Google Android versus the iPhone for medical apps

by Jeff Brandt

Verizon, Motorola, and Google, along with 9 other cell phone manufactures and countless world carriers, have teamed up to provide a smartphone with the power to deliver useful applications for medicine: the Verizon “Droid” smartphone, based on the Google Android operating system (OS).

Google Android versus the iPhone for medical apps The Droid’s processor is the same processor that powers the iPhone. The main reasons this phone is different is that it has the hardware and software features needed to build and support multitask enterprise software. The phone is equipped with a 3.7-inch touch-sensitive display with a resolution of 854×480 pixels, 16 million color depth, 512mb RAM and a real keyboard . It is also equipped with a Standard mini USB and a 8GB MicroSD memory card. Android supports both CDMA and GSM cell networks.

So, what makes this a better phone than the iPhone for medical professionals? Almost everything.

First, like the Blackberry, it has a real keyboard which most professionals prefer. It also has the touch screen keyboards for quick edits. It provides a standard mini USB connector, unlike the iPhone that utilizes an expensive proprietary 30 pin connector. For medical device connections, the USB is a necessary standard. The MicroSD card provides a much needed facility to back up your application data from the phone and transfer it to another device.

The iPhone currently has no facility to get app data off of the phone except for email which is not acceptable for transferring sensitive data. That iTunes backs up app data is a misconception; it only backs up Apple apps such as iTunes and contacts.

The main difference in the Android phone is the OS. Android was written by Google and released open source. Motorola has embraced this OS and has incorporated it into their entire line of Smartphones. This operating system is far superior to the iPhone OS for enterprise software, mainly because it can run more than on application at a time.

In contrast, iPhone apps are limited to small programs that perform only one function. Here is a real world situation of how an iPhone and Android phone handle a simple problem.

The situation: Doctor is reviewing a Chart on their phone via a Chart app and an incoming call is received.

iPhone: Once the iPhone receives the call the Chart app is stopped and the user can answer the phone. If the doctor wants to see the chart during the call, he/she will have to hangup the call and reopen the Chart app.

Android: When the phone rings, Android suspends the Chart app so that the call can be answered. If the doctor want to view the chart while on the call they just switch back to the Chart app which is at the same place that they left it when the call was received. Note, the call is still in progress.

The next advantage of Android is the OS memory management and what software engineers call “automatic garbage collection.” This is a very important feature that helps keep applications from crashing and having to be restarted. If memory management is left in the hands of the programmer, as it is in the iPhone, and the programmer forgets to release unused memory (i.e. memory of a chart must be release when a chart is deleted), the program will eventually run out of memory and quit.

Programmer memory management takes a skilled software engineer to control. Since most of the apps in the iPhone are for entertainment this is not a huge problem, the user will just restart the app. Medical apps must perform to a higher standard.

Android is a feature rich OS with the power for the programmers to write very sophisticated medical software. The iPhone OS was built as an entertainment platform. They are both great phones but with two different types of applications and audiences. The software developing company has to make the decision which platform their application will be best suited for. There is no “one size fits all” phone.

The customer will, in turn, need to make a decision on the phone based on the software that fulfills their professional needs. For medicine, smartphones based on Google Android seems an ideal fit.

Jeff Brandt is President of Communication Software, Inc., makers of the motionPHR.

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  • Jeff Kiefer

    When answering a call on the iphone, correct, the app does shut down. However, you can access the app again during the call by pressing the home button and then opening the app. You will lose the previous space but you will be able to use the app during the call.

    Secondly, there a number of apps that are able to send data to a computer or cloud database through a number of different mechanisms not just e-mail.

    Maybe, we should plan for populating the mobile software health field across multiple platforms. Evernote is one such company that is successful in doing this.

    JK

  • http://www.twitter.com/leonardkish Leonard Kish

    You make some valid points. However, I wonder if the next versions of the iPhone will likely have the same issues.

    With Apple reportedly focusing on health care, I’m sure they are also focusing on these problems, or perhaps they have another device in mind, a device meant to take over paper-heavy industries…
    the tablet, which is rumored for launch in January, could change the game considerably. It’s also rumored to run the same OS as the iPhone, so current medical iPhone apps. http://www.theiphoneblog.com/2009/09/30/itablet-rumors-apple-set-redefine-newspapers-textbooks-magazines/

    One other factor you didn’t mention was the AT&T issues with the iPhone. This is the biggest consideration for me in my next phone purchase as it seems I can’t talk to an iPhone user for more than 5 minutes before the call drops. This is a very serious problem for physicians, but I suspect Apple will open up to another carrier shortly. If they don’t offer another carrier choice by the end of the year, I’ll be getting an Android as my mobile of choice. Apple can’t forget that iphones are phones first, otherwise, I’d rather just get the iTouch and another phone.

