What will prevent the iPad from dominating health care IT?

iMedicalApps reviewed some recent news articles regarding business/enterprise adoption of the iPad as a legitimate alternative to Windows machines in the workplace, taking it as a sign that healthcare IT is poised to adopt it, too: “All in all, these developments bode well for the adoption of the iPhone and iPad as a mainstream, IT-blessed mobile healthcare solution.”

iPad enthusiast medical bloggers, and there are many, have been making optimistic predictions like these since the iPad was first revealed. I wish that I could share in their optimism, but I think that they too easily confuse a vision of what is possible with what is probable.

In the abstract, the power of touchscreen iOS devices could be the best thing to happen to healthcare IT ever. I see it benefitting nurses and pharmacists as much, if not more than, physicians. But there are a lot of things that would need to happen to make this vision a reality. Unfortunately, the history of healthcare IT is a story of under-planned implementations of misguided ideas, followed by pessimistic refusals to implement demonstrably better alternatives. Here are the obstacles I see:

1. For the iPad to become ubiquitous in healthcare, IT departments would need to overcome decades of unease with Apple products. Many IT guys I know flat-out refuse to touch them, despite the fact that they are much easier to manage than Windows machines.

2. EMR vendors would need to develop genuinely useful, native apps, and not just for physicians to review records. For the iPad to make an impact, EMR apps would need to offer a complete set of features, including support for nursing, pharmacy, and ancillary personnel. These apps cannot be one-to-one ports of legacy software. UIs designed for mouse clicks won’t work on a touch screen. I need not mention the poor track record of the usability of EMR software up to now. Do we really think that the same guys that gave us our existing crap software can produce compelling apps on an unfamiliar platform?

3. Interoperability is key. Vendors for everything from call-light systems to materials management equipment need to make it easy for new apps to interface with their solutions, either directly or through convenient middleware.

4. Last, and most important, how do we convince healthcare executives and shareholders that the costs of development and implementation are worth the benefits? As a bedside nurse, having a dreamy piece of slick iOS EMR software on an iPad with a barcode scanner would revolutionize the way I work, but how could that translate into terms that executives would appreciate? Will it reduce costs and improve quality? If so, and that is a big if, then the iPad has a chance. But it isn’t possible to reach that brave new world by rehashing the same ideas that brought us to the status quo. Healthcare needs more than an iPad. We need fresh talent and new ideas.

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

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