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.

We all know that AT&T has been having issues with their telecommunications network since the inception of the iPhone.  The NY Times did a great piece on the 3G woes and how the public finger pointing between AT&T and Apple has exposed some serious problems with their partnership – the funny thing is, the article is 2 years old yet still holds true today.  It seems AT&T was not prepared for the surge in usage brought by the iPhone, a phone that guzzles data and network resources much like a Humvee uses gasoline.  So its wasn’t surprising that the reaction was less than warm when Steve Jobs announced AT&T had once again won exclusive rights to the data plans for an Apple product, this time the iPad [it was the only time during his presentation when the audience actually jeered him].

And now, the FCC is expressing concerns the iPad, of which there could be millions on the AT&T network, could overwhelm the existing infrastructure. Two high profile FCC officials, Phil Bellaria, Director of Scenario Planning, and John Leibovitz, Deputy Chief of the Wireless Telecommunications Bureau had the following to say on their blog:

Widespread use of smartphones, 3G-enabled netbooks, and now, perhaps, the iPad and its competitors demonstrate that wireless broadband will be a hugely important part of the broadband ecosystem as we move ahead….With the iPad pointing to even greater demand for mobile broadband on the horizon, we must ensure that network congestion doesn’t choke off a service that consumers clearly find so appealing or frustrate mobile broadband’s ability to keep us competitive in the global broadband economy.

This isn’t necessarily a deal-breaker for every healthcare provider. Hospitals and health systems, for example, generally rely on local Wi-Fi networks through which a mobile device could access an EMR. The providers for whom this is more likely to be an issue are the private physicians and physician extenders (physician assistants and nurse practitioners) who work in multiple hospitals, surgery centers, nursing homes, and so on. These providers are more likely to rely on a commercial data network to access their own clinic’s EMR when, say, doing a bronchoscopy on a patient at an outpatient surgery center or on-call for a nursing home. For them, slow or absent connectivity even 1% of the time is unacceptable.

This issue is certainly not intrinsic to the iPad – it’s an effect of Apple’s relationship with AT&T. And AT&T has recognized this problem and is moving to improve its infrastructure. But time is not on Apple’s side. Lenovo, HP, and numerous other vendors are releasing new tablets at a dizzying pace with a range of features and prices. And the healthcare community is certainly looking closely at tablets right now, as various EMRs are being adopted by healthcare providers across the country. So now is the time for tablet vendors to reach out to the medical community. And carrying the baggage of an unreliable data network is certainly going to be a strike against any tablet hoping to gain traction in the medical community.