Apple iPad EMR

The hype over the new Apple iPad has been really interesting to watch. You can’t even buy one and everyone under the sun is speculating on how well the Apple iPad will do. