Its no secret that healthcare providers are adopting tablets at a rapid pace – one survey found that over 25% of physicians own a tablet and that was nearly nine months ago.

This trend, both with tablets and smartphones, has generally been bottom-up; physicians, PA’s, NP’s, nurses, and other healthcare providers are buying consumer devices and bringing them into the clinical world.

However, as Eric Yablonka, CIO of University of Chicago Hospitals put it, “This is not ‘nice to have stuff’ anymore, this is life saving stuff now.”

And so we’ve seen institutions across the country move to implement mobile devices on an enterprise level – from the Johns Hopkins and University of Chicago Internal Medicine residency programs to the entire VA healthcare system. However, Kaiser Health News reports that less than 1% of hospitals have fully functional tablet systems and points out how one of our biggest investments in health IT, the HITECH act, may be part of the reason why.

When the iPhone was first released, it transformed the way people interact with mobile devices – they became something better than just mini-computers. However, as pointed out by Jenny Gold, staff writer at Kaiser Health News,

“The most popular systems don’t yet make apps that allow doctors to use electronic medical records on a tablet the way they would on a desktop or laptop. To use a mobile device effectively requires a complete redesign of the way information is presented, Jonathon Mack, director of clinical research and development at the West Wireless Health Institute, says.”

We would first point out that the assertion isn’t entirely accurate – Epic, Allscripts, and Centricity as well as many cloud based EMR vendors like MacPractice and Dr. Chrono do have iPad and in some cases Android apps. That being said, these apps are, in many cases, limited – some allow read-only viewing for example.

What is often true, though, is that for hospitals, accessing these apps requires substantial additional cost. For example, Epic and Allscripts both require a separate licensing agreement for their mobile platforms. As Mr. Mack points out, many hospitals and healthcare systems have just made major investments in their IT infrastructure, a trend which was accelerated by the HITECH act. As he puts it, “When you look at a health system that has bought into an EMR, they’re not ready to turn the boat around and start over.”

As a result, healthcare providers are very reliant on workarounds to shoehorn tablets into existing infrastructure. For example, apps like Citrix or VMWare enable access to virtual Windows environments on the iPad or Android tablets, allowing access to fully functional EMR’s, radiology viewers, and so on.

In my own experience, while this method works, it just turns these devices into laptops without the keyboard. Windows is designed for computers and laptops; Microsofts release of Windows Phone and abandonment of Windows Mobile is a testament to that.

Despite these obstacles, healthcare providers like Kate Franko, a physician assistant highlighted in the article, are still finding utility for tablets to improve efficiency, patient communication, and more. While there are many issues to be addressed – cost, security, infection control, and so on – tablets are likely to be an increasingly common feature on medical wards and it’s only a matter of time before the IT infrastructure is forced to catch up.

by Brittany Chan, MBA, MS3

Just as I started to save in anticipation for the iPad 3, here comes the Kindle Fire.  At $199, I could pretty much afford to pre-order it now.

Amazon recently announced its new Kindle lineup, most notably including a full-color tablet device, the Kindle Fire.  Amazon also slashed the prices on its other Kindles—the Kindle Keyboard dropped in price to $99.  A simpler, keyboard-less Kindle is now available at only $79.

With so many different Kindles available, sizing up Amazon’s arsenal of e-Readers can be a bit overwhelming.  Let’s take a look at each of the different Kindle models and what this means for healthcare.

Kindle

• Price: $79 with Special Offers/$109 without Special Offers
• Display: 6” diagonal, E-ink Pearl
• Size: 6.5″ x 4.5″ x 0.34″
• Weight: 5.98 ounces
• Storage: Up to 1,400 books or 2 GB internal memory
• Connectivity: Wi-Fi
• Battery Life: Up to 1 month
• Available: Now

If all you want to do is read, this Kindle is the best value.  The device is small, inexpensive, and does the job as a solid quality e-Reader.  It has the smallest internal storage at only 2 GB, but unlimited Amazon Cloud storage allows customers to buy as many books as they want.  Of note, this Kindle is the only model that has no audio, so if you love audiobooks, listening to music on your Kindle, or text-to-speech conversion, this may not be for you.  Additionally, the absence of a keyboard may make web browsing and text annotation a little more challenging.

