Will an Android or iPad platform dominate hospitals?

Felasfa Wodajo, MD has written a post for iMedicalApps on the iPad’s future role in healthcare institutions. The title says it all: Why Locked Android Tablets Will Beat the iPad for Hospital Use.

The gist of his argument is that Android’s “openness” and hardware-agnosticism will make it more ubiiquitous in the market in general, and a more robust and affordable platform for use in hospitals.

With dozens of new manufacturers rushing into the tablet market in 2011 … the market dominance of the iPad will clearly diminish.

Although he doesn’t say so in as many words, it is clear that Wodajo perceives the battle between iPad/iOS against Android tablets through the lens of the old Mac versus Wintel story. The reality is that Apple is in a very different position with iOS and the iPad then they were with the Mac. Apple’s competitors simply can’t match the iPad’s price without sacrificing crucial features like battery life, screen size, or build quality. No one has come close to matching the $499 iPad’s specs without costing several hundred dollars more, and that was before the iPad 2 was announced. If anything, the market dominance of the iPad will clearly increase in 2011.

Vendors favor standardized application and hardware deployments for security and ease of maintenance.

Of course they do, and iOS 4 and Apple’s enterprise tools make it easy for small teams to manage hundreds of iPads. Device profiles can be remotely installed and updated. Apps can be distributed wirelessly, bypassing the App Store entirely. iOS 4 also supports commonplace IT standards like VPN networking and Microsoft Exchange.

Vendors can customize the Android operating system.

I don’t see why this is relevant. Between native apps and web-based applications, what else is there worth customizing? The iPad supports networking standards like VPN, and its security features for passcode protection and remote wiping already meet government standards for mobile healthcare devices.

Paid app downloads will continue to diminish as a source of revenue, as real value shifts to connectivity with other apps and demonstrating cost savings.

Continue to diminish? This is not only irrelevant, it’s also dead wrong. There are somewhere around 500,000 apps in the iOS App Store, with thousands more being added each month. Apple has deposited collectively over 2 billion dollars into developers’ bank accounts since the App Store launched, with most of that money having been earned in the past year.

The devices will have the apps preloaded and the operating system will have been modified so as not to allow any other user interactions or access to the Android Market.

One wonders if Wodajo has even touched an iPad. The ability to download or delete apps can be disabled with only a few taps. Furthermore, as mentioned earlier, device profiles with preloaded apps and user restrictions can be distributed wirelessly.

Apple is a hardware company and not terribly interested in commodity hardware and low-margin enterprise pricing.

While it is true that Apple doesn’t deal in commodity hardware, they have made it clear publicly that they plan to price the iPad aggressively. The iPad 2, for example, retains the $499 entry price of its predecessor, but with twice the speed, more RAM, dual-cameras, and a sleeker design. There are simply no comparable alternatives on a feature-by-feature basis at that price point.

Wodajo also overlooks one key fact that I think will drive the iPad’s entry into the healthcare space: the tide of technology adoption has shifted from the enterprise to the consumer space. It used to be the case that new technology began at the enterprise level and then trickled down slowly into the consumer space. Consumers are now the early adopters. Smart mobile devices are changing people’s personal lives. There is a growing expectation among consumers that they be able to use their smartphones and iPads at work.

Doctors in particular love the iPad. Anecdotal evidence abounds. The folks at my local Apple Store tell me that around one fifth of the customers looking to buy an iPad are physicians. I see iPads frequently at my hospital. A friend in my hospital’s IT department takes calls every day from doctors saying, “I just bought this iPad now please make it work with Cerner!”

Jared Sinclair is an ICU nurse who blogs at jaredsinclair + com.

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  • Samantha

    i think the prevlance of ipads in the medical industry has more to do with 1) ipads came out first and 2) the lack of functionality makes them inherently easier to use

    1) when i pads came out, there was no competition. and who better to buy them than busy physicians with disposable income and a promise of increased productivity?

