The iPad Makes its Impact on Health Care

February 25, 2011
Bradley Schmidt

MDNG Primary Care, January 2011, Volume 13, Issue 1

The market for tablet computers in health care may soon get crowded, but right now Apple’s iPad is the biggest game in town.

iPad, Shmipad

When Apple decided on iPad as the name for its game-changing tablet computer, they apparently hadn’t thought to ask women their opinion of the moniker (http://hcp.lv/i6Jb1N), or watched a MadTV sketch that aired long before the device was even on the public radar (http://hcp.lv/ieeTMx).

Aside from pad-related puns, Apple didn’t seem to consider just how much people love Adobe Flash, multitasking, dragging and dropping files, USB ports, SD card readers, full HD playback, native widescreen, built-in cameras, GPS support, and open software development kits; the iPad does none of it!

Silly, Apple. They claimed to be delivering a “whole new experience,” and all they gave the public was “a big iPod Touch” (http://hcp.lv/fZeVUE).

How then to explain the 7.5 million iPads sold in the five months between the device’s release date and Apple’s fiscal year end SEC filing? (http://hcp.lv/i6GA8t) It would certainly seem like a mistake to discount “a big iPod Touch” when Apple has sold upward of 45 million (http://hcp.lv/eoaTT2) of the small iPod Touch, don’t you think?

The problem with all of these criticisms (aside from those pertaining to feminine hygiene) is that they were made by tech junkies whose jobs require them to analyze the evolution and expansion of HTML standards and other topics the average consumer is largely unaware.

TouchReview.net’s Erin Peterson argues that “tech media” are so used to spec-driven product releases (Smaller! Better! Faster! More!) that they just weren’t ready for the iPad, a device that isn’t about “empirical measurements,” and one that was designed to “get out of the way of the user” (http://hcp.lv/ew1yAG).

As much as this reality may pain technophiles, most people just don’t care about the ethical repercussions of Apple’s requiring developers to sign non-disclosure agreements in order to gain access to its software development kits, or that the iPad’s aspect ratio is sub-optimum. They’re just happy to have a simple, easy-to-transport computer that performs all of the same tasks as a laptop, but in a sexier, fun package.

As a Gizmodo review puts it:

The iPad is self-explanatory: The moment you turn it on, the interface pops up and takes center stage, inviting you to slide your finger, to click. There's no need to learn a new languageto interact with the computer. The home button only takes one press to realize what it does. The same is true with the power, volume, and screen orientation lock. Each element of its design has an unequivocal function (http://hcp.lv/fE24UK).

Hence why criticisms from the average iPad owner amounted to “I love Angry Birds!”

It is this desire for function and fulfillment that has driven consumer adoption and may be what pushes, if not the iPad, then the tablet computer into the arms of an increasing number of physicians nationwide.

Consider that:

  • males age 42 years and older comprise the largest demographic in medicine (http://hcp.lv/ghWuzR)
  • the greatest percentage of women physicians are between ages 35 and 44 years (http://hcp.lv/erVYLk)
  • most iPad “users are from the 30-54 age range (peaking in the 35-44 age group)” (http://hcp.lv/fCrvAJ)
  • the week following the iPad press conference, 9% of clinicians responding to an Epocrates survey indicating that they would be purchasing an iPad “when it was immediately available,” while 13% planned to buy one within a year (http://hcp.lv/fE7w9c)
  • research from Redwood City-based Good Technology, a provider of multi-platform enterprise mobility solutions, indicates that health care is the third largest iPad adopter behind the financial services and technology sectors (http://hcp.lv/gJIBDJ)

Judging by these statistics, it appears that until a David tablet hits the market (Motorola’s Honeycomb? http://hcp.lv/dJ0xoy), the iPad will be health care’s go-to Goliath.

