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How health care could benefit if a company followed Apple

David Ahn, MD
Tech
October 30, 2010
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Health care workers throughout the country daily face the growing pains of the transition from paper charts to electronic medical systems. Not only are there frustrations within each system, every hospital seems to have selected a different EMR.  When I was a medical student at UCSD, I was exposed to 4 separate EMR’s (Epic, PCIS, CPRS, Centricity, etc) during my rotations at various San Diego hospitals.

In this Wild West era of electronic health systems, here are 5 reasons how the health care field could benefit if a company followed Apple’s Paradigm.

1. Apple solidifies emerging markets. The iPod was not the first MP3 player on the market, and it wasn’t the last. The iPhone wasn’t the first smart phone, and it wasn’t the last. The iPad is not the first touch-screen tablet computer, and it won’t be the last. However, each of those 3 devices took niche and naive markets, made them mainstream and appealing to the general consumer, and became the standard in each market.

In this time of the dawning of electronic medical record systems, there are plenty of systems that exist, some more successful than others, but not one that has emerged as the de facto standard. Each system looks and handles vastly different than the next, and many take a good deal of training and education to learn. This is an ideal field for a company to design a novel approach that “just makes sense” – as Apple has done.

2. Apple specializes in intuitive and friendly user interfaces. The iPod had the click wheel to navigate thousands of songs, and the iPhone incorporated the touch screen keyboard into a new OS designed from the ground-up for touch interaction. These designs are intuitive and user-friendly. One of the primary difficulties with adopting EMR’s is non-tech savvy physicians are hesitant to shift their practice habits. Furthermore, current EMR’s continue to frustrate users with complex and confusing user interfaces. A fresh and intuitive Apple-esque design for managing health records and clinical encounters could appeal to users of all expertise. You don’t have to reinvent the wheel, rather, look at existing interfaces that are aesthetically appealing and go from there.

3. Apple makes hardware and software. Apple designs two operating systems (iOS and Mac OSX), which power the iPhone, iPod, iPad, Macbooks, Mac Pro’s, iMac, and Mac Mini. This impressive arsenal of handheld devices, notebooks, and small and large desktops cover nearly every possible use of hospital: powerful Mac Pro desktop machines for radiologists, iMac’s for nursing stations, Macbook’s-on-wheels for rounding medical teams, and iPod touches for nurses and doctors.

There are two primary advantages to being involved in both hardware and software. The first benefit is increased support for older systems and less opportunity for unforeseen bugs and incompatibility glitches, as there are only a limited number of configurations to support. The other primary advantage is the ability to custom-design hardware and/or software specific for the needs of medical professionals.

For example, the previously mentioned iPod Touch could be equipped with barcode scanners for nurses to help log their medication administrations. It’s often ironic when electronic health record systems don’t take into account the user interfaces they are designed for.

In the evolving world of medicine, where the transition to mobile is happening quickly, the disconnect between software and hardware could not be more apparent.  While it might seem impractical for a vendor to produce the hardware, a closer partnership between vendor and hardware is necessary, yet rarely occurs.

4. Apple specializes in uniformity and simplicity. Apple’s critics accuse the company of sacrificing customizability and certain higher-level functionality in exchange for uniformity and simplicity. In this way, such people use the condescending term “walled garden” to describe Apple products because they excel beautifully in what they do well, but with a degree of limitations.

Whether or not you agree with this, such a “walled garden” approach is surprisingly appropriate in the health care industry. Electronic medical records are, by definition, very tightly controlled and limited in terms of customizability as they must accommodate employees of various technological expertise throughout an entire health care system and protect the privacy of patient data.

5. Maybe Apple itself should jump into health information technology. EMR’s and medical computing is a billion dollar industry. For any corporation, the potential profit must be massive in order for it to fund the research and development required to produce a highly-polished product. Hot off the heels of the success of the iDevices, Apple’s profits are at an all-time high, and experts postulate whether the company can continue its exponential rise.

In response, Apple has fixed its sight on expanding its market from the consumer to the business world, with increased focus on security, stability, and allowing companies to produce their own in-house apps. Health care is a billion dollar industry, and making a significant entry into the EMR field could prove to be immensely profitable, even when compared with Apple’s already staggering success.

Conclusion

The thought of an “Apple designed” EMR and computer setup is incredibly intriguing. Next time you walk into your local Apple store, observe the well-designed workflow of greeters, roaming salespeople with modified credit-card swiping iPod touches, “geniuses” taking care of and fixing PC’s through walk-in and scheduled appointments, and educators leading training sessions. Does it require much imagination to visualize a similar “Apple-designed” medical workflow with corresponding software and technology?

David Ahn blogs at iMedicalApps.com.

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