    We can hope, but it remains to be seen if the developer community will embrace the android for medicine, and that will likely be a bit of a catch-22 with user adoption. I’d love to see a viable alternative. With the rapid adoption of the iPhone (currently edging toward 50% of smart phone market in medicine.) If Android doesn’t get some traction soon, particularly with mobile EHRs starting to come out, it may go the way of other superior products that lost out on establishing the critical mass of adoption.

    As Jeff K. said, if you’re a vendor, it’s probably a good idea not to put all your eggs in one mobile platform basket.

  • Raffi

    [typo in my previous comment]

    Unfortunately, ePocrates, Diagnosaurus, and UpToDate (to name a few useful PDA programs) are all still missing on Android; a real shame as it does look real neat.

  • Niranjan B

    except for one point I disagree on all the points…

    here is the explanation…

    first point: where the writer says that there is no easy way to connect the medical devices to iphone… I agree on this point…
    but there are alternatives… it can be connected via computer… both medical device on usb to computer and iphone to computer usb… or wirelessly… directly to the medical device… when they can put usb on the medical device they can as well put wifi card or may be bluetooth on it… it might not be that cost effective and battery conserving… but there is still a way… and better ways in some sense… data without wires…

    second: data can be taken off the iphone using speciallized apps… if the medical data needs to be put on the iphone and to be taken off the iphone … data plan or internet on the iphone can be used to do that… for example… when we use the maps app on the iphone data is coming over the internet to the iphone… when we save something on that map apps it goes to the google servers and reflects in the maps app opened on the computer…

    third: multiprocessing… who says that you cannot pick calls when you are using an app… and then not go back to them? It is very much possible in iphone… while taking a call I can browse internet or open maps applicaiton or things like that…
    also iphone has the advanced technology of push… when new data comes for a perticular app which is even if closed it will be pushed from the server to the phone and alert the user that you have new data for that app….
    user can then open that alert which will open up in that particular app…

    fourth: Memory management is something which the app maker can take care of… and when dealing with apps related to medical field such things should be taken care by the app maker… proper testing and quality code would make a better iphone app for medical applications…

    fifth: iphone was not developed on entertainment in mind. It is a smartphone with capabilities cater casual as well as serious applications… there is no proper distinction to actually categorize iphone to entertainment only application….

  • http://www.blog.greatzs.com ZMD

    Funny I had just blogged the other day on my purchase of an iphone after agonizing over the decision of whether I really needed a smartphone at work. But let me just say that one of the main reasons I chose an iphone over say a Nokia or Motorola is that the iphone OS is becoming a de facto standard for smartphones. Our hospital has enabled the iphone and Blackberry to access directly the hospital computer system. So now the hospital is supporting three standards: Windows, Blackberry, and iphone. I’m not sure if the IT dept wants to support another OS. It may be too little too late for Android or Palm Pre.

  • AnnR

    Is the battery replaceable?

    The memory management aspects are a good feature. Our theory is that the camera on the iPhone has a leak and contributes to problems.

    We’ve had iPhones for 2 users since they came out and just replaced another one, bring the device count to 4.

  • Novadoc

    I have lousy AT&T coverage with my “dumbphone” and am reluctant to go for an iPhone for that reason alone. However, the iPhone OS platform is polished from an end-user standpoint, with many available medical apps as already mentioned above. Witness open source pioneer/developer Jamie Zawinksi’s recent switch from the Palm Pre to the iPhone because, well, it just works.

    Whether or not Android turns out to be the medical phone platform of choice has yet to be seen, because it’s all about the apps. Apps are a chicken-and-egg situation, however, as developers may be reluctant to develop apps for a platform with few users, and prospective customers may be put off by a lack of apps. No ePocrates, a program I’ve been using for the past 8-9 years? major bummer.

    The upcoming Verizon/Motorola Droid with Android 2.0 looks fantastic on paper, but don’t forget that iPhone OS is a moving target, as Apple has a major update annually. Summary: if a phone can’t do what you and your work/practice/hospital/etc. require, it doesn’t matter what operating system it has.

  • http://goomedic.com Hamza

    Well , i agree with your point of view , but i believe The New Palm WebOS has a future as well .

    Google Android needs at least one more year to can compete with the iPhone , even with the Super Hardware features in the example phone !

  • http://www.ohioinsureplan.com AMH in Ohio

    The coverage area alone makes anything other than ATT attractive. I love the I Phone, but hate all the outage problems. That would be especially difficult for docs and other business professionals.