10 Reasons why Doctors Love the Apple iPad

By Joe Kim, MD, MPH

  1. They already use the iPhone, so the iPad just makes sense.
  2. Long battery life means they don't need to walk around the hospital carrying an AC adapter with their tablet PC.
  3. The iPad is simple. Doctors don't like complicated technology. They prefer simple. Thus, they don't feel threatened by the iPad.
  4. They can use the iPad to entertain patients who are waiting in the waiting area of the exam room.
  5. They'd rather carry a light iPad over a heavy tablet PC when they're using an EHR.
  6. They can use the iPad to explain complex medical anatomy to their patients.
  7. If they can't figure out how to do something on the iPad, they can ask their 10-year-old kid.
  8. The iPad is a true multipurpose tool: robust productivity in the clinical setting and pure entertainment for the kids at home.
  9. They just like having the latest gadgets (even if they don't know how to use them).
  10. Very easy to pinch-to-zoom. Who needs reading glasses now?

Check out Kim's blog at www.mobilehealthcomputing.com.

The iPad: Not a Health Care-grade Device?

By Brian Dolan, editor, MobiHealthNews.com

Common complaints or observations about the iPad’s hangups for health care providers:

  1. The iPad has no camera, an important feature for any connected health tablet.
  2. Despite the iPad’s rather impressive “up to” 10 hours of battery life, some have lamented Apple’s continued use of non-swappable batteries. Most tablets targeting the health care environment boast swappable batteries so clinicians can continue using them without waiting for a charge.
  3. Industry onlookers have argued that the iPad’s 9.7-inch screen is not quite big enough for use with intensive medical applications.
  4. Some people believe that the iPad is perhaps too big for many clinicians who would prefer a device that fits snugly into their pockets.
  5. The iPad is not ruggedized, and its screen will likely break if dropped. Many health care tablets claim to be drop resistant from about three feet.
  6. The iPad’s inability to multi-task, meaning it can’t run more than one application at once, is another big shortcoming that might hamper uptake for health care workers.
  7. Most health care tablets have barcode scanners—the iPad does not.
  8. Most health care tablets are easily disinfected, water proof, and dust resistant. The iPad does not appear to address any of those issues.

Reprinted with permission from MobiHealthNews.com

There were more than a few examples of iPad adoption in the health care space in 2010. Following are some of the more notable instances:

Chicago a Hot-bed of iPad Activity

Loyola University Medical Center and the University of Chicago Medical Center both expanded pilot programs that would provide iPads to their internal medicine and orthopedic residents, respectively; iPad adoption at MetroSouth Medical Center spread “like wildfire” once physicians could use them to access the hospital’s EMR; University of Chicago plastic surgeon Julie Park, MD, uses the iPad to help patients better understand “what they might look like after reconstructive surgery.”

(http://hcp.lv/dQrLMB)

The iPad in the Operating Room

Felasfa Wodajo, MD, director, Orthopedic Oncology, Inova Fairfax Hospital and Hospital for Children, and senior editor at iMedicalApps.com, describes his experiments assessing whether the iPad would work properly and effectively “in the sterile environment of the operating room.” (http://hcp.lv/gJLkP9; http://hcp.lv/hRin4M)

iPads for all Down Under

John Brumby, the Premier of the Australian state of Victoria, promised that if his incumbent Labor Government was returned to power in the latest Australian elections, “every doctor in the state’s public hospital system would be issued with an Apple iPad.” (http://hcp.lv/fgkZ6S) Unfortunately (or fortunately…we don’t know Australian politics), his party was voted out, and Brumby resigned from parliament on December 21, 2010. Still, his resignation did not kill iPad adoption in Victoria; a pilot program testing 500 iPads began this month (http://hcp.lv/iaVSUM).

Medical Students and iPads

Students at the UCF College of Medicine, Stanford School of Medicine, and the UC Irvine School of Medicine all received iPads as part of university initiatives to “improve the student learning experience [and] give students flexible access to the content that they need” (http://hcp.lv/iedzRb); as “part of a two-year research study on the use of technology in medical education” (http://hcp.lv/i04pJ0); and to reinvent “how medicine is taught in the 21st century” by emplying “a completely digital, interactive learning environment for entering students” (http://hcp.lv/hpJ73O).

