5 reasons why Apple’s iPad will have trouble in health care

Originally published in HCPLive.com

by Colin Crawford

The Steve Jobs iPad Tablet media show held at the Yerba Buena Center for the Arts in San Francisco was always going to have a hard time living up to the ridiculous pre-launch hype that’s been circulating around the Web.

5 reasons why Apples iPad will have trouble in health careSteve’s presentation was more moderate than at previous product launches as he tried to manage expectations positioning the device as a tweener product – “more intimate than a laptop and so much more capable than a smart phone.”

By the time we emerged from the iPad presentation and the demo area where, under the watchful eyes of Apple execs and security staff, we were allowed to play briefly with the device and the few announced accessories, it was obvious that the world was very much the same as when we went in.

This was always going to be Apple’s toughest audience. The crowd reaction was generally positive if rather muted. Of course, the group was largely press who have a tendency to be ultra critical and even cynical given the amount of marketing and PR hype to which they are subjected. People also react to what they know and understand and have more difficulty seeing the longer-term vision and opportunity.

A big challenge facing Apple’s iPad is that unlike phones and laptops, this is a nice-to-have, not an essential-to-have product. But it’s a very slick device and a lot people will want one even if they don’t absolutely need it. It’s a product that will evolve and build over time rather than be an instant success.

The light and thin iPad has a bright and crisp resolution, the performance is fast, web sites look great (well, those without Flash). Unmodified apps scale up to full screen and generally are acceptable while the Apps written for the enhanced iPhone operating system raise the bar significantly.

A typical reaction of “It’s just a big iPod Touch” is understandable, as that’s what it looks like, but that does not begin to do the device, or the engineering effort that went into the product and supporting eco-system, justice. Customers understandably may see this as a bigger iPod touch but it’s no trivial matter to scale-up a multi-touch captivate screen to 9.7 inches.

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 18-24 month lead.

There are, however, some notable omissions that will affect its adoption by healthcare providers.

No Flash
If the device is positioned as great for web browsing, the lack of flash support is a problem, especially with video streaming. While Apple may be moving to HTML5 (http://dev.w3.org/html5/spec/Overview.html), Adobe’s Flash is going to be around for a long time, and this limits the accessibility of many useful Internet medical resources. Multi-tasking would also have been nice.

No camera
There is no camera, but then again we don’t have iChat on the iPhone. However, the device seems a natural for video chat and the camera is an essential tool to bring together the physical and digital worlds. Whether or not healthcare reform passes, the importance of telemedicine will only grow as myriad parties attempt to address provider shortages, the challenges of rural medicine, and other situations that necessitate remote delivery of care.

Given Apple has pushed video cameras in its desktops, laptops, and the iPhone (but not iTouch), the lack of this feature is really surprising. Maybe it’s just as well Apple is positioning the product as environmentally friendly and recyclable, as I have a suspicion that as with the iPhone, I could be upgrading each year.

Paying for a separate data plan
Given I carry around an iPhone all the time, having a tethering option for the iPad or laptop would be welcome rather than having to sign-up for another data plan.

No mouse support
The virtual keyboard is thankfully enhanced by physical keyboard options, either dockable or via Bluetooth; however, the iPad does not support Apple’s Bluetooth mouse, so extended activity within iWork and other click-heavy applications may be problematic. While it was good to see the iWork applications, the target audience release of iPad iLife applications would have been more appropriate; expect them to appear relatively soon after launch.

Durability and battery issues
As noted earlier, the iPad is light and thin, which lends itself to portability and ease of use. However, what does this say about the long-term prospects for its use? How well can it withstand rough usage, dust, disinfectants, water, etc.? Further, even if it can handle the rigors of an intensive healthcare setting, how will providers react to the lack of an interchangeable battery?

Apple claims that the iPad offers “up to 10 hours of surfing the web on Wi-Fi, watching video, or listening to music” which, if a reliable figure, could cover most of a hospital shift or a private practice workday. But 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.

This is a product that is likely to grow on you and it has enormous long-term potential. Its immediate strengths are in entertainment – games, movies, and music. The opportunity for content publishers is significant but needs a lot more work. While I have already signed up to be notified of when I can purchase an iPad, the absence of a camera and video chat prevents me from granting the device the “magical” status Apple has already bestowed on it.

Colin Crawford is CEO of Media 7 Consultancy and blogs at Colin’s Corner.

