Why Apple’s iPad will beat Android tablets for hospital use

Earlier this week, one of our senior editors, Felasfa Wodajo, published a fantastic piece stating why Android tablets will beat the iPad for hospital use. His piece received significant comments, with people both agreeing and disagreeing.

Although I agree with many of his views about how medical apps will be consumed in the future, I respectfully disagree with his overall assertion.

The Apple iPad will beat Android tablets for hospital use because of four key reasons:

1) The iPad’s head start — Apple basically creating the “new tablet” category
2) Apple’s and enterprise — their interest in medical use
3) Lack of fragmentation
4) Massive quantities of data on how to utilize the iPad in a hospital setting — the most important reason

First, I want to say I agree with Felasfa’s assertion that medical apps in a hospital setting will be home grown. This strikes down the argument many make for the iOS (iPhone & iPad) platform’s superior app community compared to Android. No matter how much more vibrant the iPad’s medical app ecosystem is when compared to Android, this will not affect how hospital systems decide to use tablets. Hospitals will decide to make home grown apps or customized apps, and the utility of these apps will be their ability to be seamlessly interwoven into the EMR system.

The iPad’s head start

The first iPhone 2G was released in July, 2007 — and it revolutionized the mobile ecosystem. Ever since, phone manufacturers have been playing catch up. Only with the release of the HTC Evo, released in June 2010, did we see an Android product that compared favorably against the iPhone. It took almost 3 years for competitors to catch up.

This is the same paradigm tablet makers currently face, and it would not be surprising for the same timeline to been seen. Although the Galaxy Tab and the Motorola Xoom show promise, they are not up to par with Apple’s iPad 2 from a hardware standpoint. Sure, they might have a higher megapixel camera, but would you rather have a faster and thinner tablet, with a longer battery life, or a point and shoot camera tablet?

The most important part of the iPad’s head start is the sheer number of tablets sold. Over 15 million units in less than a year. The Android Galaxy Tab, considered the most successful Android tablet, hasn’t even sold 2 million units yet, and their sales numbers have fallen under recent scrutiny for being inflated. The volume of iPads sold has created a legion of users who already know how to use Apple’s operating system. To expound on this, the argument that Apple’s iPad has essentially the same operating system as the iPhone and iPod Touch is actually seen as an advantage in regards to medical professionals. In healthcare, many view technology as a hindrance due to the learning curve it requires — the iPad significantly reduces the learning curve due to the operating systems ubiquitous nature.

Learning Android’s tablet operating system, Honeycomb, would be a significant learning curve for health care professionals, not mention they would be required to learn the electronic medical record (EMR) as well. Hospital administrators could soften the blow of learning a new EMR by at least providing a familiar ecosystem for users.

Apple and Enterprise

Contrary to their history, Apple has shown an interest in Enterprise solutions, and Fortune 500 companies are taking note. In Apple’s 4.0 release of their operating system, they specifically built in enterprise features for the iPad. In their keynote speech for the iPad 2, Apple featured a video showing how many industries were using the iPad for business, even specifically mentioning its medical uses — by showing its use for patient education and EMR in the hospital setting.

Furthermore, Apple has already collaborated with hospitals to help integrate the iPad into the clinical workflow. The University of Chicago’s internal medicine residents use the iPad in the hospital setting to improve their workflow, using it to chart patient data, and for patient education. When a University of Chicago resident e-mailed Steve Jobs telling him of how the residency program was using the iPad in the hospital, Apple executives came to the University hospital and offered assistance — Clearly showing Apple is paying attention [refer to below embedded video].

In regards to making home grown apps, medical institutions are already doing this. The medical college of Georgia has made a suit of applications for their health science graduate students, ranging from medical calculators to medical reference tools.

Anti-Fragmentation

The second greatest reason why Android is destined to fail in the hospital setting is because of fragmentation issues. This has been a key reason why it has taken many medical app developers, such as Epocrates and Medscape, so much time to transition to the Android platform. And if you look in the comments section of our Medscape review, you’ll see that users are still having issues with various types of Android phones and operating systems.

Android is open, yes — but the same openness that has enabled it to pass Apple’s iPhone in market share is also the reason why it’s not a good option for hospital and enterprise systems. If a hospital system wants to upgrade their Android tablets with new hardware, how sure can they be that their customized apps will work? Or, will the new Android platform they upgrade to even work with their existing hardware?

