Apple’s iPad health impact for doctors and hospitals

Apple just yesterday introduced the iPad, essentially an iPhone on steroids that bridges the gap between smartphones and small computers.

Apples iPad health impact for doctors and hospitals Will this be the platform that accelerates eHealthcare on the provider side (hospitals, doctors, medical education, etc.)?

I say yes. Here’s why:

First of all, the pace at which doctors are using smartphones as part of their practice (and especially iPhone/iPod Touch) is accelerating dramatically, as is uptake/usage of the applications. Younger doctors especially will not want to practice untethered medicine.

Second, we are now at a place where the convergence of form factor, power, connectivity, affordability, and functionality argue for widespread adoption. An iPhone screen is pretty small. A laptop is inconvenient. An iPad which can be used for data lookup, data entry, point-of-need multimedia education and reference, and access to electronic health records – what’s not to like?

Third, because Apple knows how to create interfaces, and because app development is now in full swing, this device and its siblings (iPhone and iPod Touch) cross the threshold of easy. That’s crucial for rapid uptake. Also, it’s not a totally “new” device, so many of the potential users will be accustomed to the interface scheme.

Imagine an iPad mounted in hospital patient rooms, and other doctor-useful locations. A physician comes into the room, equipped with an iPhone, and the iPhone sends a signal to the iPad. A quick biometric finger scan and the doctor is “in” the system, with access to all information and medical records necessary for the patient. When the doctor leaves, he/she logs out, or failing that, once his/her iPhone is 20 feet out of range, the system logs the user off. Or the doctor simply carries around an iPad for always-on accessibility during rounds and other daily duties.

It’s not so much that the iPad is a gamechanger in and of itself – it should be an accelerator of trends that are already happening, and inevitable. It’s a right-device-at-the-right-time evolution. It could also be a fabulous tool for a pharma salesforce, but that’s another subject.

Lots of other possibilities come to mind – what do you think? Gamechanger – or big yawn?

Steve Woodruff is Founder and President of Impactiviti.