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  • http://www.academicobgyn.com Nicholas Fogelson

    To be honest, I don’t think any of these issues will affect its use in healthcare at all. I really believe we will see these devices, or devices like them, all over hospitals in the next 3-5 years. In fact, I’m going to write some of the apps that help us get there!

    Here’s your points
    No Flash – just not important. Health care will be run through custom iPad apps, not the browser. There is no reason whatsoever to try to use the browser. The entire strength of the iPad platform for vertical integration is that you can write efficient apps that talk to whatever web resources you need, providing a beautiful and intuitive interface that is far more efficient than you could provide in a web browser. Flash is irrelevant here.

    No camera – maybe would be nice in some specific applications, but for the vast majority of what we do it wouldn’t be neccessary. Do you see doctors and nurses running around with digital cameras shooting pictures of stuff? Neither do I. This is a nice thing, but in no way would be a core functionality in medicine. This will be added over time anyway.

    Separate data plan – again wouldn’t matter. Used in hospitals these will always have WiFi access anyway. I suspect that all units used in healthcare will be WiFi only, except maybe personal MD units that would allow access on the go. But even then, its unlikely that the doctor would need access when they weren’t in their home/office/hospital, so even then its hardly necessary. The form factor of the iPad is such that it will predominantly be used under one roof or another, in range of a WiFi signal.

    No mouse – isn’t this an advantage. Correctly designed apps in this framework don’t require a mouse. One of the problems with current EMR apps is that they have so many controls. A correctly designed EMR will be way more intuitive and require far fewer controls. A more Apple-like EMR that is.

    Durability – time will tell here. Maybe that’s a problem, we’ll see. Battery – 10 hours is a lot of time given that these things will be docked a lot. I’m sure there will be a third party case that will address both durability issues and battery life anyway.

    Personally, I think the iPad will be completely revoulationary. The ability to use the iPhone SDK to create intuitive software that can really be used in a vertical environment is groundbreaking. It will be absolutely incredible. Developers that don’t see that will be left in the dust, in my opinion.

    Nicholas Fogelson, MD
    http://www.academicobgyn.com

  • David Huss

    It’s clear that this wasn’t meant to meet the needs of professionals and is a purely entertainment oriented device, which is unfortunate, but fits Apple’s overall strategy.

    The choice of screen was especially disappointing. A glossy, back-lit screen makes a lousy e-reader. I was really hopeful that the rumors surrounding Pixel Qi and the iPad were true. Google “notion ink” to get an idea of what advantages a Pixel Qi screen brings to a tablet.

    It’s quite obvious though why Apple did not go with a transfelctive/reflective screen (ala Pixel Qi). Despite the increase in readability and battery life, such screens suffer a bit in the vibrancy of their colors. Sacrificing such would be against Apple’s sensibilities that puts aesthetics first over usability (how many useless one button mice to long-term apple users have stashed in their basements? I have at least 3).

    The good news is that the newer transflective/reflective screens should be able to be any size for not too much more than a traditional LCD (though pixel qi is only producing 10.1 screens at this time). The first company that produces a polished tablet with a 13.3″ (widescreen) pixel qi (or similar) screen should sell exceptionally well amongst the professional crowd. At that size you will be able to read PDF’s at near real-world size (you’ll have to cut off a bit of the left/right margins to display A4 paper at a 1:1 ratio), which would be totally awesome for anyone who needs to read journal articles on a regular basis. I’d buy 2 right off the bat (one for me and one for the wife).

  • http://DigitalNeurosurgeon.com Pieter Kubben

    I do not agree with the negative attitude. It just depend what you expect from the iPad.

    In my case, that would be a stylish color-enabled e-reader, that allows me to run Papers (from mekentosj.com). Include some rich media content (if not Flash-powered ;-) ) and I’d be happy.

    Of course it won’t be the best web browsing experience, but at least decent enough to check some websites from your lap. It won’t replace a regular computer, whether it’s running Mac OS X or something else. But hey, marketing is a game as well, isn’t it.

    I’d like to have one, and if the screen seems nice and large enough, I’ll buy one. Just a WiFi version, no need for 3G on my e-reader.

    So it’s just what you expect from the device, I think…

    Blogged about this topic on:
    http://blog.digitalneurosurgeon.com/?p=646

    Best regards,

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

  • MD

    One of the worse lack is absence of USB connector. No need other comment to prevent me buying this thin.