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12/12/2011
10:35 AM
Paul Cerrato
Paul Cerrato
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Docs Have iPad Fever: Is There A Cure?

Clinicians are excited about what iPads can do for practices. But if you're shopping for a medical tablet, dispassionate analysis is in order.

In case you're questioning reports of a tablet epidemic in healthcare, take a look at stats from a QuantiaMD survey. Thirty percent of doctors use a tablet device, compared with just 5% of U.S. consumers, the online physicians' forum said. Of tablet-using physicians, two-thirds, equivalent to 19% of all physicians, use their tablet in a clinical setting. Another 35% of doctors surveyed say they're "extremely likely" to use a tablet in the next few years to help their practice. That sounds like a fever to me.

It's probably no surprise to most health IT managers to hear that Apple's iPad tops the list of tablets that clinicians want to use. But if your clinicians are hot for an iPad, my advice is take two aspirins and call me in the morning.

iPad fever has gotten a little out of hand. Granted, there are lots of practical advantages to using one, including all the medical apps that run seamlessly on it, but the iPad burn goes deeper than that.

[ Explore docs' fascination with iPads. See Apple Capitalizes On Doctors' iPad Romance. ]

A certain segment of the American public--including many physicians--has been hypnotized by Apple's elegance, design savvy, and marketing. Whenever you walk into an Apple Store, you rarely see customers looking for a bargain. It's often folks with designer jeans and keep-up-with-the Jones lifestyles. So I suspect many clinicians have bought into the iPad mystique, the same way they've bought into the Rolex and Jaguar culture. They're status symbols.

Thus there's a need for some dispassionate analysis. The first question IT managers have to ask their physicians: Realistically, how mobile is your daily schedule? A psychiatrist who sees all her patients in one consulting room, for instance, may do just as well with a laptop as a tablet. After all, if you're not that mobile, you don't need a mobile device.

On the other hand, if your providers are constantly on the go, start thinking about battery life. The latest tablet tests, as reported in the January 2012 issue of PCWorld, revealed that the Android-based Galaxy 10.1 battery outlasted the iPad2's by more than 2 hours. The downside, however, is recharge time. The Galaxy took 5 hours, 34 minutes to recharge, versus 4 hours, 10 minutes for the iPad.

Battery life is only one piece of the puzzle. Your tablet has to run the apps that you're most likely to need. The iPad is still the best bet for physicians working in dermatology, radiology, or surgery, because it has the largest collection of relevant apps, said Steve Chan, a physician in training at the University of California, Irvine. But psychiatry would do well with generalist apps like Epocrates, Medscape, and Skyscape, which are also available on Android-based tablets.

Before investing in an iPad, also consider one major disadvantage: iOS lacks a central file management system. Without a centralized system, it's difficult to move files among applications. In practical terms, that means if you want to edit a file in one app and then rename it and open it in another app, you may run into problems. Without a central file system, files are too "sticky," that is, they become associated with specific applications and usually only open in the app they're written for. Android-based tablets have a central file management system, so that's less of an issue.

When choosing a tablet, also think about your physicians' note-taking style. Some are comfortable filling out structured forms and using dropdown menus, but others may benefit from a tablet that lets them write in longhand and do freehand sketches as a patient education tool, for instance. If the latter is the case, think about the ThinkPad tablet which uses the N-trig digitizer pen.

Finally, IT managers and clinicians have to come to grips with the software/hardware "schizophrenia" that's inherent in the iPad. Everyone admits that you can get some really great medical apps for the iPad, but the device itself wasn't designed for healthcare. It might not be able to withstand repeated falls on tiled floors or regular wipedowns with antiseptics, nor is it covered with antimicrobial plastic. These are all factors you must consider when choosing the right tablet for your organization.

According to the QuantiaMD survey, physicians have eagerly embraced both smartphones and tablets to get reference materials on drugs and treatment options, help provide patient education, and access patient records. You obviously don't want to discourage all that online productivity. Now if you can just get docs to choose with the head and not with the heart.

When are emerging technologies ready for clinical use? In the new issue of InformationWeek Healthcare, find out how three promising innovations--personalized medicine, clinical analytics, and natural language processing--show the trade-offs. Download the issue now. (Free registration required.)

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MGUHAROY000
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MGUHAROY000,
User Rank: Apprentice
3/6/2012 | 8:17:31 PM
re: Docs Have iPad Fever: Is There A Cure?
Hi Paul. We at StoryDesk agree. We are designing native apps for healthcare that creates clearly defined ROI for healthcare.

I think more than the hardware( where the iPad is the runaway leader), the software is now up to the level it needs to be.

If you are in healthcare and are using/considering the iPad check out

www.storydesk.com

We would love feedback, and hear more about the vision of the iPad in healthcare going fwd.

Cyberstrider
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Cyberstrider,
User Rank: Apprentice
12/14/2011 | 4:46:10 AM
re: Docs Have iPad Fever: Is There A Cure?
Shalom.

Overall Paul, I agree with your thesis that our hearts can be persuaded by many shiny ideas, but in the end we need to do some fact checking. You had a fun idea and your readers have been eager to help get some details straight, but on re-reading today, feel we should be able to assist with the detail checking without personal attack.

Cheers!