Kindle Touch/Kindle Touch 3G

• Price: Kindle Touch – $99 with special offers/$139 without special
• Kindle Touch 3G – $149 with special offers/$189 without special offers
• Display: 6” diagonal, E-ink Pearl
• Size: 6.8″ x 4.7″ x 0.40″
• Weight: Kindle Touch – 7.5 ounces, Kindle Touch 3G – 7.8 ounces
• Storage: Up to 3,000 books or 4 GB internal memory
• Connectivity: WiFi, plus free 3G on the 3G version
• Battery Life: Up to 2 months
• Available: November 21, 2011

For those in love with touch-screen technology, Amazon has announced the Kindle Touch.  It is just slightly larger and heavier than the Kindle, with the same size display.  EasyReach, a new type of touch technology invented by Amazon, allows the reader to turn the page by tapping instead of swiping the screen.  The Kindle Touch is available for pre-order on Amazon.com and will be released on November 21, 2011.

Kindle Keyboard/Kindle Keyboard 3G

• Price: Kindle Keyboard – $99 with special offers/$139 without special offers
• Kindle Keyboard 3G – $139 with special offers/$189 without special offers
• Display: 6” diagonal, E-ink Pearl
• Size: 7.5” x 4.8” x 0.34”
• Weight: Kindle Keyboard – 8.5 ounces, Kindle Keyboard 3G – 8.7 ounces
• Storage: Up to 3,500 books or 4 GB internal memory
• Connectivity: WiFi, plus free 3G on the 3G version
• Battery Life: Up to 2 months
• Available: Now

This is the familiar Kindle version that was announced back in July 2010, commonly referred to as the third-generation Kindle, or “Kindle 3.”  The keyboard, of course, makes this Kindle larger than the Kindle Touch or the simplest Kindle model, but web-browsing and annotation are much easier.  Interestingly, the price points for the Wi-Fi-only versions of the Kindle Touch and the Kindle Keyboard are exactly the same, while the 3G version of the Kindle Touch is $10 more expensive than its Kindle Keyboard counterpart.  The Kindle Keyboard is also available in both graphite and white colors.

Kindle DX

• Price: $379
• Display: 9.7” diagonal, E-ink Pearl
• Size: 10.4” x 7.2” x 0.38”
• Weight: 18.9 ounces
• Storage: Up to 3,500 books or 4 GB internal memory
• Connectivity: WiFi + free 3G
• Battery Life: Up to 2-3 weeks
• Available: Now

A larger screen is available on the Kindle DX, at 9.7 inches versus the 6-inch screen on other Kindle devices.  Newspapers and magazines are beautifully presented with this screen size, and it may be a better choice for the visually impaired.  The Kindle DX is equipped with a keyboard for easy surfing, shopping, and annotation.  However, the price is significantly higher, and the device is more cumbersome than the others.

Kindle Fire

• Price: $199
• Display: 7” diagonal
• Size: 7.5″ x 4.7″ x 0.45″
• Weight: 14.6 ounces
• Storage: 8GB internal (Enough for 80 apps, plus either 10 movies or 800 songs or 6,000 books)
• Connectivity: Wi-Fi
• Battery Life: Up to 8 hours of continuous reading or 7.5 hours of video playback, with wireless off
• Available: November 15, 2011

The star of the new Kindle lineup is no doubt the Kindle Fire.  Amazon’s hot new tablet (no pun intended) is geared toward customers who love media consumption but aren’t willing to shell out $500 to $800 for an iPad or other high-end tablet.  At 7 inches, the vibrant, full-color display is larger than those of its non-DX kin, but smaller than that of the iPad. The Kindle Fire uses touch-screen technology and is ready for games, apps, music, movies, and more.

As an iPad owner and avid Amazon customer, one of my gripes was that movies and shows purchased via Amazon Instant Video could not be viewed on the iPad, as they are Flash-based and no Amazon-supported app was available to make viewing possible.  From my experience, media available on Amazon Instant Video is often cheaper and more promptly released than on iTunes.  Amazon Instant Video is, of course, fully compatible with the Kindle Fire, and Amazon Prime customers enjoy free streaming of more than 10,000 movies and shows.

