems to be moving away from the server space as well.
    What you can do is install Ubuntu running under VirtualBox:
    Then you can use the "one click" OpenEMR installation that Brady supports.
    Apologizes for any confusion as a result of "geek speak."  However the bottom line is that Mac/OSX is the least supported server environment.  Virtualization will get you onto the "best supported" OpenEMR platform.  It will also simplify upgrading PHP, Apache and MySQL in the future for any security updates that might come from those development camps,

    One of the key advantages of this approach mentioned in the Virtualbox guide is:

    Because Ubuntu is contained within a virtual machine, it’s practically impossible to screw up your host computer, so feel free to explore

  • Roger Gietzen

    Roger Gietzen - 2013-01-07

    Virtual Server.. SOLD.  If I understand correctly, its not even on a separate partition or anything.  It looks pretty clever.  :)

  • Kevin Yeh

    Kevin Yeh - 2013-01-07

    Yup.  You can also keep copies of the entire virtual server as backup.  I'm hoping the instructions I've linked to are straightforward enough and you can get everything up and running yourself.  However, we are here to help if needed. 

  • Roger Gietzen

    Roger Gietzen - 2013-01-08

    It might be helpful to put your advice about using Ubuntu VirtualBox on the installation link below, with the caveat that it is highly recommended over using mac as a server because of less support, etc:
    Also, looking through some of the forum threads, it seems that people are using tablets and smartphones to some degree.  I've decided to start a new thread to see what people's experiences are.  Thanks

  • Roger Gietzen

    Roger Gietzen - 2013-01-09

    Good news, I successfully installed OpenEMR in a Ubuntu VirtualBox.
    I downloaded the patch, but got hung up with these instructions:

    " Linux

        1. Move the patch file to the openemr web directory, then type 'unzip 4-1-1-Patch-8.zip', and confirm ok to copy over files.
        2. Open web browser and go to http://your_server_name_or_ip/openemr/sql_patch.php

                (this script will run automatically and patch the database)
                (if you are using the Multisite Module, then skip step 2 and follow these instructions) "

    1.  I'm not sure what the OpenEMR web directory is, or how to move the patch there.
    2.  I'm guessing I will open the browser to:  http://localhost/openemr/sql_patch.php  because I have not assigned a specific server name, and "local host" was the address I used to navigate to the OpenEMR in the beginning.  Is that correct?


    BTW, to test a smartphone, how do I find my server IP address in this VirtualBox?  Is it the same procedure I use to look up my computer's IP address?  If I understand correctly, I can remotely access OpenEMR through a web browser, if I know the server IP address.

  • Kevin Yeh

    Kevin Yeh - 2013-01-09

    If localhost worked during your install, then it should work for your patch as well.
    The OpenEMR web directory is going to be /var/www/openemr
    If you start from the "Home Folder" you can navigate there via "File System".

    I suggest that you try and find an Ubuntu "basics" tutorial.

    If I understand correctly, I can remotely access OpenEMR through a web browser, if I know the server IP address.

    It's more complicated than that.  There are issues regarding port forwarding/router and firewall configurations.
    also it depends on how you configured Virtualbox (NAT vs. Bridge Mode)

    However, if you open the ubuntu command prompt, you can use "ifconfig" to get the server's IP address on your local network.

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