iPad Should You Make the Investment?

ONCNG Oncology, February 2010, Volume 11, Issue 0210

ON JANUARY 27, APPLE INTRODUCED THE iPad, touting it as "a revolutionary device for browsing the Web, reading and sending email, enjoying photos, watching videos, listening to music, playing games, reading e-books, and much more."

ON JANUARY 27, APPLE INTRODUCED THE iPad, touting it as “a revolutionary device for browsing the Web, reading and sending email, enjoying photos, watching videos, listening to music, playing games, reading e-books, and much more.” Anticipation ran high, but at the end of the press briefing, many were disappointed, and some mockingly referred to the iPad as the “iTampon” on Twitter. Yet even if the iPad’s moniker were not vulnerable to such crude comparisons, a single letter sets its name apart from Apple’s own iPod, and paired with its features, this left some dismissing it as simply an “iPod Touch on steroids.”

Despite its generally lukewarm reception, there is no denying that the iPad is a slick device that has the potential to carve a niche in the tech sector. According to Steve Jobs, Apple’s CEO, “iPad creates and defines an entirely new category of devices that will connect users with their apps and content in a much more intimate, intuitive, and fun way than ever before.” The iPad thoughtfully combines features of a smartphone, notebook, and tablet, and according to Colin Crawford, founder & CEO of Media 7 Consultancy, who attended the press briefing and blogged about it on HCPLive.com, “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 to 24 month lead.”

While the iPad has superb functionality, there are several notable omissions and limitations, some of which may affect its adoption by the healthcare sector. Yet despite its inability to meet some consumers’ high expectations, the iPad offers features that are sure to put it on many wish lists, including those of healthcare providers. A recent survey conducted by Epocrates, one of the leading providers of mobile medical reference solutions, found that almost 20% of physicians intend to purchase an iPad within a year and another 38% are seriously considering purchasing one but want more information first. Wondering if the iPad is right for you? We take a comprehensive look at this novel device and examine its limitations and potential role in the healthcare sector, allowing you to better decide whether to make the investment.

Flaws or Meaningful Design?

While the iPad has been touted as a “revolutionary device” by Apple, several limitations have been noted. Proponents of the iPad say that these seeming flaws are actually meaningful design choices. Regardless, some may be significant enough to impact the iPad’s utility in the healthcare sector, whereas others have workarounds or may pose no issue at all. Let’s examine the major criticisms so that you can decide whether any are indeed deal breakers for you.

No Flash Support

While the device was touted to revolutionize Web surfing, it does not support Adobe’s seemingly ubiquitous Flash video technology, leaving some wondering how good the Web surfing experience can be on the iPad since Flash is heavily employed on the Web and its presence may be growing. According to Adobe, more than 75% of all videos on the Web use Flash, and more than 98% of Internet- connected computers have the Flash player installed on their system. In addition, Adobe is working hard to get Flash 10.1 installed on smartphones. It is estimated that 53% of smartphones will support Flash by 2012, with several popular smartphone models anticipated to adopt it by the end of this year, including the Palm Pre, Motorola Droid, and Google’s Nexus One. The lack of Flash on the iPad may preclude accessibility to certain Websites, including some useful medical resources.

According to Apple, the reason for the omission is that Flash is “buggy” and that problems with its plug-in software are likely the culprit behind the majority of Mac computer crashes. While Adobe has developed a version of Flash that can run on the iPad, Apple has instead chosen to back HTML5, an emerging rival to Flash that is being developed as the next major revision of HTML. While Apple may eventually adopt Flash, it is unlikely to do so in the near future, but some say that a lack of Flash support on the iPad won’t have a major impact on the Web-browsing experience, partially because an increasing number of Web developers are finding alternatives to Flash content on their sites. Further, because most medical apps do not employ Flash, this may not be a deal breaker for physicians.

Limited Ability to Multitask

Although numerous functions can be performed on the iPad, it appears there will be limited ability to multitask; thus, this device cannot be considered a replacement for a netbook or laptop. For instance, a user cannot listen to Pandora while writing a document, have a Twitter app open at the same time as their browser, or minimize their e-book to look something up on the Web. Some have noted that the lack of multitasking, however, is only restricted to third-party applications, allowing you to perform multiple tasks using some of the iPad’s built-in apps, but not those of third parties. Clinicians are constantly multitasking, and limited ability to do so on the iPad may have some impact on its utility. It is said that the iPad is running the iPhone’s 3.2 operating system (OS), and some speculate that multitasking might be an iPhone (and iPad) OS 4.0 feature.