Amazon also promises smooth web browsing with its new browser Silk, available only on the Kindle Fire.  Silk utilizes “split-browser” technology through the Amazon Web Services Cloud.  The Kindle Fire and Amazon Elastic Compute Cloud servers cache websites and predict user browsing patterns to send content to the device quickly, allowing pages to load faster.  There are some concerns about privacy and security with this system since all your web data will be transmitted through the Amazon cloud.   Amazon touts this as “machine learning.”  “As Silk serves up millions of page views every day,” Amazon says, “it learns more about the individual sites it renders and where users go next.”  In other words, Amazon is watching what you browse.  Welcome personalization feature, or gross invasion of privacy?  You decide.  Fortunately, customers will have the option to use Silk without having to go through the cloud, though speeds will be slower.

No tablet would be complete without apps, which are available on the Amazon AppStore.  However, the AppStore contains only a fraction of the apps available for iOS or Android devices.  Though the Kindle Fire runs a modified Android OS, you will only be able to purchase apps through Amazon’s own AppStore, not the Android Market.  This is a severe limitation of the Kindle Fire, as the availability of Angry Birds simply won’t cut it for more hardcore tablet users.

Then again, the Kindle Fire is not intended to be a hardcore tablet.  It has only 8 GB of internal memory and does not even have 3G capabilities or a camera.  This is reflected in the extremely affordable price of $199, a major source of appeal for customers simply looking to enjoy their media.

The Kindle Fire is a smart marketing device that will undoubtedly boost Amazon sales all around.  It combines the convenience of Apple’s one-stop media shopping with a reasonable price for consumers and unlimited cloud support.  It remains to be seen whether this gadget will meet customer expectations upon its release in November.

Applications for the Kindle in Healthcare and Medical Education

A few months ago, we discussed where the Kindle had failed as an education tool. With the release of the Kindle Fire, students who can’t afford more expensive tablets now have a more financially feasible option for electronic textbooks.  The LCD screen will allow medical students to view Netter’s Anatomy in all its full-color glory, along with other pictures and graphs that aren’t as friendly on the e-Ink page.  As an MS3 myself, I love using Kindle textbooks for school—one click and I can start studying, not to mention significant discounts given for Kindle books versus print.

The Kindle also has great potential to help busy healthcare professionals keep up with current literature.  A few medical journals, such as the New England Journal of Medicine, Annals of Internal Medicine, Pediatrics, and the Journal of the American College of Cardiology, are currently available for subscription on the Kindle.  As the Kindle becomes even more popular, this limited selection will hopefully grow to include publications such as JAMA and journals from all medical specialties.

Portability of the Kindle Fire on medical rounds also makes it a favorable device for physicians.  I was disheartened when my iPad proved too large and heavy for my white coat pocket.  The 7-inch size of the Kindle Fire, following the likes of the Blackberry Playbook and the HTC Flyer, slips comfortably into a white coat for easy accessibility on the job.  And since it weighs less than one pound, doctors will hardly notice its presence.

While the Kindle Fire is an attractive device for medical students and physicians, its promise seems to lie more with its e-Reader features and not so much as a medical tablet.  As discussed earlier, its app selection is relatively dismal when compared to those of Apple and Android; commonly used medical apps as Epocrates and Medscape are not yet available on the Amazon AppStore.   The healthcare community has been buzzing about the potential use of tablets in telemedicine, especially with the revelation that Apple’s FaceTime can be HIPAA-compliant. With its relatively weak hardware and absence of a camera, the Kindle Fire will have no role here.  Furthermore, the questionable security of Amazon Silk makes it unlikely that the Kindle Fire will be used for sending or recording patient data.

The Bottom Line

The new Kindle lineup seems to have something for everyone, from bookworms in search of a simple e-Reader to avid media consumers with expansive music and video libraries.  With its convenient availability of media and affordable price, the Kindle Fire will appeal to a large audience.  Medical students who wish to ditch their huge backpacks and save significantly on textbook costs may find that the Kindle Fire suits their needs.  As it stands, however, the Kindle Fire may be little more than a personal, quick reference device for healthcare professionals.  Despite its marketability as a tablet, the Kindle Fire simply does not have the horsepower to directly compete with more powerful devices such as the iPad in the medical setting.  More robust tablets will be needed for use in actual medical practice.