  • http://askanmd.blogspot.com/ Doctor D

    I would prefer with such an article that the writer disclose if there is any financial relationship between himself and the makers of any android phones. I googled “Jeff Brandt” and found several none of which appear to be the author of this post.

    Mr Brandt makes some good points, however the Android platform is still in it’s infancy. Android has almost no medical applications. It remains to be seen if developers will embrace it. From what I have read there are problems with having to write multiple versions of an app for each smartphone which make Android app programing problematic.

    Right now the overwhelming preference of medical professionals is the iPhone. This momentum means that there will continue to be innovations in medical software on that platform.

    Will Android pass the iPhone? Maybe. But maybe it will linger without any useful medical software.

    I think it’s a bit premature to call enthusiastically for all doctors to go out and buy Android on a very popular medical blog–which is what makes me wonder a bit about any ulterior motives the author may have?

  • LMHracer

    Did anybody look at the authors work web page? iPhone backed programs all over the place. Nice Google association/sponsor too. Time to consider the source and if there is any professional conflict.

  • Mark

    Many of today’s mobile device choices are about the availability of software applications – and the iPhone appears to be favoured by many software developers (even though it’s certainly not the ‘smartest’ smartphone available). But as a consumer, I don’t want to think of my doctor relying on any kind of consumer technology. I want to see them using something designed for medics, not for music.

  • http://www.motionphr.com Jeff Brandt

    Hi Everyone, Great responses.

    First I like the iPhone, I just don’t like it’s OS for Medical. Yes, you can jump though hoops to get it to do a lot of thing but why bother when there is a better platform for the job. I hope Apple is listening but my experience with them is they don’t, to arrogant about their religion.

    LMHracer
    As for the owner and my web pages, Yes, My main apps are for iPhone. I know the platform, unlike many, I like to write about what I know.

    No conflict, I am partner with both Apple and Google. I wish I had a real relationship with Google. or anyone in fact
    Thanks for the complement :’)

    AnnR
    It is hard to not to get memory leaks. Memory leaks on 4gb machine not much of a problem, on a mobile device, big problem. I was an embedded mobile cell phone programmer for years. I was a C programmer since college, again a religion.

    Yes replaceable battery
    in Android phones, but this is up to the manufacture.
    I hate devices that you cant remove the battery. I have to remove the battery of my mac book pro every once in a while it hard reboot it.

    Raffi
    These to will come. I developed an Android PHR first then when the market was not there moved to the iPhone. Just business for me not religion.

    Jeff Kiefer
    I agree but it takes jumping through hoops that are not necessary on Android. motionPHR my iPhone app backup to Google Docs and our reminder utilize Google Reminders. FYI, I received a 1 star rating because a user didn’t like this. I think she thought the OS or iTune performed these functions.
    It is a Poor overall architecture to have to go to such extremes to backup. Most users think there app data is backed up to iTunes, NOT.
    My only point is you can drive your car with your feet but why would you want to. And on returning you your app after a call. If I am deep into an app such as a EMR and I loose my place because my maid called me. I am not happy.

    Single threaded OS went out with Barry Goldwater.

    In closing, I have been a system architect for many years and my success is selecting the correct tool for the job. I painfully have chosen MS HealthVault over Google Health for a cloud base PHR and I though I would never suggest a microsoft platform, but it is the best product.
    Thanks for the engagement.

    Jeff
    http://www.comsi.com

  • http://Www.docbookmd.com Ian

    I am in Austin and realize that this application hasn’t made it very far from Texas yet, but when it does look out for it! I use it daily in replacement of our society’s directory. I like my iPhone and take the good with the bad, and as we get more apps like this one, my life and practice will continue to progress- I hope!
    Iml

  • scott

    Hi, I just sort of stumbled upon this post and it does sound like you just don’t want to like the iPhone. I’ve tried using my friend’s Blackberry and the tiny keys and key combos to hold down to type certain characters was ridiculous.
    iTunes does backup the entire phone apps with data. I use Diamedic on the iPhone for my glucose readings. If I were to wipe it and restore from the last backup, it would be exactly as if it was before I wiped it out.
    I think Palm has a good product, but going with Sprint meant it wouldn’t be a homerun winner. They needed to be with Verizon or AT&T for that. I hope they can remain afloat.
    And for the fellow who said that Apple doesn’t listen, that’s not true. They will listen, but if a million people say they like something the way it is and a hundred say they don’t, it won’t change. They’re trying to keep the majority of the users happy. If you want a product change, you need to go to Apple’s feedback page:
    http://www.apple.com/feedback/iphone.html
    Tell all your medical professional friends to do the same thing.