This is not the case for Apple — where iOS apps seamlessly integrate on the iPhone, iPod Touch, and iPad.

Data — The most important reason

The most important reason the iPad will beat Android tablets for hospital use is because of the current state of iPads in hospital systems, there are numerous pilot studies and current examples to point to — the data that will be released from these example can not be understated.

Along with the already mentioned example of the iPad use in the hospital setting — the University of Chicago’s Internal Medicine Residency Program — there are numerous examples that we have covered in the past:

* Ottawa Hospital has deployed more than 1,000 iPads to physicians and health care providers in their hospital system

* California Hospital piloting more than 100 iPads for hospital use

* Kaiser Permanente experimenting with iPad use for hospital and clinical workflow

* Australian’s state government launches $500,000 pilot program to use the iPad in the hospital setting

* Cedars-Sinai Medical Center experimenting with the iPad in the hospital wards

Moreover, there are numerous examples of the iPad being used for medical students. The following are medical schools that have given their first year medical students iPads, and in the process transformed their curriculum to mobile form: Stanford, UC-Irvine, and USF. This list will only increase. iMedicalApps has received e-mails from educators at other medical schools who are considering having a paperless, mobile medical curriculum, and want to use the iPad to accomplish this.

All this adoption and testing of the iPad in the hospital setting further separates it from Android and other platforms. The iPad has not been released for a full year, and yet these pilot studies and full implementations of the iPad in the medical field have been in full effect.

These case studies of the iPad will produce crucial data for other hospital administrators considering deploying tablets in the hospital setting. Administrators will have access to a wide range of data, from small to large hospital system use of the iPad — something they won’t have for Android tablets.

Conclusion:

The iPad’s head start on the tablet category, their improved Enterprise solutions, lack of fragmentation, and the pending data that will be released from the iPad’s integration in current hospital settings are the four key reasons why Apple has a chance to be the de facto hospital tablet.

Author:

Iltifat Husain, MD

Founder, Editor-in-Chief of iMedicalApps.com. Emergency Medicine Faculty and Director of Mobile App curriculum at Wake Forest School of Medicine.

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17 Responses to Why Apple’s iPad will beat Android tablets for hospital use

  1. john@chilmark March 10, 2011 at 1:53 pm #

    While I agree with your overall argument that the iPad will win out in the healthcare enterprise, the thesis for that belief rests more with the control that Apple has over Apps developed and deployed on iOS. In healthcare, with ever rising concerns regarding privacy of patient data and actual enforcement of HIPAA, healthcare executives will take the conservative and more secure path forward, which is certainly not Android. The full post can be found at: http://chilmarkresearch.com/20

  2. drrjv March 10, 2011 at 1:58 pm #

    1. In addition to the reasons you state, the real reason iPad will beat Android is the silky smooth, easy-to-use interface.

    2. I doubt most hospitals will use ‘home-grown’ Apps. Most hospitals can barely keep their all-to-common Dell computers on the floors working.

    3. The Galaxy Tab and Motorola Xoom hardware is fine – it is the Android software that is not up to snuff, with most reviewers complaining of application crashes, screen lags, complicated user interface.

    Apple essentially ‘invented’ the current tablet market and is at least a generation ahead of the competition. Due to their sales volumes, they are able keep costs down (just compare iPad prices with the Xoom) and, as you stated, due to the uniformity of the Apple devices, software compatibility and stability (isn’t that important in healthcare?) will always be much better than Android.

    PS: Apple expected to hold 80% of the tablet market this year:

    http://arstechnica.com/apple/n

  3. movinmeat March 10, 2011 at 7:26 pm #

    20% of US hospitals are or will be on EPIC alone in the next year or two — that’s one vendor alone! With ARRA looming, the pressure to be on an EMR with CPOE is huge. most hospitals do not have software creation talent in house and would much rather purchase an off-the-shelf EMR. I would be astonished if “home-grown” beats out “best of breed” in the healthcare IT world. (Now, “cheapest and fastest” might beat out “best of breed,” but that’s another issue.)

    I should also point out that with Haiku and Canto, Epic already is supporting iOS, so it has a head start there, too.