Medicine and the iPad: Lessons from an Early Adapter

On October 28, 2010, HCPLive and Don Dizon, MD, FACP, Director of Medical Oncology, Integrative Care, and Co-Director of the Center for Sexuality, Intimacy and Fertility at the Program in Women's Oncology at Women and Infants Hospital of Rhode Island, hosted a live webinar focusing on Dizon’s experiences as one of the nation’s first physicians to use the iPad as a practice tool.

Some highlights:

· Dizon didn’t opt for the 3G unit because he tends not to use his iPad on the go. “The probability that I’m going to grab my iPad in my car while I’m stuck in traffic is quite limited,” he said. “If I need it, I use my iPhone.”

· Regarding privacy concerns, Dizon says his do not stem from the iPad, but from the type of EMR being utilized in the workplace. Dizon said he feels proprietary EMR systems, built in-house by the health care organization, are generally riskier than vendor-sold EMRs. Vendor EMRs, he said, are “far more vigorously tested” than proprietary EMR systems.

· Asked by an attendee whether he thought the iPad could become an agent for infection or disease, Dizon said it’s possible, but noted that even a physician’s necktie, long-sleeved shirt, and other clothing items and accessories have been implicated in the spread of infection in hospitals. “I don’t have patients handle my iPad, and I wash my hands before every visit," he said. He also uses a screen protector for the device and regularly wipes it down with disinfectant cleaning solution.

· Dizon feels that the iPad’s biggest drawback is its inability to play Flash video, which he finds frustrating. “Where it comes into play is when I’m not using my iPad for work use,” he said. “I do not think it has limited my use of this device in any significant way on the job.”

16 iPad Must-haves for the Health Care Professional

iMedicalApps.com Recommends 5 Key iPad Accessories

  1. Stylus
  2. Medical-grade case
  3. Battery case
  4. External camera and video recording adapters
  5. VGA/AV out adapters

iMedicalApps.com’s Top 5 Medical Apps

  1. Blausen Human Atlas ($19.99): 3D human atlas (http://hcp.lv/hvL0Fb)
  2. Visual DxMobile (clinician: $99.99; pediatrician: $49.99; free trial available): Diagnosis validation tool (http://hcp.lv/dIJO9C)
  3. Procedures Consult ($39.99): Multimedia procedures training and reference solution (http://hcp.lv/ewsGim)
  4. OsiriX ($19.99): DICOM image viewer (http://hcp.lv/a9N5eV)
  5. Papers ($14.99): Personal library of research organizer (http://hcp.lv/esacnx)

Don Dizon, MD’s Top 6 Medical Apps

  1. KeyNote ($9.99): Creates presentations (http://hcp.lv/hD99cd)
  2. Pages ($9.99): Word-processing (http://hcp.lv/gmMJVz)
  3. Good Reader ($1.99): PDF reader with annotation, markup, and highlighting capabilities (http://hcp.lv/fBY7lC)
  4. Citrix Receiver (Free) Allows secure access to Windows 7 virtual desktops, applications and data. Citrix XenApp or XenDesktop infrastructure required.(http://hcp.lv/h4CTU5)
  5. SignMyPad, ($3.99): Allows users to sign digital documents using their fingers (http://hcp.lv/ijjvAF)
  6. PubMed On Tap ($2.99): Searches PubMed to find and display reference information (http://hcp.lv/f9xwqd)

Searching for the Next Revolution

It’s tough to say who will build the next killer health care app, but there’s a good chance that it could come out of the Healthy People 2020 campaign or the Health 2.0 Accelerator Apps Network. Think of them as short- and long-term idea incubators.

Healthy People 2020 is a Department of Health and Human Services campaign designed to spur development of wellness applications, and they are making available mountains of research data to that end. Submissions are due March 7, 2011 by 11:59pm. (http://hcp.lv/eFAQgG)

The Health 2.0 Accelerator Network comprises health care organizations working together “to leverage information in a way that helps consumers manage their health more effectively, thereby reducing cost, increasing quality, and improving overall health.” They do this, specifically, by taking “web applications and services that work together — collaborating 2, 3, 4 and more at a time, serving as platforms for other apps and as interoperable bridges between apps – all to connect and support patients, caregivers and providers.” (http://hcp.lv/fIhF6W; http://hcp.lv/enO8Pr)