AustinIT
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AustinIT,
User Rank: Apprentice
12/13/2011 | 9:39:42 PM
re: Docs Have iPad Fever: Is There A Cure?
Thieves will take anything that is left vulnerable. There have been MANY more thefts of PHI from PCs and Servers than from iPads. And, you don't have to walk out the door with it to get that data. All unprotected devices (no matter the size and value) are just as guilty under HIPAA.

I'm not a big fan of using an iPad in a clinical setting so don't think I'm defending the iPad. The rules apply equally to all tablet devices.

Also, please don't generalize on how you think people are smart enough to protect their PC's yet dumb enough to ignore a tablet when it comes to HIPAA.
AustinIT
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AustinIT,
User Rank: Apprentice
12/13/2011 | 9:15:37 PM
re: Docs Have iPad Fever: Is There A Cure?
"So Paul, tell me which of the iPad alternatives will withstand a drop to the floor that a non iPad can, and which one can withstand better the repeated wipings with an antiseptic wipe."

I believe you would then be looking at the Motion C5v with a solid state drive. They are designed from the getgo to survive drops as well as to be disinfected on a regular basis.

At the end of the day, the iPad is NOT the right device to be used in a pure clinical setting. It was not designed for it. And, the majority of applications were not designed for it. Yes, the iPad is great device to be used for that which it was intended for... not for everything under the sun. Will it be one day? Sure thing.

Right now, vanity rules. I do IT for a variety of clinics and all the docs want iPads despite the fact they know nothing about the current limitations of them.
tmaniaci850
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tmaniaci850,
User Rank: Apprentice
12/13/2011 | 7:03:11 PM
re: Docs Have iPad Fever: Is There A Cure?
This article is typical of IT's reaction that users being more informed than IT staff. Insulting doctors when they are more educated than IT staff is a sad commentary on the IT profession. This may explain why outsourcing of IT is so prevalent. I develop on both iOS and Android and based on the statements in the article it is clear that the Author has never written one line of code on either Xcode for iOS or Eclipse for Android.
Tom LaSusa
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Tom LaSusa,
User Rank: Apprentice
12/13/2011 | 4:46:30 PM
re: Docs Have iPad Fever: Is There A Cure?
Unfortunately I cannot make you believe that we didn't delete your reply other than my assurance we didn't. As I've said, we only block spammers and offensive comments. We have an extensive list of keywords in our filter and its always possible that maybe you used one of those (obviously not in the context that we have them filtered out for).

As Community Manager, it's my role to make sure that comments are regulated -- but I have never blocked a comment simply because the writer disagreed with the author. That's simply not how we operate.

As for your decision to no longer follow us because of something you read in an 'opinion piece', well we can't change your mind on that either. Personally I think it's a shame, given all the great content we produce -- if I stopped going to every site where I disagreed with something I read, life would be very boring for me :)

Best Wishes and Happy Holidays
Tom LaSusa
Community Manager

jaygranite
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jaygranite,
User Rank: Apprentice
12/13/2011 | 2:25:19 PM
re: Docs Have iPad Fever: Is There A Cure?
If your using any tablet then you are an early adopter. The ROIs are not there yet but they will be. Simple fact: iPads are currently (and will be at least until 2013-14) the best option on the market. You have to remember apple created their 1st tablet (the newton) over 20 years ago EVERYONE is catching up. Its just a trite and irritating to call apple users 'fan boys'. Im 34, been in a windows world for over 20 years, and got my first mac when I worked in education 9 years ago, now that I am in healthcare I see the need for divises that simplify access to information more than ever. Apple just has the best offering but its a tool and if there was a better one I would support them. I cant think of a better company to support right now. They are adding jobs to the economy and keep most of their workers here (you cant outsource their level of innovation).
jaygranite
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jaygranite,
User Rank: Apprentice
12/13/2011 | 2:14:49 PM
re: Docs Have iPad Fever: Is There A Cure?
Ipads are manageable using the same windows technology as any phone (active sync with exchange) and are remote wipeable (thats better than a laptop). There are even better solutions out there but the point is that its a devise that is manageable just like any other piece of IT equipment.
jaygranite
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jaygranite,
User Rank: Apprentice
12/13/2011 | 2:11:38 PM
re: Docs Have iPad Fever: Is There A Cure?
As I wrote the largest disadvantage is that entrenched EMR apps may not be designed to work efficiently on an iPad and citrix is hardly a solution. The app really needs to be designed for a clinical workflow AND designed for touch use. Simply building an app and throwing it out there does not make a solution. As for the durability an Otterbox case solves that and they really should treat the tablet the same way they treat any clinical equipment to minimize infection. Wipe it down and make sure you have a good screen cover. (ipad cover is glass mind you)
Cyberstrider
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Cyberstrider,
User Rank: Apprentice
12/13/2011 | 5:10:29 AM
re: Docs Have iPad Fever: Is There A Cure?
"but others may benefit from a tablet that lets them write in longhand and do freehand sketches as a patient education tool, for instance. If the latter is the case, think about the ThinkPad tablet which uses the N-trig digitizer pen."
Actually, there are numerous designs for doing such work on an iPad. Search for 'ipad stylus' or read this review of a dozen iPad stylus devices. http://www.macworld.com/articl...

There's also a reason for the iPad file system, security. You might want to explore why its file handling is designed the way it is and give your readers a clearer understanding of the differences.

So, perhaps physicians have been thinking from the head and the article is from the heart.
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