  • http://www.motionphr.com Jeff Brandt

    Scott, Thanks for your thoughts. I am just trying to tell people the technical faults in the platform. As for Diamedic, don’t know how they are backing up but they are not using iTunes. Just like out App motionPHR we backup to Google Docs.

    I am telling Apple but their platform is fine as a entertainment device which is what they want.

    I have no religious attachment to any platform, it is my job to inform my customer which platform is best for their needs. This article was written to assist others in our business to make solid choices.

    Jeff

  • BB

    “to arrogant about their religion.”
    You just killed any credibility you might have had. (strong emphasis on “might”)
    For the record the iPhone is a handheld *NIX based computer, not some “consumer based music toy”. Your characterization just shows your ignorance.
    Meh, your opinion doesn’t matter. The rest of the medical community sees the potential, and is going to go full tilt (well on it’s way) with development for the platform, and for whatever is to be Apple’s next follow-up to the iPhone.

  • http://www.motionphr.com Jeff Brandt

    BB
    “to arrogant about their religion.” What?

    Interesting, Thanks, I see you drank the cool-aid. But you missed my point, This article was to inform, no malice was intended. Again, My company develops for different platforms. I am typing on a Mac but I also own PC but don’t get me started.

    Yes, it is just my opinion and i hope apple does see this and corrects these problems. Remember, That Apple is happy where they are, They have never really competed in the enterprise or business software. They have it nailed on graphics.

    Again, sorry for stepping on your toes, I could care less which platforms rules the Smartphone. I am just trying to provide the facts and find the best platform to do the job in medical, and today it is not the iPhone.

    In a year or two we will wonder why we had this conversation. Proprietary OS are dinosaurs, Everything is going to to Clouds, but today this is what we got so we must do. If not the Cloud then a VM running any app on any phone. Have you read that there is a company that is running Mac OS on a Intel PC.

    BTW, If you would like to reply please use your real name. It help to keep people honest.

    Thanks,

    Jeff Brandt
    http://www.comsi.com

  • rvassar

    If you had an iPhone, you would realize that you can easily multi-task with the phone application. I use other programs while talking all the time (see #1 below too.)

    Here is why the iPhone is 10x’s better than the ‘Droid:

    1. No simultaneous Voice and Data with Verizon’s old CDMA network. So try taking on the phone and reviewing a chart, email, browser, etc on the ‘Droid (this is no sweat with the iPhone). So much for ‘multi-tasking’ with the ‘Droid!

    2. Compare the memory for Apps on the iPhone (essentially unlimited) with the ‘Droid (256 Mb – your medical programs proabably won’t even fit!)

    3. Look at the intuitive interface of the iPhone vs the Android. No comparison.

    4. Typing on the iPhone works great. I recently matched an experienced Blackberry user in a typing race (and I am not that fast). BTW, the ‘Droid keyboard is difficult to use in my opinion.

    5. Replaceable battery sounds nice but who really does this? The only good thing about having this on the ‘Droid is so you can take the battery out when it freezes up. Some ‘Droid users have already complained about the battery door falling off.

  • http://www.motionphr.com Jeff Brandt

    rvassar,

    Sorry but you have provided a lot of incorrect and misleading information. I am talking about Medical application which are very important so l am going to clarify because of the audience need useful information
    R
    1. No simultaneous Voice and Data with Verizon’s old CDMA network. So try taking on the phone and reviewing a chart, email, browser, etc on the ‘Droid (this is no sweat with the iPhone). So much for ‘multi-tasking’ with the ‘Droid!

    JB
    Sorry but CDMA is a qualcomm specification where iPhone is Euro GPS standard. Verizon has the best network in the world, and its is all about the network.

    2. Compare the memory for Apps on the iPhone (essentially unlimited) with the ‘Droid (256 Mb – your medical programs proabably won’t even fit!)

    Droid also has 512 MD RAM, 16 GB storage internal (HD)
    microSD (TransFlash), up to 32GB, 16GB included,
    So most medical program and data will fit, which is more dependent on the software not memory

    R
    3. Look at the intuitive interface of the iPhone vs the Android. No comparison.
    J
    Yes, it is very simple. Droid has 2 keyboard touch and QW, roller ball, menu keys. Providing the developer with much more to work with when building complex programs such as Healthcare or Business
    R
    4. Typing on the iPhone works great. I recently matched an experienced Blackberry user in a typing race (and I am not that fast). BTW, the ‘Droid keyboard is difficult to use in my opinion.

    JB
    QW keyboards are loved by many typing users so Droid provides both, so we can all make our own choice. For user that do not type or type well (hunt and peck) I can understand this preference.

