Chromebooks: The Ideal Healthcare Desktop?

Somewhere between 1995 and 1996, I remember reading an article by Marc Andreesen, the creator of the Mosaic browser and a key part of the Netscape team, in which he surmised that at some point in the future, the browser would make Operating Systems obsolete, by providing all the services a user would need.  That didn’t happen during the lifespan of Netscape, but his prediction was enough to rattle Bill Gates and trigger his Internet-focused turnaround of Microsoft.  I remember this being described as Microsoft’s “oh sh*t” moment when they realised the potential scale of the damage that could be caused to their revenues unless they “embraced and extended” the Internet to suit their own commercial model.

And so it was that during the next decade, Mr Andreesen’s idea got kicked into touch and became lost in the browser wars and subsequent Internet-related fun and games.  Microsoft made it their business to scupper the upstart Netscape’s nasty plans, and Netscape duly folded.

Unfortunately for Microsoft, some years later, along came a company called Google, and a few years ago, Marc Andreesen’s prediction came immediately back to my mind when I read about their then newly-announced ChromeOS Operating System, and their development of the Chromebook.  If you’ve not checked out Chromebooks, then you should.  A lot of people don’t get the point of them: why, they ask,  would you want a laptop machine that just runs the Chrome browser and nothing else?  Why not get a full-blown laptop that can run Chrome and do all the other things you need to do too.

In fact, when you look at “all the other things you need to do”, it turns out that in 2013, and I’d predict increasingly into 2014, you already or will soon do most of them “in the Cloud” via a  browser.  Think about it:  the browser already provides the User Interface (UI) and User Experience (UX) for most of the applications we use in our personal daily lives.  In addition, Google Docs, Microsoft Office 365 and Adobe Creative Cloud allow you to write documents, create spreadsheets, presentations and do creative work in the cloud, all via a browser.  Even games are being moved to the browser!

If you look at business corporate applications, for example Healthcare IT systems such as Electronic Health Records (EHRs), there’s no reason why these shouldn’t be re-engineered to run in the browser too.  That’s exactly what EWD.js has been designed to do of course.  We’re already seeing what’s possible with the recently announced NHS VistA Demonstrator, and with EWD.js being a Web-Socket-based framework, the NHS VistA Demonstrator is a great example of “client-server in the browser” and proves just how capable and potent a UI platform the browser really is these days.

If you think this through a bit further, you soon realise that there’s every reason to re-engineer healthcare applications to work in the browser, and it’s because, if you do, you can make the IT environment of a hospital or any other healthcare workplace a lot more secure and safe and a lot less costly than it is at present, by getting rid of those PCs that are designed to “do all the things you need to do” and replacing them with Chromebooks which limit you to doing all those things via the Chrome browser.

Not only are Chromebooks a fraction of the price of a full-blown PC or laptop – I just bought the excellent Acer 720 for about £145 excluding VAT here in the UK – but also they are incredibly secure: all local storage is automatically encrypted, and despite high-profile hacking events, its Chrome OS operating system has so-far proven unbreakable.  Chrome OS is updated whenever necessary by Google when you switch on your Chromebook, and it’s immune to the viruses that are the bane of Microsoft’s Windows Operating System.  Furthermore, Chromebooks are a system administrator’s dream – actually you can probably get rid of several system administrators if all you have is Chromebooks because there’s really very little to administer!

Security of healthcare systems has become a critical issue in recent years, particularly since the well-publicised theft in 2006 of a laptop belonging to an employee of the US Dept of Veterans Affairs (VA) which unfortunately had on it the personal records of millions of US veterans.  The fallout of this event included a $20m lawsuit settlement, and almost total paranoia ever since within the VA related to the use of portable or off-site IT devices.  Everything has to be locked down with strict procedures.  All data stored on laptops must be encrypted.  USB ports are disabled.  The cost of enforcing such procedures and processes in terms of person time as well as the hardware and software required to keep everything locked down is, I’d guess, pretty substantial!

Coincidentally, last week it was reported that the VA are looking, for a second time this year, for an alternative to the Microsoft products that most employees use for “all the things they need to do”.  It strikes me that they need look no further than the Google Cloud.  If, at the same time, VistA’s UI is re-engineered to be 100% browser-based, they could also kick out all those expensive and insecure Windows-based PCs and switch to Chromebooks (by the way, there are also equivalent desktop devices known as Chromeboxes).  It would seem to me that the result would be a significantly lower-cost IT environment and a whole lot safer one to boot.

For example, let’s say an employee’s Chromebook is stolen: what’s the fallout and consequences?  No patient data is lost, because if VistA is running in a browser, then no data is saved on the Chromebook itself.  Any downloads that might have been performed by the user will be in an automatically-encrypted form on the Chromebook’s hard drive that can only be unlocked with the user’s Google password.  If all users are set up with 2-factor Google authentication (if you’re not already using this, why ever not?), then that Chromebook is useless to a thief except perhaps as a Chromebook for their own use.  The hospital has lost £150-worth of equipment – that’s pretty much it.

A further little-know fact about Chromebooks: type CTRL & Alt & T and up pops a stripped-back terminal OS shell client (known as crosh).   What you can do in that shell is limited, but one thing you can do is connect to a remote system via SSH.  I’ve not tried, but I think you should be able to use this for VistA’s older roll & scroll applications.  So the VA shouldn’t even need to wait for VistA to be re-engineered to run in the browser!

Owning a Chromebook for just a few weeks has convinced me what I’d already guessed: there’s very little of the “stuff I need to do” that can’t be done with one of these devices.  As you’ll see in my next posting, I’ve now even made it possible to do all your EWD.js development using only a Chromebook.

In my opinion, Marc Andreesen’s prediction has come to fruition.  The browser really is now the operating system, and is capable of doing “everything you need to do”.  As the basis of a low-cost, safe and secure healthcare IT environment, I believe the Chromebook is a no-brainer.

I’d recommend that all readers should take the plunge and try out a Chromebook: I think you’ll be pleasantly surprised, and you may begin to wonder why anyone would need anything else.




  1. But how does all the Google’s spyware play with healthcare enterprise security?

  2. Couldn’t help noticing you have a GMail email address which seems odd if you really believe such stuff

  3. Here’s an indication of where this technology is going – the new Asus ChromeBox which is coming in at only $179 yet great specs. The perfect healthcare desktop device!

  4. Interesting article, regarding the use of Chromebooks in a clinical setting by a doctor, James Legan:

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