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Apple's iPad an Impressive Product in Need of Tweaking for Healthcare Success
By Colin Crawford
Published Online: January 28, 2010 - 11:14:32 AM (CST)
The Steve Jobs iPad Tablet media show held yesterday at the Yerba Buena Center for the Arts in San Francisco was always going to have a hard time living up to the ridiculous pre-launch hype that's been circulating around the Web.

Steve's presentation was more moderate than at previous product launches as he tried to manage expectations positioning the device as a tweener product - "more intimate than a laptop and so much more capable than a smart phone.''

By the time we emerged from the iPad presentation and the demo area where, under the watchful eyes of Apple execs and security staff, we were allowed to play briefly with the device and the few announced accessories, it was obvious that the world was very much the same as when we went in.

This was always going to be Apple's toughest audience. The crowd reaction was generally positive if rather muted. Of course, the group was largely press who have a tendency to be ultra critical and even cynical given the amount of marketing and PR hype to which they are subjected. People also react to what they know and understand and have more difficulty seeing the longer-term vision and opportunity.

A big challenge facing Apple's iPad is that unlike phones and laptops, this is a nice-to-have, not an essential-to-have product. But it's a very slick device and a lot people will want one even if they don't absolutely need it. It's a product that will evolve and build over time rather than be an instant success.

The light and thin iPad has a bright and crisp resolution, the performance is fast, web sites look great (well, those without Flash). Unmodified apps scale up to full screen and generally are acceptable while the Apps written for the enhanced iPhone operating system raise the bar significantly. 

A typical reaction of “It's just a big iPod Touch” is understandable, as that's what it looks like, but that does not begin to do the device, or the engineering effort that went into the product and supporting eco-system, justice. Customers understandably may see this as a bigger iPod touch but it’s no trivial matter to scale-up a multi-touch captivate screen to 9.7 inches.

The magic in Apple’s iPad is just how seamlessly it appears to work. It's going to be a while before Apple's competitors can match the functionality in a similar form factor, which could give Apple an 18-24 month lead.

There are, however, some notable omissions that will affect its adoption by healthcare providers.

No Flash
If the device is positioned as great for web browsing, the lack of flash support is a problem, especially with video streaming. While Apple may be moving to HTML5 (http://dev.w3.org/html5/spec/Overview.html), Adobe's Flash is going to be around for a long time, and this limits the accessibility of many useful Internet medical resources. Multi-tasking would also have been nice.

No camera
There is no camera, but then again we don't have iChat on the iPhone. However, the device seems a natural for video chat and the camera is an essential tool to bring together the physical and digital worlds. Whether or not healthcare reform passes, the importance of telemedicine will only grow as myriad parties attempt to address provider shortages, the challenges of rural medicine, and other situations that necessitate remote delivery of care.

Given Apple has pushed video cameras in its desktops, laptops, and the iPhone (but not iTouch), the lack of this feature is really surprising. Maybe it's just as well Apple is positioning the product as environmentally friendly and recyclable, as I have a suspicion that as with the iPhone, I could be upgrading each year.

Paying for a separate data plan
Given I carry around an iPhone all the time, having a tethering option for the iPad or laptop would be welcome rather than having to sign-up for another data plan.

No mouse support
The virtual keyboard is thankfully enhanced by physical keyboard options, either dockable or via Bluetooth; however, the iPad does not support Apple's Bluetooth mouse, so extended activity within iWork and other click-heavy applications may be problematic. While it was good to see the iWork applications, the target audience release of iPad iLife applications would have been more appropriate; expect them to appear relatively soon after launch.

Durability and battery issues
As noted earlier, the iPad is light and thin, which lends itself to portability and ease of use. However, what does this say about the long-term prospects for its use? How well can it withstand rough usage, dust, disinfectants, water, etc.? Further, even if it can handle the rigors of an intensive healthcare setting, how will providers react to the lack of an interchangeable battery?

Apple claims that the iPad offers “up to 10 hours of surfing the web on Wi-Fi, watching video, or listening to music” which, if a reliable figure, could cover most of a hospital shift or a private practice workday. But what happens when the iPad gets handed off to the next person? The inability to swap out a dying battery for a fresh one becomes prohibitive to the iPad’s effective use.

This is a product that is likely to grow on you and it has enormous long-term potential. Its immediate strengths are in entertainment - games, movies, and music. The opportunity for content publishers is significant but needs a lot more work. While I have already signed up to be notified of when I can purchase an iPad, the absence of a camera and video chat prevents me from granting the device the "magical" status Apple has already bestowed on it. Check one out when you can.