Sources:
Amazon.com
MSNBC
ComputerWorld

Smart MIMAS, a tablet and server system developed by KDDI Labs, gives clinicians the ability to view high quality medical images on their android devices and tablets. Images can be sent securely to specialists whether at a hospital, at home or on the road. This is invaluable in the case of an emergency, since quick and accurate instructions can be relayed to staff back at the hospital. However, this system goes far beyond just viewing.

“This system has three main features. One is that images can be viewed quickly. The second feature is that images can be sent at high speed. And the third feature is that it’s very secure. Regarding the first feature, high-speed viewing, this system uses unique memory management technology to enable large images to be viewed quickly. As for the second feature, high-speed transmission, a CTU image contains a very large amount of information, with over 4,000 gradation levels in a single picture. Usually, physicians in the hospital adjust those levels to see the ones they want. But if the pictures are used on a mobile device, then with the Internet until now, the number of levels was limited due to JPEG compression. So physicians couldn’t adjust the pictures they received. Our system uses JPEG2000, so the compression preserves as many levels as possible. That makes it possible to adjust the gradation on a tablet or smartphone. Regarding the third feature, security, we’ve used KDDI’s own encryption technology to achieve a very advanced level of security.”

As can be seen, this system will dramatically impact the way physicians access medical images, and will give more flexibility in what settings the images are viewed. The image quality is also very high, decreasing errors related to misinterpreting an illegible image. Multiple test images can be compared easily and quickly, allowing for an accurate diagnosis.

“There may be only a few specialists in a hospital, or they may not come to the hospital very often. In that case, if there’s an emergency, a specialist can look at pictures while outside the hospital, and tell staff on the spot what to do. The specialist can also tell staff, “I’m coming back in. Get everything ready for surgery.” I think that’s a big advantage of this system. In provincial areas, lack of physicians can be a problem, so I think there will be a great many cases like that from now on. And in such cases, a specialist at another local hospital can provide support. We think Smart MIMAS could be utilized for that kind of
support.”

The cost to hospital administrators for Smart MIMAS will run around $65,000 for both the server and tablets. KDDI aims to supply 20 sets to hospitals by the end of the year.

Source: diginfo.tv

Advantech has designed an infotainment terminal that takes the best ideas from tablet computers and medical devices and combines them into a very powerful and useful product. As with many things, this device builds on the accomplishments of its predecessors.

In this case, the success of the iPad has created demand for small form-factor computers. The HIT-W121 then, while it does not have the most awe-inspiring name, is the natural progression of the tablet market. This small lapse in name creativity is completely overshadowed by the plethora of attributes and attachments that are possible on this device.

The tablet has the following features (non-exhaustive list):

• 2MP front-facing webcam for video conferencing and taking pictures
• RFID Reader chip is installed for tagging and tracking
• Wifi access of b/g/n standards for internet and hospital server access
• Intel Atom dual-core process for improved performance
• 3 mm thick slim fanless design makes it easy to handleHigh quality, 11.6″ display with a 16:9 viewing angle
• Easy to clean touch panel, IP54 compliant
• Accessory items that can be added include – Handset/ Smart card reader/ Barcode Scanner/ MSR
• VESA 75 mm standard mounting holes for a myriad of mounting demands
• Various ports/connectors including USB, and coaxial cable allow for even more uses
• Instant function key access via programmable touch hotkeys on front panel
• ITE & medical dual certificates provide full application coverage

Advantech seems to have addressed nearly every conceivable hospital scenario. The HIT-W121 is even certified to endure various extreme and environmental conditions!  With the realization that tablet computing is not a fad and is here to stay, Advantech is trying to capitalize on this market and produce a product that is both relevant and functional in the hospital setting.

The infotainment terminal can be ordered from the company’s website in a variety of colors and finishes.

Source: Digitalsignagetoday

The HTC Flyer promises to be the perfect medical tablet: it supports a fine-tip stylus and is small enough at 7 inches to comfortably carry around in a white coat. The recently reviewed BlackBerry PlayBook impressed with its size (also 7 inches), but ultimately suffered from its lack of third party apps. The HTC Flyer offers the potential of the growing Android marketplace and its many medical apps, so I was thrilled to purchase one for review. One of the two tablets earned a permanent spot in my white coat. Read on to find out which one and why.