  4. Pascal March 11, 2011 at 3:16 am #

    These are great points and I mostly agree with your standpoint. One thing that I think will become more and more important, regardless of tablet platform, is that individual medical developers will be or will *have* to be able to produce software that integrates with EMRs. As we see on the iPhone, there are a lot of high quality medical apps being developed by individuals with a medical background. Since these developers know how such software should be designed to be most useful, as many use them theirselves in their daily work, these apps are so successful. The medical IT industry can only benefit from letting physicians use that kind of software.

  5. drrjv March 12, 2011 at 7:01 pm #

    Looks like iPad is already Doctor’s first choice!

    “With Apple launching its iPad 2 on March 11, Aptilon, an online marketing firm in Montreal, has released the results of a survey revealing that 79 percent of physicians preferred the iPad, while 12 percent would go for a Windows-based tablet and 9 percent for an Android model.”

    http://www.eweek.com/c/a/Healt

    • Iltifat Husain March 12, 2011 at 10:01 pm #

      Interesting, wish there were more than 350 physicians actually interviewed,
      but it’s a better sample size than some of the other physician surveys on
      tablets. Again though, just because docs prefer it, doesn’t mean
      administrators and CIOs will. Definitely will be interesting to see how the
      doctors and administrators decide in the future — wouldn’t be surprised if
      it’s unique to each hospital or health care setting.

  6. HIS Consultant Malaysia March 15, 2011 at 7:37 pm #

    Wait for BlackBerry Playbook, I think it will beat iPad for Hospital use.

  7. Scott March 19, 2011 at 6:08 pm #

    This article is incredibly flawed.

    1) head start doesn’t matter all that much. That is particularly true if they will be using home brewed apps. Further more it won’t matter if everyone is out testing iPads, hospitals will benefit from the studies whether the findings are implemented on an iPad or an android device.
    2) apple’s enterprise solutions are not that much better than androids if they are at all.
    3) fragmentation doesn’t matter. The hospital will mass purchase a tablet device, thus they will have identical devices with identical software.
    4) as mentioned before the data can be implemented on either an iOS device or android device.

    Additionally, battery power will likely not be an issue since there will be charging stations readily available. Not to mention the android OS lends its self to the “home brewed” app more than iOS does since the app approval process is vastly different (open vs closed is how it has been described).

    Needless to say it will most likely come down to which tablet device will be the cheapest to procure and implement. Functionality is not that vastly different And an android device is not truly all that much harder to use than an iPad (some would even say it’s easier…).

    Although I also don’t believe this debate will be settled anytime soon and most likely it could vary from location to location.

    • Iltifat Husain March 20, 2011 at 7:36 pm #

      1) I would think a head start does matter. If more health care professionals understand how to use the iOS platform, it means less of a learning curve, and a better adoption rates. Less time IT has to spend with employees and overall better satisfaction. Also, it does matter that the iPad is being tested at other places, because data is extremely useful before CIOs will make the plunge. They aren’t going to treat Android tablets the same. We’ve had CIOs directly contact us at iMedicalApps because they don’t have data on Android tablets, and aren’t sure where to turn to for that.

      2) I would agree that Apple’s enterprise solutions aren’t THAT much better. Blackberry still has the lockhold on this. But with that said, Android clearly doesn’t have a succinct enterprise platform. Can you name major companies that are giving their business employees Android phones? Or really using the Android platform for major enterprise solutions? There are plenty of Apple examples, few Android ones.

      3) Fragmentation does matter. As I already mentioned, hospital CIOs are worried about it — they ask us about it, and most of the time, they don’t even understand the full ramifications of it.

      4) Battery power is a HUUUUUUUUGE deal. Ask any residents who use laptops on morning rounds about battery issues with laptops. Sure, there are plenty of charging stations, but when you round with a team of greater than 5 to 8 people, which is often the case, you can’t find 8 plugs within a 10 foot vicinity for everyone to charge their laptops. Rather, you are left trading off charging stations, and often times only 2 or 3 plugs are available. To say battery power is not a big deal is lacking a fundamental understanding of how technology is used by physicians in the hospital workflow.

  8. drrjv March 23, 2011 at 6:45 pm #

    Yet another opinion piece | Albert: iPad has already won healthcare tablet war

    “The inventor of RhythmStat—and founder of Data Critical—is a familiar name in mobile healthcare, Dr. David E. Albert”

    “To call Albert bullish about the iPad would be an understatement. “I think tablets are going to become the one must-have in clinical medicine,” he says. “I see the iPad, not the smartphone, as the main clinical device.””

