The question at hand is: are we on the brink of having a computing device which is not invasive and disruptive to physicians and nurses in their daily care of our patients? This question has been under consideration for at least 8 years in hospitals and physician offices. It started as a discussion on having wireless enabled in the physician office and on the floors. After which realities of computer on wheels, ubiquitous printer availability, laptop ergonomics, floor space availability, tablet longevity, and battery life came to light. Needless to say we have been through the device gambit and our clinical colleagues have become camels carrying every portable device from VOIP Phones, Beepers, Barcode Scanners, and tablets. Not to mention asking where the COW is located being overheard by patients and their families....
Truth be told all of the above are hard issues to be dealt with when implementing clinical systems. There are also the soft issues, of a patient wanting to see what the physician is actually placing in the chart, before the discussion and understanding comes about. There is the balance between time the clinician needs to think before placing the information into the system and the precious time a clinician has available. There is also the fact that an alert can be received upon the iphone while picking the kids up from afterschool activities, but the action to be taken needs the physician to drive home and log into the remote access service. Universal computing access is just not there, just yet.
Is Apple coming to our rescue with the iSlate?
<--- Snipped from Huffington Post -->
Sometime today, Apple will be announcing the iPad. The iPad is rumored to have 3g connections being offered by both AT&T and Verizon. The operating system appears to be based upon the iPhone, and it has the safari browser. The touchscreen ability is kicked up several volumes. It has been overheard that the battery life is at least 6 hours on a single charge, there may even be a solar charging ability.
One critical barrier to success is the ability of the clinical systems to operate on the iphone OS platform. To date, I'm only aware of citrix having a client which runs on the iphone. This can enable citrix enabled solutions to function, but having a cerner millenium profile or an Allscripts touchworks on an iphone screen seems like a usability nightmare. Perhaps these vendors are working on having an iphone os compatible client behind the scenes. Needless to say, the iphone isn't on everyone's standard device for support these days, safari is also not the standardized supported brower.
The other barrier is the fragility of the device. Tablets do get dropped, and need to be almost immediately replaced. Motion Computing has been advertising the gorilla proof c5 for quite some time. Hopefully, Apple has used this wisdom in their device development.
So do you think the iPad will be the "killer" device of the clinical environment? What factors would be key to success? Where are the barriers?
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2 Comments to “The Holy Grail for Clinical Computing Nirvana, iPad”
Very good post. As cool as the iPad is, tablets have too many problems that have already been proven by the Panasonic H1 and Motion C5 to be fraught with peril. As tough as those devices are they are still getting broken (and that iPad is not nearly as tough or disinfect-able), they routinely get left behind by a nurse when she puts it down to administer meds or takes some vitals and Lithium Polymer batteries have shown to not be up to the task of 24/7 use, especially when Apple makes the battery unchangeable, you would end up throwing the devices away after 12-18 months of use.
The C5s and H1s are already getting stolen at incredibly high rates and if you add something as cool and well-known as the iPad, the theft problem will only get worse.
Tablets also have the serious problem of screen size. Especially in Cerner's PowerChart, there is a lot of scrolling when you use such a small screen and side by side comparisons of labs and medical histories just aren't possible.
Until the EHR vendors make an interface that requires minimal typing, people will still want a full keyboard for entry.
The funny thing is, healthcare vendors are having a hard enough time making their apps work on windows systems and I just don't see them taking the time to develop those apps to natively work on the iPhone OS.
Maybe for small physician practices but for hospitals I just don't see this (or any) tablet being the answer. Actually, I really just don't see any magic bullet coming down the road anytime soon.
As bulky as those WOWs are (I still call them COWs out of habit sometimes) they give the best user experience from a screen size and keyboard perspective, unless you want to go to a wall mounted computer in every room but then you need a system that will give the users a seemless experience as they move from one room to another.
Yikes, that was too long.
There is a large gap between what many HOPE the iPad will do and what it actually CAN do. Tablet PCs have been on the market for many years and promised many of the same things. The limiting factor has been (and most likely will continue to be) software. In the US, CCHIT/Drummond certification (via the ARRA stimulus) will be the badge that differentiates what healthcare facilities will actually support and purchase.
I've listed another 10 reasons the current iPad will not be significantly deployed in healthcare if you have the time.
Please share your thoughts and suggestions
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Welcome to the Healthcare IT Project Management Blog of Elyse Nielsen. This is the place where I share the ideas I have learned, the things I’d like to remember, and my thoughts for a brighter future. Find out more.
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