Beautiful Android Home Screen

Operating System: Powerful, Multitasking

For the Flyer’s operating system, HTC took Android OS 2.3 (aka Gingerbread), which was not intended for tablets, and customized it to support the larger screen of a tablet. Since other new Android tablets (eg. Samsung Galaxy Tab) run Android 3.1, the Flyer is running a version that is essentially 2 iterations behind. On the upside, though, HTC did an excellent job customizing the OS, and the Flyer functions quite effectively on the larger screen.

Quick-Launch Apps from the Lock Screen By Dragging Its Icon to the Ring

One unique feature of the OS that I appreciated for hospital use is that one can launch one of 4 user-specified apps directly from the launch screen by dragging the selected app on the lock screen to the “unlock ring” at the bottom. This cuts out some extra steps for quick tasks like referencing the dosing for a medication through Epocrates. Also, the operating system is quite beautiful, with flashy animations for the weather and a large flip-style clock. Another benefit of Android is that it allows for various other applications/widgets to be running on the home screens, which provides a welcome level of complexity above the iPad’s simplified iOS homescreen icon launcher.

Android’s implementation of multi-tasking is effective and powerful. Programs will continue to run in the background unless you intentionally kill the process. You can alternate between open apps through a notifications/settings panel that can be flicked down from the top of the screen, which is just slightly more complex than its BlackBerry and Apple competitors.

Left to Right: HTC Flyer, BlackBerry Playbook, Apple iPad 2

Hardware/Specifications: Chubby and Less Professional

After owning the BlackBerry PlayBook and iPad 2 for several months, I can’t help but describe the Flyer’s overall feel as cheaper than its counterparts. What immediately stands out is the two-toned back surface (white and grey) that awkwardly bulges at the bottom. The white color is concerning for showing marks/scuffs, although it does at least fit the white color scheme of most hospitals. Overall, it simply does not have the same professional, sleek look of the PlayBook and iPad.

The Flyer (Right) is Slightly Thicker Than the PlayBook (Left)

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.

One member of the healthcare tablet family is Motion Computing and it’s tablet, the C5. The C5 has many things that a physician, nurse, pharmacist, and many other healthcare providers would want. First and foremost, its a rugged piece of equipment. It’s designed to be capable for taking a hit on the floor or being cleaned with disinfectants. If you’ve seen the sheer number of hand sanitizer dispensers in a hospital, you know how important that latter capability is. It also has a barcode scanner and RFID reader. This feature would be incredibly helpful for nurses who need to verify patient identity before dispensing a medication or confirm a medication they are about to administer is the correct one. In addition, it has built-in microphone and camera, the latter of which would be very helpful in areas such as wound management or patient identification. As for the microphone, if the Speak Anywhere technology is as good as Motion Computing claims, it would allow physicians to dictate patient notes without a peripheral microphone (though I suspect its not that good). Also, these machines are  Windows and stylus based. While this isn’t necessarily a functional strength, it does reduce some short-term barriers to adoption by increasing the likelihood of compatibility with established EMR’s. And if you’re going to be working with patient information in a HIPAA world, security is crucial. That’s why data security solutions for tablets like the C5, specifically those using Intel processors, are another crucial advantage that established vendors like Motion Computing have.

All of that being said, there is certainly a reason tablets like the C5 have not achieved widespread adoption already. For example, the C5 weighs in at over 3lbs, not that heavy, but more than twice as much as the 1.5lb iPad. In addition, it’s battery life is pretty weak in comparison with the iPad, 4 hours vs. 10 hours (per manufacturers reports).  To me – this means I’d have to lug the C5 around all day, stopping probably twice on the average day to charge up. And while the fact that it can run Windows 7 is key for compatibility and widespread adoption, there is a reason the iPhone has been so incredibly successful. Its user-interface and enormous developer community make it a far more versatile and easier to use medium than a Windows-based product can be. Finally, the $2,000+ price tag on the C5 makes it a large investment for even a suburban dermatology practice, let alone cash-strapped hospitals and private primary care practices.