Some more thoughts from physicians around the web
Lyle Berkowitz, MD, who runs the blog “Change Doctor”, wonders how the iPad might be incorporated into the clinical workflow and how it might work with EMRs. He says he could see the iPad being used for “data retrieval, some ordering, and possibly some basic documentation,” though he still thinks that most documentation will still be done using voice recognition software. Berkowitz thinks that the iPad “might make the most sense in the inpatient setting where there is a lot of movement and a big limiting factor has been not enough computers for all the rooms.”

Sam Basta, MD, over at “Healthcare Innovation by Design” says that “this technology will stimulate a lot of healthcare innovation - from better EMR user interface to healthcare consumer apps,” and that its greatest potential lies in “how it can completely change face-to-face healthcare conversations.”

Alex Drossos has weighed in at iMedicalApps.com with “Five Lessons Apple Must Learn from Current Healthcare Tablets if the Apple Tablet (iPad) is to Succeed in the Medical Industry.”

iPad Specs
Apple's iPad mobile device is 0.5 inches thick (or thin) with a 9.7-inch, 1024 x 768 display. Storage options of 16 GB, 32 GB, and 64 GB are offered. The device is powered by Apple's custom A4 1 GHz "Apple A4". Pricing starts at $499, $599, and $699 for the varying capacity Wi-Fi models without 3G, and $629, $729, and $829 with 3G. Wi-Fi (802.11n) only models are scheduled to ship in 60 days with 3G-capable model shipping in 90 days, pending FCC clearance.

The US 3G data plans will be offered by AT&T at $14.99 for 250 MB and $29.99 per month for unlimited usage as well as free access to AT&T hot spots. No long-term contracts are required and the products, which use GSM micros SIMS, will be unlocked. Plans for non-US users should be in place around June / July.

iPads feature an accelerometer, compass, speakers, a microphone, and 30-pin dock connector features. The iPad offers a claimed 10 hours of battery life for viewing video and 1 month of standby battery life.

Colin Crawford is Founder & CEO of Media 7 Consultancy. He blogs at Colin's Corner.

COMMENTS

James
- February 1, 2010 - 1:52:22 (CST)
Camera – It’s questionable how useful a camera would be, but admittedly, it would be a nice addition, but not necessarily a ‘con’ No Flash – I would move this to the ‘pro’ column! Flash is clunky and unstable. It will be painful to wait for HTML5 to catch on, but it will. No Mouse – This is a departure in the way we think about computing devices… does anyone complain that an iPhone doesn’t have mouse support? No… because the interface is not the same point and click interface we have infused in our brain. Battery – I don’t think this will be an issue. No one walks around with these types of devices for hours on end without setting them down. There will be docking stations, and the apps and data we use on them won’t be tied to just that one device; it will be on the local network or a form of cloud. That being said, I don’t think these devices will be mobile thin clients either. Ruggedized – I am sure someone will come up with a ’skin’ for it that would help it in this aspect. To be honest… most the devices I have looked at that have the iPad’s same category of device cost $2k or more. iPad is almost disposable at this price point (relatively speaking). There is room for improvement with regard to the sanitary issues. Maybe it would be possible for a disposable skin to be created or gloves that allow for electrical conduction. This isn’t insurmountable. The biggest challenge that the iPad will face for adoption is whether the devs create great software for it. Our HIS vendor has their eye on this platform (iPod Touch, etc.) but they are approaching it as a web page client, unfortunately. What makes this platform shine is the departure from the old point-and-click desktop metaphor, to a new, more intuitive interface that you navigate with a finger. It would be a mistake for anyone to look at these devices from the perspective of a desktop or laptop and this is why previous devices like pen based tablets never really caught on.
Michael Segal
- February 2, 2010 - 10:00:15 (CST)
One of the nice things about real tablet computers is that you can dock them and use a keyboard and a mouse when you need to. With the iPad you can dock with a keyboard and no mouse, which seems like it would be a bother. The dimensions of the iPad are one inch wider that bigger white coat pockets, which is unfortunate because there is more than one inch of non-screen width. Despite an iPad being pulled out of a suit pocket at the Grammy awards, Apple does not seem to have thought through the pocket issue well, and that makes a big difference to doctors. The lack of multitasking is a huge bother for doctors. Doctors multitask. The lack of Java is a big problem for many types of medical software that need Java. The iPad moves the ball forward by introducing a thin form factor, but also leaves out a lot that is needed by doctors. It will be interesting to see whether Apple moves upmarket or upcoming non-Apple tablets adopt the thin form factor pioneered by Apple and provide the functionality one would expect in a real computer.
 
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