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Comments

Blake
I agree completely. Image an EMR system that does not require your back to be turned to the patient while entering symptoms. It doesn’t require a flat surface and is incredibly mobile. It is no more obtrusive to a patient visit than a clipboard. In fact, that is probably its best comparison: a clipboard holding all your patient’s records, MRIs, X-rays, etc., easy and direct internet consultation, and prescription pad to electronically send them to the pharmacy. All of this while fully facing the patient. In an age of EMR, this can bring back warmth to a patient encounter.
http://jenward.wordpress.com/ Jen Ward
Great viewpoint Scott. I think you are bang on with the applications for the iPad for docs. Beyond that, I see big possibiliites for patients too. Rather than sitting in the waiting room filling out paperwork, the receptionist can hand an iPad to a patient and have them complete either the new patient paperwork, or ask some pertinent questions based upon the patients illnesses. For instance, in a Rheumatologists office, the iPad could have an app to run a HAQ questionaire on the patient. A few questions, and the doc now has the patient’s HAQ score – all before they are even put back into a room. The applications of this new and affordable hardware (and accompanying apps) is endless.
http://medicinafamiliar.info Ruben Roa
No doubts, is a gamechanger. But I would prefer an open OS, and non propietary software. Take a glance to the project OSCAR in Canada, with Linux (Ubuntu) and file records.
http://polymathmind.keithklan.net David Keith
I also agree. I think the Iphone is amazing(I use an iTouch), and use it daily for clinical things, but an iPad will expand this functionality, making it more userfiendly to puruse medical text, show images to patients, and be a fantastic in-room teaching tool. Imagine if our professonal societies has teaching tools we could bring up on an iPad as we’re explaining COPD, or immunizations!
I hear many of the critics say it’s nothing new, but I think its an expansion that docs can monopolize as tools for the medical setting.
http://www.stevewoodruff.com Steve Woodruff
Jen, you’ve touched on something incredibly useful – how I despise filling out PAPER FORMS when going to a doctor’s office. And I’d far rather have an iPad to look at in the waiting room than a 2-year old Highlights magazine…
http://www.mmfemr.com Leor Feder
As providers of open source Open EMR software, I can tell you that the i-pad is a wonderful option to help physicians enter the EMR world. We have users already integrating our EMR with the iPad and are very satisfied with its interface and portability.
This will only help close the gap between the computers in a practice and the mobility of the physician.
Andrew C
I don’t see it as a particularly amazing product. iPhones are used primarily for communication and entertainment, with some other button-press utility apps. Their greatest weakness is data entry. The iPad does nothing to enhance the data entry characteristics, which I’d see as one of the more important capabilities for use in medicine. It is too bulky to carry in a pocket, and with no rigid cover over the screen, more fragile than I’d want to carry in a bag. No keyboard, so data entry is limited to using a stylus or an on-screen keyboard – so you’re limited to maybe 30 wpm for data entry. I’d rather see something like Apple’s interface design stuck on something closer to the tablet designs currently out there – which actually have a keyboard!
http://sergiouribe.com suribe
as a radiologist, the ipad is exactly what I want.
http://jenward.wordpress.com/ Jen Ward
Andrew – the iPad wll be compatible with a wireless keyboard (which I already use on my Mac) or with a docking station. Imagine a waiting room or patient room with a keyboard docking station and keyboard already in place….just drop in the iPad and you now have a computer terminal. Check out the photos here: http://www.apple.com/ipad/specs/
kp
As a patient, I find it very irritating for my doctor to be typing away while I am speaking to him. He admits it slows him down. He doesn’t like it. My husband’s practice only uses their emr after the patient is gone for this very reason (also a time gobbler.) If there is no stylus or pen for the ipad (which is what the situation is as of now) it will not be easy for the physician or patients to enter any information that is not a check box. Unless it has that capability it is a glorified iphone.
jrm
Like EMRs in general, handing out iPads for patient registration sounds like a great idea. After the first four or five are stolen, you may not think it’s so great. It’s very easy for patients to rationalize stealing from “rich” doctors.
Brian
Two things:
One, I think it’s a bit premature to conjecture on the iPad’s impact on medicine just yet. As far as I’m concerned, this will be a mere footnote, though it may lay some groundwork for future iterations of medical hardware.
Two, this reads more like sales copy than anything really informative.
But hey, I was an HDDVD early adopter, so what do I know?
gc
@ kp
I think we’re actually missing the point here in viewing this as a mere extension of current computing trends. Most patients hate it when the doctor is merely watching a screen and typing while talking to them, and few doctors can do it at speed. What was the ‘gold standard’ of patient communication? The pad and pen. Sit down, face the patient, and write your notes on a pad of paper. Unfortunately, that does not lend itself to EMR.
Well the iPad now gives us a way to do so. Hand-writing recognition software has been getting better and better, and with a market incentive like the iPad spurring innovation, we can reasonably expect it to be acceptably accurate (99%) within a few years. Take the iPad and a stylus, scan in the paper forms we’re all used to using (along with a box for freehand notes! what a concept) and voila, we’re back to the good old days while simultaneously being EMR compliant and tethered to the mainframe!
Words can’t express how my excitement (and that of the patients I’ve discussed this with).
http://www.bryantsstatisticalconsulting.com Tex Bryant
I believe that Jen Ward and kp hit upon some important ideas and questions–how easy is it for a provider to input data using an iPad and how much interference does it create between physician or nurse and the patient? Nurses that I have talked to in hospitals love the EMR’s that they use. My PCP used his laptop the other day to access my records and input data. I found it useful for my visit as he could pull up data from my recent blood work for my physical and discuss it with me easily. From these experiences, I believe that the iPad will improve the functionality of EMR’s.