So is the healthcare tablet market ripe for an iPad sweep or do the entrenched players already have the market cornered? Frankly, I can’t predict the future. On the one hand, the C5 has most of the features I’d want in a tablet. However, it also has a few things I don’t want, especially an eye-popping price-tag. And while the iPad really wallops the C5 on those weaknesses, it doesn’t come close to approaching its strengths. Honestly, I don’t think either tablet really fits the bill for what healthcare needs. But I’m excited Apple has entered this market, not because I think the iPad will become the dominant tablet, but because I want to see this fight. Apple’s record of innovation are likely to spur unprecedented competition in the healthcare tablet arena – and that kind of competition is almost always good for the consumer.

With Apple’s soon to be released iPad re-energizing the tablet market, there has been much speculation on how the tablet will transform personal computing.  However, the tablet has been with us for quite some time. Almost a decade ago, I started testing and using Windows-based Tablet PCs for two cancer centers in Canada. They worked pretty well for what we were trying to do back then, but had definite limitations within the healthcare environment. If Apple’s iPad is to survive in healthcare, let alone transform it, then there are five key deficits Apple must address.

1) Input Method(s) and User Interface

This is the most crucial area and where the most problems arise.  For the tablet to be accepted by the healthcare community, versatility is the key. The basic input methods such as a touch screen (or pen based), keyboard (or lack of keyboard) and handwriting recognition accuracy need to be revamped and revolutionized. True, all of these features exist in today’s tablets, but they have yet to be implemented in the most effective and user friendly method.

In order to be transformative, the iPad will need to include inputs that consider the workflows and usages in healthcare. For example, consider input methods such as voice recognition and audio input (think transcription and also patient voice recording), photo/video capabilities (think user recognition, but also photos for wound care or tracking skin infections), and even the option for additional “medical stuff”, presumably through accessory hardware such as measurement of temperature or blood pressure. Such considerations would allow the iPad to be integrated in the clinical field in ways previous tablets were not.  A further discussion of the robust user interface the Apple Tablet operating system could bring was discussed in a previous post.

2) Look and Feel

For the most part, tablets used in the medical world have been too heavy and are often not built with enough toughness.  It might seem frivolous, but there are good reasons why a tablet has to look and feel right in a healthcare setting. Prior to computers, patients had the undivided attention of their physicians.  Now, with the advent of mobile computing and tablets,  a consistent complaint from patients is the lack of eye contact physicians make because of the computer screen they are staring at.  This is why the weight, look, and feel of a tablet is so key in the health care setting.  The more comfortable a physician is with their tablet, the less time they spend dividing their attention between the patient and the computer, allowing for a more seamless patient-physician interaction.

3) Battery Capacity

The battery on a typical tablet used in the health care setting needs to last long enough to get through an entire shift, which can be anywhere from 8 to 12 hours. Currently there are health care tablets available that can get close to 12 hours, but with repeated use this number significantly declines.

The battery issue might be the most interesting issue the health care community might have to consider with the Apple Tablet.  Apple is notorious for having non-removable batteries in their products.  The iPhone, iPod Touch, and even the newest MacBooks do not have removable batteries.  Apple claims they use high end batteries that lose capacity much slower than their competitors, this was their reasoning when they took out removable batteries from the latest Macbook.  If Apple decides not to include a removable battery in their tablet, it could be a huge blow in their efforts to be embraced by the healthcare community.

4) Privacy and Security

One of the great features healthcare tablets offer is their portability, but this same portability makes them targets for theft.  General physical security needs to be built into the device.  Also, software and hardware based privacy and security measures need to be options in healthcare tablets as well. Currently no manufacturer has yet to master these in full. Without getting overly technical, some examples include user recognition (e.g. finger print, retina, face, voice), patient verification, data encryption over wireless connections, remote data storage, and auto-log off features. In a HIPAA-dominated healthcare world, these features will be critical to widespread adoption.

5) Cost

Cost is always a central issue in health care.  But today’s healthcare tablet’s are generally priced greater than most high end notebooks, which works in Apple’s favor.  Current projections have the Apple tablet hitting the $1,000 price point.  If this is true, the healthcare industry might actually find using the Apple Tablet is a cost saving proposition, which usually isn’t the case when Apple products are in play. However, it will also be important to consider emerging competitors who may price lower than Apple, with some reports suggesting prices as low as $200.

If some of these issues are addressed on Wednesday, Apple might actually be a legitimate player in the healthcare tablet arena.  I’ll report back later this week to let you know.