    “Albert believes Apple has already won the tablet battle among physicians. “Nobody has anything but iPads,” he says. “Game over.””

    http://mobihealthnews.com/1053

  9. hopkinsmed March 26, 2011 at 9:51 am #

    The picture in this article shows everything thats wrong with the iPad. You can’t write on the damn thing! How are you going to write a patient note with your finger? I tried just about every notetaking app out there, and nada.

    Now take a look at the new Fujitsu Q500. Its a 10.1″ Windows 7 slate with an active digitizer. That means that a) it will run your EPR, and your rad viewer b) you can write on it! Yes, its not as nice for browsing the web, but you’re using your iPad for patient care right?

  10. Rich May 25, 2011 at 3:03 pm #

    1. Apple will fall behind because despite their head start the Android OS is on the cusp of exceeding their worldwide numbers and has reached that point in an incredibly short time.

    2. Apple has already started testing support for things like iHealth, which follows their usual script. The make/support hardware to for their products then they make the software to replace their own app store developers. What Apple will do is destroy their own lead by making their own medical app. Being that Apple is scared of competition, they ban any app that “duplicates” them. Even if they put out their medical app long after other companies they will revoke their license to sell on the app store to ensure Apple gets 100% of the profits from that market. It is why they have denied thousands of apps including Amazon’s Kindle app (selling ebooks through Amazon and forcing the sales though Apple’s ebook store), any web browser app, etc. Android does not even require market access to use an app as it allows “sideloading” (installing an app without the market) which gives developers the ability to release their app from their website, even sell it from there, without having to go through the bureaucracy of Apple’s app store. 

    3. Planned obsolescence - Apple designs their hardware to require you to replace it every 12-18 months. Their latest iOS does not work on older devices and cannot be ported there because of their “closed” nature. I’d like to see the face of the board members at Ottawa Hospital when they have to replace their 1,000 iPads at $500 (assuming they go with the cheapest version) a piece each year. Plus the cost of implementing the new hardware. An extra $500,000 a year expense is unlikely something that will be easy to swallow. Android OS is portable to previous hardware while sacrificing nothing. Even Google’s first Android phone, the Nexus, can still run the latest Android versions. The “End of Life” cycle for an Android device is 2-3 years, in addition to their price point being almost universally less and Apple. Add to the fact that Android is open source allowing EHR companies to develop as they please and that it’s updates are not only more frequent than iOS, but their feature set is greatly influenced by the Android developer community. Apple has an approach of “this is what we made and you’ll like it” while Android responds to developers with “that was a great idea, let’s implement it!”

    4. Fragmentation is a minor and temporary problem. As someone that has developed for both Android and iOS I can assure you the fragmentation is just something that Apple fans keep repeating to spread dissent. Even Apple got caught spreading lies lately by hiring a PR firm to attempt to get major news outlets (Washington Post, NYT, etc) to say that Android was tracking and sharing your private information after it was revealed that every iOS device tracks your every movement without your consent and leaves those tracks on the device as well as every computer it has been plugged into. Yes, fragmentation exists, it is not that hard to overcome, is increasingly minor, and Android’s latest version (scheduled for release later this year) will solve this problem.

    5. Numbers game – Android is about to exceed iOS’s numbers and the data on usage will skew from Apple to a generic term of medical tablets. Apple is merely popular, but not the best solution. Numbers mean little and while Apple has the lead at the moment, look around and see how many smartphones you see. How many are iPhones? 50%? 60%? That used to be 90%… Times are changing, GM used to be the biggest automaker too…

    • Felasfa Wodajo May 25, 2011 at 3:18 pm #

      I believe you are arguing against a straw man here.

      This is not an Android vs iOS flame war (sorry)

      Apple does not want to be Android (or Nokia). The point of the post was that hospitals will provide low cost, probably Android, tablets to their users. I agree with you here. I also say that is not much of a problem for Apple – this is not their business model.

      The rest of your arguments are probably best made on other websites.

  11. Shinto August 20, 2011 at 9:46 pm #

    There is no argument here.. the iPad already wins in the most crucial section.
    1) Hardware stability.
    2) Framework stability.

    Android is a chaotic mess of fragmented hardware and software.
    Would you want a Frankenstein device to care for you?

    flat out Android based Pads Have already failed -game over-

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