E-book Compatibility Issues and

No Electronic Ink

The multipurpose iPad has been touted as an e-book reader, and with its launch comes Apple’s new iBookstore. Apple has said that it will adopt Adobe’s EPUB format for its books. The technology has been adopted by libraries and many leading e-book reader manufacturers; however, compatibility issues may arise when Apple adds its own copy-protection scheme to this format, and these books may no longer be compatible with other e-book readers, affecting the ability to transfer books to different devices in the future. Further, the iPad does not feature electronic-ink display, making reading books on it akin to reading them on a computer screen, rather than mimicking print. While the reading experience may not be as comfortable on the eyes as electronic-ink displays, an advantage of using the iPad as an e-book reader is that any images can be viewed in color. Dedicated color e-book readers are in development and slowly being brought to some markets, such as the Fujitsu FLEPia, which was released in Japan in 2009, but the system is costly, sluggish, and its onscreen colors are dull. No electronic-ink displays are able to render images in color, and while viewing pictures in color may not be important if the objective is to read a novel, it can be critical for oncologists and other healthcare providers who need to view pathology, surgical, and other medical images in color.

No Camera

Another major criticism of the iPad is that it lacks a camera. Because images and video play a major role in interactivity on the Web, especially when it comes to social networking sites, the lack of a camera hinders the connectivity that the vast majority of people are accustomed to. Further, video chatting using a service like Skype is out of the question because there is also no USB port to allow a Webcam to be attached. This may be inconvenient for healthcare providers who wish to stay in touch with their families while away at a convention or with their office while on vacation. It also limits the ability to use the iPad as a telemedicine platform, an area of medicine that is rapidly expanding, including in oncology.

No Interchangeable Battery

Although the iPad is said to provide up to 10 hours of battery life, many are skeptical that it will live up to these claims. Even if it did, the lack of an interchangeable battery could limit its utility in the healthcare sector. As Crawford questions in his HCPLive.com article, even if the 10 hours were a reliable figure, which would cover most of a hospital shift or a private practice workday, “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.” However, as one physician notes in a blog post at MacDoctors.org, while some physicians work 12-hour shifts, the iPad “will likely not be in continuous use. If docked into the keyboard it will get a chance to recharge.”

No mouse support

Although the iPad contains a virtual keyboard, and can be enhanced by a physical keyboard option, including a keyboard dock that also serves as a charging station, the iPad does not appear to support Apple’s Bluetooth mouse. This may limit the utility of the iPad when it comes to some clinical applications.

iPad’s Potential Role in Healthcare

In early January, rumors circulated on the Web that Apple executives had visited Cedars-Sinai Hospital in Los Angeles on several occasions to meet with hospital administrators to discuss the utility of Apple’s then-rumored tablet device in the medical setting. Whether these meetings actually occurred remains unknown, but following the announcement of the iPad, there have been numerous posts on the Web speculating on how the iPad may serve as a workflow solution to clinicians. In an article on ZDNet, Dana Blankenhorn, a tech journalist, notes that the iPad’s size, price-point, and capabilities make it the “[device that doctors have been] dreaming of ever since the PC revolution began.” He notes that the iPad can transform medical practice by “delivering a solid, easy-to-follow upgrade path directly from paper. Put security on the clinic’s WiFi and HIPAA is happy. A little VOIP and pager software and you can follow the staff wherever they go, which is one reason WiFi is so cool in a hospital setting to begin with.” He also notes that the iPad can be set up to interface with either an in-house EMR system or a SaaS system by running a small clinic’s signals directly through a router at the nurse’s station.

In the Change Doctor blog, Lyle Berkowitz, MD, says he could see the iPad used for “data retrieval, some ordering, and possibly some basic documentation.” He 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” versus the outpatient setting, “where one doctor usually works consistently in 2 to 4 rooms” and “having a regular PC type device (or net device) with a large monitor and keyboard still makes the most sense for now.”

The iPad will also spur the development of more robust healthcare apps geared to physicians and consumers. Although the iPad won’t be available for another month, some companies have already announced developing or tailoring existing apps specifically for this device. Epocrates, for instance, will be tailoring its signature drug reference database for the iPad. In addition, Voalté announced that its Voalté One solution—a point-of-care app that enables users to send and receive text messages, make voice calls, and receive critical care alarms on the iPhone, allowing for more prompt responses to patient needs—will be available on the iPad by the time it is released in late March.

While the iPad may have some drawbacks, it is likely a product that will develop and gain popularity over time. Even with its current specs, it affords some exciting possibilities, especially in the healthcare sector. Do you think you will buy an iPad? Oncology Net Guide wants to know what you think of this new platform. Send an e-mail to Christina Loguidice, editor, at cloguidice@onclive.com.