Apple’s tablet computer, the iPad, hits the stores in 2 months. It seems destined to compete successfully in the market for e-readers and netbooks, and some have suggested it will find a niche in health care as well.
The iPad certainly has features that make it attractive to clinicians. It is priced reasonably, for example. In addition, thousands of doctors use iPhones in clinical settings, and for them there is no learning curve. These doctors suspect the iPad’s gorgeous 9.7-inch interface will enhance viewing of patient records and medical images, which are vexing challenges on the iPhone. Doctors will like the iPad’s finger touchscreen for data entry, or if not they can always use an external keyboard (optional).
Even so, surveys taken at the height of last month’s Apple iPad Public Relations Extravaganza suggest that most people doubt the iPad will be a difference-maker in health care, at least short term.
For example, in a reader survey by Healthcare Technology Online, just 5% of respondents thought the iPad would have a major impact in health care. Nearly 20% thought it would have a moderate impact, and 75% thought the iPad would have little or no impact.
Another survey by Epocrates found that 22% of physicians planned to purchase an iPad within a year, a number that is actually quite low given the marked selection bias associated with this survey (Epocrates sells clinical decision support tools in the Apple app store).
A third survey of 178 clinicians and HIT professionals by Software Advice helped explain the lukewarm reaction to iPad health care.
In this survey, 34% of respondents said they were very likely to purchase a tablet computer during the next year, but that 34% figure includes all tablet computers, not just iPads.
That’s important because the Software Advice survey also asked respondents what features were “must-haves” for a health care tablet, and the iPad doesn’t have most of them (see figure below).
Illustration from Software Advice
The iPad has these “must-haves”:
Wi-Fi access
Lightweight hardware
Ergonomic design
The iPad does not have these “must-haves”:
Resistance to dust and liquids
Wide selection of medical software
Fingerprint access
Barcode scanning
Voice-to-text dictation
Integrated camera
RFID reader
So-called “toughbook” tablets for health care typically feature sealed ports, can be disinfected and can withstand spills and drops. These features substantially increase the cost and the weight of the tablet, by comparison to the iPad.
In addition, the iPad also lags behind other tablets when it comes to medical software selection, according to Software Advice. Although there are thousands of medical apps in Apple’s App Store, there’s nothing in there that looks like a “Meaningful Use ready” electronic health record.
It’s also well to remember that the iPad’s battery is not replaceable. If it dies during the day, it can't be swapped out. The only option is to recharge the device. iPads also lack a microphone, a USB port, and the ability to do multitasking, which pretty much describes what doctors do every minute of their working days.
Conclusion
iPhones and other smart phones have made an impact in health care as drop-in-your-pocket reference tools, but compared with this, the marginal benefit of an iPad seems small, at best. Frankly, I doubt Apple was even thinking about health care when it released its snazzy, consumer-oriented, media-consumption device.
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Glenn Laffel, MD, PhDSr. VP Clinical Affairs, Practice Fusion
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3 comments:
I always think it's a little short-sighted to guess about any product this far in advance. Who REALLY knows what the final product will look like? Maybe it'll have a camera?
As far as the "must haves" that it doesn't:
Resistance to dust and liquids: how long before the ipods had resistant covers in all shapes and colors? 2 months after the product was released?
Medical Software: That's up to the software makers. Surely brower/cloud based software can write a native app that interacts well with their site with savvy use of authentication and structured data. Given that interfaces with EMRs have taken flak, maybe they need a gesture-based interface to really shine. And wouldn't that be a cool value-add to an EMR? It's risky, but doesn't SOMEONE have to try to see if gesture-interfaces are what this market needs?
Fingerprint access/Barcode scanning/Camera: This one's tricky, I'll admit. My belief is that a savvy hardware maker will use the Bluetooth abilities of the iPad (or the competing Android/Chrome platform that will surely emerge) to create all sorts of pluggable devices. So then all sorts of functions are possible and in the pocket and portable.
Voice-to-text: It exists on the iphone. Should exist on the ipad. Once again, this is up to the software people to do and Dragon's voice-to-text already works fairly well on iphone (at least as well as its traditional tablet counterpart).
Battery stuff: I use a Palm Pre for most of my phone stuff. One of the cool things about it is that it DOES store stuff locally, but it also continually backs-up to a central point. I could get another Pre tomorrow and all of my stuff would be there for me when I turn it on. There is plenty of synchronization software for iPhone. We're entering a cloud world (and you're surely betting on that proposition). Who cares if the device runs out of juice? Just get another charged one from the stack, turn it on, and there you go! Hospitals already do that with batteries (stacks of charging batteries). Just have stacks of charging ipads.
I agree that Apple was likely not thinking about the HIT vertical, but in my experience in the Legal Services vertical, Apple tends to go after a vertical after the fact and then make sure subsequent versions of a product can work with that vertical if it proves to be promising.
I'm not an Apple Fanboy. I barely use their products. But gesture interfaces might be really good in the healthcare IT world. With complaints of "it takes me 10 clicks to do what I do in 10 seconds with a pen/paper" maybe gestures are a way to really change the EMR world. It would be a shame to not have someone try it out.
Say, what hardware does Dr. Rowley's practice use?
Dragon Dictate is available for the iPhone OS, just need to plug a cheap microphone into a device that doesn't have it. As for running out of iPad battery power? If you're on the cloud, they're so cheap in comparison to the Intel MCA's that you simply pick up another unit and keep on going.
There are already a couple of EHR apps, Epic and Life Record, already running on the iPhone, so I wouldn't count the iPad out just yet.
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