    2) physicians are notoriously busy and the majority of other doctors Ive met, while intelligence, seem to get frustrated with new computer systems and are quick to dismiss non essential technologies with a learning curve.

    I think android provides a much more extensible platform that allows for a better experience and better integration, but I think that since the ipad came first, it will be a while before doctors are ready to switch to a different platform

  • z

    Samsung Galaxy tab 10.1 matches and bests ipad specs at same price

    Asus Transformer is thicker but overall retains all the honeycomb specs at almost $100 cheaper.

    If you love the shine of the apple product, that is fine. It seems that most physicians do love their apple tech, but to say there are no viable alternatives is just wrong.

    It is like the smartphone race. People who want to pay more for a name will do so but physicians should try to stick with open playforms.

    • John Ryan

      “Paying more for a name”? Common response from also-rans who can’t match the acceptance of the leading product in any market. Substitutes for figuring out why people buy and use a superior product.

      “frustrated with new computer systems and are quick to dismiss non essential technologies with a learning curve” Hey, you sound like my EMR vendor! Yes its true, physicians don’t like software that needs tinkering daily and hardware that needs replacement with each new product cycle. In short, I don’t like being oversold, overcharged and then patronized.

  • z

    With apple you are paying an apple tax, and this is a widely accepted phenomenon in the tech world. Who cares which product is leading. Leading does not mean better. There are viable alternatives that most power users would consider superior. Heck, just access to a universal USB port and SD card make android more compelling at the moment for easy interfacing. Not to mention ADK supported hardware that could directly interface and be controlled by the devices natively (as announced and showcased at this years google I/o).

    ohh the shiny! Talk about being oversold, overcharged and patronized. Apple products are notorious for the forced upgrade path. They are great for the general consumer who has no desire to learn computing, but a slight learning curve to a product is no excuse to not go for a much more versatile product in the field such as health care.

    Just like with android phones, there is not much the ios line offers other than pretty hardware being locked into a proprietary ecosystem which limits choice and flexibility. The device is a great toy for a general consumer, but we are talking about actual usefulness here.

    At the end of the day these are just nascent enthusiast devices. The fact that I consistently want to throw my ipad out the window for what it can’t do shows that there is much room for improvement and we really should be waiting till the product range and choice have matured.

    • pcp

      “we really should be waiting till the product range and choice have matured.”

      Doesn’t that apply to EMRs in general?

  • anon

    while some apple products are priced more expensively, i am not sure i would consider the ipad to be one of them. in return for the extra money i have spent on the computers, i have had to spend much less time with reboots, uncertain virus/malware issues, and compatability issues

  • John Ryan

    “apple tax”, “pretty hardware being locked into a proprietary ecosystem which limits choice and flexibility” => jargon without facts
    “most power users would consider superior”=>most users aren’t techies, they want something that works without a steep learning curve. The iPad delivers.
    “Apple products are notorious for the forced upgrade path”=huh? I have a 3 year old 3GS that works fine with the latest iOS version. As for Android…NOT!
    “access to a universal USB port and SD card make android more compelling at the moment for easy interfacing”=>sure, then you need a computer, not a tablet
    “Leading does not mean better”=>uh, yeah, it does in the real world. iPads alone have outsold every Windows tablet ever produced in the past 5 years. Vox Populi!

  • Justin

    Write a program for Apple and Android. Make it simple and sleek. And make it inexpensive. Make it the best. You will make a profit due to immense volume of sales. The best tablet EMR will win regardless of platform, and ideally will run on both (all).

    The platform debate is tired. I can open a macintosh powerpoint on my PC. My Mac can run windows. The question is in the software not the hardware. And the software so far sucks.

  • Oliver Richards

    speech to text will be huge in patient charting, and that is why android will win hands down. The inroads they have made with integrating speech to text throughout the entire os will make charting super easy.

  • Oliver Richards

    not to mention that some company can take android, and form it too their desires (open source) and then sell a specific medical platform for the entire hospital. With iOS there is no way apple will let go enough to let this happen.

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