Friday, January 29, 2010

The iPad and Healthcare

Several folks have asked - will the iPad revolutionize healthcare?

The answer is Yes and No.

My ideal clinical device is

*Less than a pound and fits in white coat pocket
*Has a battery life of 8-12 hours (a full shift)
*Can be dropped without major damage
*Has a built in full keyboard, voice recognition, or very robust touch screen input
*Provides a platform for a variety of healthcare applications hosted on the device or in the cloud

Netbooks and laptops are too heavy, too large, and do not meet my battery life requirements.

The iPhone is too small for reliable data entry.

The Kindle is a great device but not a flexible application platform.

The iPad comes closer to my requirements than other devices on the market.

However, the ideal clinical device would include a camera for clinical photography and video teleconferencing.

Entering data via the touch screen with gloved hands may be challenging on a capacitance touch screen.

Holding the iPad with one hand means hunt and peck typing with the remaining hand.

The device is a bit large for a white coat pocket, may be hard to disinfect, and may not be tolerant of dropping onto a hospital floor.

I look forward to trying one to validate these assumptions.

My general impression is that it is not perfect for healthcare, but it is closer than other devices I've tried.

It will definitely be worth a pilot.

13 comments:

Bernz said...

I'm not convinced the battery life is as long as they say. They say 10-hours... but 10-hours doing what? The iphone battery needs charging after after 2-3 hours of video/net (real use).

If iPads are essentially interchangeable, then you can have a whole stack waiting to take around and for the low-price on the low-end device, that might be appropriate.

It's the one-handed thing that makes me most annoyed, frankly. I suppose the ideal use is hunt/peck or two hands while it's on a table or lap (which seems uncomfortable). Neither of those situations seems like a good idea in ambulatory situations.

Might be good for entering structured data, though. A smart EMR maker will make a dedicated data-input screen that has pre-populated fields/forms for fast, easy, one-handed, data-input and then voice dictation for free-form fields. Small bluetooth wireless camera can stream images to the device (though as you point out, an attached one would be better).

In the world that I'm building software for (assisted living, eldercare) I can think of several uses. I just wish they'd open up the bluetooth functionality! There's lots of medical devices with bluetooth and not enough leeway in how Apple lets you handle it.

Glen said...

Let's invite Apple to join the rest of us in healthcare IT to produce an standards-based interoperable iPad that meets basic health IT platform requirements.

This would include fulfillment of the recent ONC IFR's transport and security requirements to support Meaningful Use. It at least needs mutually-authenticated and encrypted communication (HITSP/T17), security audit (HITSP/T15), common time base (HITSP/T16). Without a constant network connection, it also needs local access controls (HITSP/TP20) and would do well to have an on-board two-factor authentication capability.

The communication capability needs to embrace a wider choice of wireless broadband vendors. Otherwise the users will suffer from availability and reliability issues.

lucienengelen said...

Right, some other insights and discussions : http://lucienengelen.posterous.com/will-apples-ipad-change-healthcare

Barry Blumenfeld said...

With its smooth surface, it will probably be easier to disinfect than a standard device with a keyboard (for example, we struggle with disenfecting devices for bedside med admin). You can also set it on any suface for typing. I agree that it isn't "perfect", but with the right applications the iPad could have major utility in healthcare.

Steven Bishop said...

What we need is not a white coat with a pocket big enough to hold it. What we need is a pair of cargo pants with a pocket on the front of the thigh that will hold the iPad and have it accessible to use. Sit and type on your thigh, no table needed. Pocket in the other leg could hold a spare power source.

Earl Hose said...

John, I wonder why Jobs left out the camera. The omission must have been as deliberate as any of the features. Then the question becomes - in what situations would absence of camera be an advantage?
People are suspicious of cell phones where children are present, because they can be used to intrude. If then, the iPad had been designed, in its first iteration, to be suited to privacy-sensitive domains, then it is up to the imagination to figure out how the device can be used to enhance clinical work. I bet the Apple crowd have a few scenarios planned out. Like "you can bring information into the bedside, to illustrate or explain a complex procedure, but this device cannot be used to abuse your patient's privacy".
In short, it isn't at all likely that Apple want to position the iPad in the traditional kind of medical computing. IMO.

Jared Houck said...

I think you are spot on with your assessment. The iPad is neat, but it's no workhorse.

iPad supporters all seem to be talking about things they HOPE the iPad will do. Unfortunately, it doesn't actually DO any of those things. Tablet PCs have been around for 5+ years and made the exact same promises. The iPad will struggle for the exact same reasons - software. There is no CCHIT certified software that makes healthcare hold hands and sing kumbaya.

I've got another 10 reasons why the iPad won't be deployed in health care if you've got the time.

Pieter said...

Nice article... I think that if the iPad will offer decent color e-reader opportunities, it will be interesting for medical doctors to keep up to date with literature. Like the NYT has demonstrated on the iPad, rich media content can easily be included.

I would like to have one for e-reading, in combination with the software from http://mekentosj.com/papers/

Blogged about the topic and some arguments on how to deal with the missing Flash (is it really missing?) on:

http://blog.digitalneurosurgeon.com/?p=646

Best regards,

Pieter Kubben, MD
Dept of Neurosurgery
Maastricht University Medical Center
The Netherlands

Brett said...

What are your thoughts on Motion Computing's C5 tablet? Our testing has shown the battery to last an entire shift depending on use, is rather durable, uses a pen for data entry which mitigates capacitance issues when wearing gloves and can also be docked to a keyboard, supports all windows based clinical apps, while not as light weight as the iPad, it is lighter than most other tablets, has a built in camera and scanner, is easily cleaned, and is easy to carry and hold steady with one hand (with it's built in handle).

http://www.motioncomputing.com/products/tablet_pc_c5.asp

Carl Dirks said...

I think this is a great rounding device, and may not do ALL that a stage 7 hospital might do, but does enough (reference data, make simple orders, approve a template note, record dictation) that it is a great intermediary between sitting down at a desktop and having no information during rounds.

A bag sized for the iPad (plus stethoscope) or a larger coat pocket can keep it mobile. Having docks on the unit is a nice to have to ensure trickle charge capacity.

Cecil said...

Well Dr. John I hope the I-pad goes pretty well hand-in-hand with you and your daily routine at your work. I would bet it lives up to your standards pretty well. Also I would like to point out I enjoyed your blog thoroughly and was wondering if we could exchange blogroll links? I would much appreciate it. Thank you for your time!

arnostginsberg said...

8-12 hours battery life is not so much convincing.Voice recognition seems to be the best part of i pad.Also for me it seems to be quite beneficial than the other devices i have ever used.

Mimi said...

iPad... could be a good companion for the reception table, but not the perfect fit for surgeons, what about the new dell streak? any thoughts?