Since many sites will be adopting EMR’s in the near future, it is perhaps the right tool at the right time. As indicated in one comment, some EMR vendors seem to believe that it will be a good tool for use with their software. With Apple’s penchant for hitting “home runs” consistently with their product line, I think that it will probably have a positive impact on providing better healthcare and improve the bottom line for the provider.
R Watkins
“What was the ‘gold standard’ of patient communication? The pad and pen. Sit down, face the patient, and write your notes on a pad of paper. ”
I disagree. Handwritten notes, whether with pen and paper or with the iPad, are incredibly tedious due to current documentation and liability concerns.
The best and most efficient system to date is for the doc to sit down in front of the patient, maintain eye contact, and concentrate 100% on what the patient says. Aside from brief scribbles on a scrap of paper, the doc relies on his ability to remember. After the visit is over, the doc immediately dictates a note, talking a blue streak that can be understood by a trained transcriptionist, again focussing only on this one task.
Any system that requires ANY degree of data entry in the chart by the doc is a step backwards: it inevitably means less time and attention for the patient.
http://dustin-burke.com Dustin Burke
The current generation iPad I don’t think meets the needs of the majority of health care providers (IMHO, at least for physical therapists and other “hands on” professionals). I consulted at a medium-sized Physical Therapy Center and recommended the EMR and tablet PC solution for the clinical director (this was in 2005 so they were early adopters of the technology). Physical therapists are VERY hands-on and always on their feet. They were using paper and pen to record their daily notes and had lots of concerns about replacing with tablets. Tablets are heavier than a clipboard, breakable when dropped, took awhile to learn the (not user-friendly) software and just didn’t fit within their standard workflow. Most would constantly toss their clipboards down to assist and focus on the patient, something not possible with a tablet. Rather than seamlessly and transparently assisting the clinician (to make them better at their job), the technology was an impedance.
The iPad has the potential to be revolutionary in health care but it must allow verbal dictation (voice-to-text) for note taking and figure out an equivalent touch experience for one-handed stylus data input. Right now the iPad needs to be placed down on something to type – you can’t hold it in one hand and write on it like you can with a stylus. Also, one-handed portability is a concern. The iPad would need a rubberized back (perhaps a case could solve this) and/or a contoured body for better ergonomics holding it.
Otherwise, it would be hard to justify replacing the existing wall-mounted flat panel LCD screens and keyboard shelf with an iPad and keyboard dock.
“Better is the enemy of good enough” – Voltaire (misquoted)
kp
The ipad may just be the jumping off point for something better – in the future. Apple tends to be very incremental in improvements such as with the iphone. I could see them coming out with a more expensive product just geared to the medical community down the road. So far, reviewers are commenting on how difficult it is to type on the ipad’s virtual keyboard with any speed or accuracy. Viewing test results, xrays, etc. – works very well, but so do the computers that exist now. To be a game changer the ipad needs a user friendly and natural input device. Doctor’s need to be able to input with one hand, not have to turn away and plop it down to input data. It should help facilitate doctor and patient communication, not stand between them, slow the doctor down, have him turn his back to the patient, or spend his time giving his patient only half his attention while the patient is speaking and the doctor is trying to type and listen at the same time. After all, patients just want to be listened to with 100% focus.
http://www.mmfemr.com Leor Feder
R Watkins I agree with you. A pen and paper can arguably be the worst thing for patients. A dr. with lots of notes and handwritten sticky sheets are the enemy toward making the patient consultation safer and more efficient. I don’t think a dr. scribbling notes pays more attention than a dr. typing. Now imagine what would happen if your physician is on vacation and you have a situation that needs immediate care… the interim physician taking care of you may not be able to read or even find the handwritten notes your dr. wrote. Dr. records need to be electronic, it can even be argued that it saves lives…
kp
Handwriting recognition anyone? I don’t believe turning your back on a patient and typing is ideal. The last time I was at my doctor’s office he was so rushed to type he forgot 3 of the referrals he was to give me. I had to call back to get them arranged. His nurse had to ask him again. A waste of my time and his. What good is an emr for safety of you are rushed and forget pertinent items and forget orders or prescriptions? He had allowed extra time for me and things still got lost in the shuffle. As he can attest, that computer is a detriment to his practice. Somehow I believe dictation with a transcriptionist’s input into the emr is the way to go. Let each professional do what they do best. The records are there, but it doesn’t disrupt the encounter. A doctor is there for his ability to diagnose and treat, not type. Typing is the waste of a valuable intellect.
http://www.drewmgriffin.com Drew Griffin
I think the iPad is a game changer! Despite the lack of some features that would enhance the functionality (which will undoubtedly be included in future generations of the device), this can certainly impact delivery of quality and efficient health care.
As a Wound Care Certified Nurse, I often have to educate patients about their health conditions. Additionally there is an EMR task involved. The portability and interface is simplistic and functional. We are only seeing the beginning possibilities at this time. I can’t wait to develop applications for this interface. It makes sense.

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