Iltifat Husain and Satish Misra contributed to this post

As the debut of the iPad fast approaches, speculation about it is reaching a fevered pitch. Scanning the thousands of articles written about the iPad’s potential, one may walk away thinking that Steve Jobs has just cured cancer, ended global warming, and established peace in the Middle East. Some people are even calling Apple’s latest creation the “Jesus tablet.” While the iPad probably falls somewhere short of some of those lofty projections, it has already done what Apple seems to do best – transformed the way we look at an existing market, in this case mobile computing and the tablet. We’ve talked previously about how the iPhone paved the way for the iPad in healthcare. Again, Apple’s entry into this market has signaled a huge shift in the way users will interact with the tablet and, through it, their environment.  This new user interface has a great deal of potential to change the way physicians deliver care. But perhaps more importantly, it could also have profound impacts on the way patients experience healthcare.

Innovative therapies

Over the past decade, there have been a number of examples of novel technologies being used either therapeutically for sick patients or in preventative care. For example, there have been numerous trials, with more success in the pediatric population, that use text messaging to remind patients to take their medications. When the iPhone transformed the user interface for the smartphone, therapies centered on that platform also emerged – autism and major depression are two conditions with iPhone apps that are therapeutic in nature. Enter the iPad. With a more advanced touchscreen, a high-quality webcam, and perhaps even 3d graphics, the possibilities become far more rich.

Take children with cancer – these kids can be hospitalized for weeks at a time and, due to the chemotherapy, stuck largely in isolation for most of that time. An app that utilizes the webcam to connect kids while playing a fun and interactive game together would provide a far richer interaction than a networked gaming console. Or consider the numerous elderly patients who succumb to delirium while in the hospital largely because, on top of being sick, life in the hospital, void of sunlight and normal sleep-wake patterns, gets so disorienting. Consider an app that, much like the mentally challenging games on the Nintendo DS, helps older patients stay a little more active during the day and perhaps ward of delirium. Will the iPad cure cancer or, for that matter, anything? No. But what it will do is provide some interesting and creative adjuncts to standard therapy that could make the patient’s quality of life a little better.

Improved patient-provider communication

In the ever growing iPhone app store, educational apps are among the most numerous. One of the biggest reasons why is because the interface allows user to interact with the material in a number of different ways. Take the Blausen Human Atlas or Pocket Heart – both of these apps allow the user to interact with anatomy in an incredibly rich way. With much more powerful graphics capabilities, these kinds of apps can certainly be taken to another level.

Consider a patient going into surgery. Today, explanation of the surgery is restricted to some form of charades by the surgeon and 2d radiology images. An app that allows 3d reconstructions of a patient’s scans to be pulled onto the iPad and manipulated would allow for a far better explanation, improving patient-physician communication. Or how about the diabetic patients or the heart failure patients? These poor folks are often subjected to hours of mind-numbing “educational” videos in the hospital – iPad apps could bring an element of interactivity that allows patients to engage with material that is critical to their health. Finally, consider the stroke patient. There are rumors that the iPad’s camera will be sufficiently sensitive to allow facial recognition. Perhaps then it could also be used to detect facial, or for that matter limb and trunk, motion with apps designed for post-stroke rehabilitation therapy. In a “game” format, individual goals outside of professional physical therapy could help empower the patient as they fight to recover.

The key opportunity that the iPad offers here is not just another platform to convey information, but a way to make it fun and engaging. While the iPad won’t replace a good physician taking the time to talk to a patient, it could certainly augment the patient-provider relationship in a fun and engaging way.

These are just a few ways that the iPad could transform the way a patient understands their illness and interacts with their healthcare providers. Among the most elusive goals in medicine is helping patients understand complex diseases and empower them to manage these conditions. Nothing will ever replace a strong patient-provider relationship, a personal support network, and evidence-based therapies based on a thorough scientific foundation. But the iPad could herald the introduction of innovative adjuncts that help patients take control of their own health and improve their quality of life.

The rumor mill keeps on churning with the soon to be released Apple Tablet, and now the medical community is supposedly involved.  According to an article by VentureBeat, Apple Reps have been talking to the Los Angeles Cedars – Sinai Medical Center about the potential of an Apple Tablet for medical professionals.