    R
    5. Replaceable battery sounds nice but who really does this? The only good thing about having this on the ‘Droid is so you can take the battery out when it freezes up. Some ‘Droid users have already complained about the battery door falling off.

    JB,
    Well Power users such as doctors, First responders… change their batteries all the time. FYI, I have had to remove my battery from my Macbook Pro several times when it locks up.
    As for the door, Least I has the option

    Following URL for Droid specs.
    http://www.phonearena.com/htmls/Motorola-DROID-phone-p_3853.html

    BTW, I like the iPhone, I develop and own one but it is a Tool and you have to select the correct tool for the job and the current iPhone fails in the enterprise. I think Apple is very happy with their position.

    I see that you blog against anything that is not iPhone, If you decide to respond please use your real name, It tends to keep people honest.

    Jeff Brandt
    http://www.comsi.com

  • rvassar

    Sorry, Jeff, you’re the one not providing correct information.

    You never refuted the fact that Verizon’s network does not provide simultaneous Voice and Data when on 3G. It can not, so forget about reviewing a chart while on the phone (unless the all the chart data is pre-loaded.) More information here:

    http://www.wmexperts.com/cdma-development-group-announces-svdo-handle-calls-and-data-same-time

    Likewise, you’re wrong to claim that you can not talk on an iPhone and use other apps. You can talk and use other programs simultaneously. I do it all the time. I can use the iPhone to interface with our EMR system through the Internet in real time, while talking to a patient or doctor.

    By the way, having 2 keyboards does not equate with intuitive user interface (would 10 keyboards be even more intuitive?)

    The Droid only has 256 MB RAM available for applications (as noted in the link you provided. Do you know the difference between RAM and ROM?) The SD card can not be used for application space (only data). Here is a link with more detail regarding memory issues:

    http://androidandme.com/2009/10/news/google-fails-to-address-app-storage-issue-with-droid-and-android-2-0/

    I re-read your article and found a number of other issues too:

    1. You incorrectly state “iPhone currently has no facility to get app data off of the phone except for email which is not acceptable for transferring sensitive data” There are multiple apps that allow this functionality, both over the air (OTA) or when connected to a computer.

    2. Your statement “For medical device connections, the USB is a necessary standard. The MicroSD card provides a much needed facility to back up your application data from the phone and transfer it to another device.” is also just an opinion that you state like it is fact. I would wager that there are more USB iPod/iPhone connectors laying around than MicroSD cards.

    3. Your statement “First, like the Blackberry, it (Android) has a real keyboard which most professionals prefer” is just your opinion and condescending by inferring that people that use the iPhone are maybe not professionals?

    4. Again, another opinion: !This operating system is far superior to the iPhone OS for enterprise software, mainly because it can run more than on application at a time.” What good is multi-tasking if you have no simultaneous Voice and Data (something ATT/GSM/iPhone provides!)

    5. “….iPhone apps are limited to small programs that perform only one function…” What is a “small” program. Again, a condescending comment with no basis. Some iPhone Apps are more than 1 GB in size (and based on the current 256 MB application limit, won’t even fit on the Droid).

    6. This statement is completely false and should be retracted: “Once the iPhone receives the call the Chart app is stopped and the user can answer the phone. If the doctor wants to see the chart during the call, he/she will have to hangup the call and reopen the Chart app.”

    7. Yet another condescending comment with no basis: “Since most of the apps in the iPhone are for entertainment this is not a huge problem, the user will just restart the app. Medical apps must perform to a higher standard.”

    8. And another with no basis: “Android is a feature rich OS with the power for the programmers to write very sophisticated medical software. The iPhone OS was built as an entertainment platform.”

    Many of your comments are really laughable and reminisent of the old PC vs. Mac arguments which intimated that one needed a ‘PC’ to do real work and that the Mac was just a toy. I hope that you do better research if you publish future articles and that your editor does a better job of checking the facts.

    Ask Kevin for my email address and send me a note if you would like to chat about these issues.

    Bob

  • http://www.motionphr.com Jeff Brandt

    Bob,

    Sorry that I upset you, Again it is just a phone. I could retort on all of your statement but the Apple Religion is a strange thing that is not based on facts.

    I would say that your comment do have some valid technical points (e.g., OTA over the air data) , Yes this is true but how many people and healthcare facility have Bluetooth printer and computer. One more, how many Healthcare facility use Apple? Very few.

    BTW, Bob I am typing on my Macbook pro. I use the right tool for the right job.

    To the others on this blog, my information was written to educate those in the health care field, not convert.

    Jeff Brandt