When I was handed my first pager, I was stunned. It looked like the beeper that Will Smith used to flash on the Fresh Prince of Bel Air (and not even the later seasons, I’m talking about the early, crazy outfit seasons!). So I asked why I couldn’t simply use my phone or, for that matter, why we didn’t all use phones. The answer was simple – reliability. The paging system, of which this rather archaic looking item was part, was very reliable. But was that enough? No. The hospital also maintains it overhead paging system just in case. And if that goes down – yep, there’s a back up there too. In health information technology, reliability is everything. And for the iPad, that could prove to be a major barrier to adoption in the medical community as it faces off with other medical tablets, at least if the FCC’s recently voiced concerns prove to be true.

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When I first entered the clinical world, physician order entry and electronic medical records were just concepts to me. As I learned how to navigate the hospital, diagnose everything from the mundane to the incredibly rare (my first patient was a baby with an idiopathic subdural venous thrombosis), and figure out how to treat the sick, I also had to learn how to use those two systems as a prerequisite to doing everything else. The four hours of class didn’t seem to cut it, so I probably spent at least a month trying to get my bearings on how to manage these IT systems. So for anyone who is already familiar with some form of healthcare technology, in this case a tablet, I suspect the adoption cost is far higher than just the price tag. You may be surprised how highly some medical students and residents weigh the notion of learning a new system in their career decisions. And because of what seems to be a particularly high barrier to adopting new information technology in healthcare, anyone interested in whether the iPad will succeed in healthcare should first ask who the competition is.

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Having had the opportunity to visit nearly a dozen academic medical centers in the past few weeks, I saw quite the spectrum of IT systems – from simple order entry to fully-integrated decision support systems. And for programs with the former, that revelation was quickly followed by the timeline for the coming upgrade. But what’s next for the most IT-savvy institutions? Well, Steve Jobs thinks he has an answer. Rumors abound that Apple is already pitching the iPad in LA-area hospitals as the replacement for the old physician clipboard. For outpatient practices already running a Mac-based EMR, MacPractice has already announced development plans for an iPad interface. According to their press release, they plan to develop apps that will allow patients to fill out registration, medical history, and other forms on the iPad. For physicians, it will integrate with the MacPractice EMR to manage schedules, view patient records, and even enter clinical notes. So could the iPad become the new best friend of healthcare providers? Well, there are a few challenges that need to be overcome first but the opportunities are exciting.

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With over 100,000 apps available for the iPhone/iPod Touch and billions of downloads since the App Store opened just under two years ago, the market is clearly hot. And with the release of the iPad, expect a new flood of apps into the market.  However, a recent article in the New York Times suggests that even with the wealth of options, people generally use only five apps despite having downloaded far more.

The average iPhone or iPod Touch owner uses 5 to 10 apps regularly, according to Flurry, a research firm that studies mobile trends. This despite the surfeit of available apps: some 140,000 and counting.

Another finding that the article notes is that even thought hundreds of thousands of apps are available, the entire user group is generally exposed to the same few thousand apps.

A survey of iPhones, iPod Touch and Android users conducted in July 2009 by AdMob, an advertising network that helps people promote their applications on smartphones, found that people discover apps most often by browsing app stores. And even though the iTunes store is bloated with offerings, people tend to gravitate to the most popular….

“…The top apps featured at the store do change out,” Mr. Putney said. “But most users will never see more than 1 percent of the total apps available.”

These findings are important for iPhone/iPod Touch/iPad users, app developers, and even us here at iMedicalApps, and here’s why. For users, this means that finding the best apps requires some work – a conscious effort to search the app store for things that interest you. That includes looking beyond the most popular medical apps. For developers, this means that reaching potential customers requires finding ways to climb that popularity ladder. For the Malcolm Gladwell enthusiasts, this means finding the Mavens, Connectors, and Salesman (from Tipping Point) – basically the people with large social (or professional) networks who are most likely to adopt early and spread the message about your great app. And for us here at iMedicalApps, it means actively looking for that diamond in the rough, languishing at the bottom of the popularity rankings, and helping our readers discover useful apps they wouldn’t have seen otherwise.

The iPad has created a great deal of buzz in the tech community. The medical and healthcare community at large are set to benefit from some of its key features, mentioned in our prior posting.  One of these key features, the beautiful 1024 by 768 pixel, 9.7 inch screen, is set to change the overall user experience for medical apps that have a focus on imaging, such as anatomy applications.  Although this medical app review was done using an iPod Touch, we can only imagine how much more aesthetically pleasing the iPad’s experience will be. As will be discussed later in the post, these applications are a perfect example of how the upcoming iPad could be used in the clinic setting to improve patient education.

A key thing to remember is your iPhone medical apps will run just fine on the iPad.  This post will review a trio of Modality’s latest anatomy flash card apps and provide extensive pictures of the following: Clemente’s Anatomy, Rohen’s Photographic Anatomy, and Moore’s Clinical Anatomy.

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