The article goes on to mention one of the reasons why tablets haven’t been universally embraced by medical professionals:

We’ve been told for years that medical professionals were the guaranteed-to-succeed market for tablets. Bill Gates raved about his in 2006. But tablets like the Dell Latitude XT2 XFR, pictured above, have stiffed again and again, in part because of their ungainly laptop-with-a-backwards-facing-display design.

I’ve mentioned in a previous post why the Apple Table could be a huge success in the medical industry, and it’s not because of form factor.  I can’t emphasize this enough.  There is this idea in the tech community that bulky tablets are why you don’t see medical providers using tablets for electronic medical records.  This couldn’t be further from the truth.  In my previous post I talk about how the User Interface of potential Electronic Medical Records in a native Operating System made by Apple would be one of the keys to success.

A nice looking tablet PC for medical professionals is already available.  The Motion C5 is viewed as a great Tablet for medical professionals, it’s a clipboard like computer that has an RFID reader, photo capability, and other nice features.  Basically, its a slim tablet with a nice form factor.

One of the largest barriers holding back medical tablet PC’s are the hundreds of iterations of Electronic Medical Records(EMR) that are too complicated and not easy to use.  The User Interface and workflow on the EMR software is certainly functional, but not fun to use.  One would think an EMR program that has the Apple touch would be significantly more aesthetically pleasing, easy to use, and functional at the same time.  All qualities Apple is famous for.

I doubt Apple is going to be designing these EMR programs, but at the same time, we’ve seen how controlling Apple is about software running on its devices (think App Store).  I wouldn’t be surprised if Apple leveraged their hardware to force EMR companies to design better software in tune with Apple’s core principals. Surprisingly, Apple’s desire for control might actually help with the progression of electronic medical records. In the upcoming weeks this is a topic we’ll discuss in detail to a greater length.

Rumors of an Apple tablet have been all over the place during the past few weeks. Although Apple is notorious for pulling off clandestine product launches, the consensus appears to be that Apple will launch a tablet early next year. With the $19 billion dollars from the stimulus package set aside exclusively for electronic medical records, it would make business sense for Apple to venture into making tablets that can be used for electronic medical records. So then hypothetically, if we get an Apple tablet in 2010, will it really be used by the healthcare world? Everyone seems to be talking about how great an Apple tablet would be for the medical community, but few are talking about if it would actually be used.

In almost every keynote related to the iPhone, Apple has embraced the medical community and set aside time to show how its platform can be used in healthcare. The same can’t be said for other mobile technologies, such as Windows Mobile and the current reincarnation of Palm. Palm was a leader in portable medical technology and their old PDA’s continue to be used by healthcare providers. Their fall in the medical tech world can largely be attributed to their history of lackluster phones. The current Palm-Pre, a beautiful device, leaves much to be desired from when it comes to medical technology. There was a recent study stating six out of ten doctors prefer iPhones. Although this wasn’t a super-scientific survey, we’ve all seen a huge increase in the doctors and providers using the iPhone in the clinic.

This preference for the iPhone is largely due to it’s beautiful UI and ease of use. I’ve had plenty of colleagues pick up my iPhone and intuitively use the medical applications I have. Quite literally, the iPhone makes the medical technology experience fun again. This experience isn’t exclusive to the iPhone, but also with the iPod Touch. Both devices are great to hold and look at, but it’s not the hardware that makes the device exciting, it’s the software. This experience gives the iPhone a great brand name in the medical community, even to those who don’t use the phone.

I think the brand name and the fun experience the current iPhone operating system provides will be the key to the tablet’s success. Using electronic medical records definitely saves me time, but the different platforms I’ve used can be cumbersome and sometimes I feel like I’m using a program developed for Windows 3.0. Overall, it’s an efficient experience, but not a fun one. Can you imagine selling a electronic medical record to a physician who has exclusively used Windows operating systems? If they don’t like change, as many physicians are notorious for, this would be a difficult task. In the medical community the iPhone is associated with fun and innovation, two things that will get physicians like the one I mentioned excited about change. The iPhone’s Operating System has bridged the gap between PC and Apple, and it’s going to be interesting to see how the tablet will be used once the stimulus money really gets rolling in 2010. I’ll venture to guess the tablet will actually help with the implementation of electronic medical records because of the excitement it’ll bring.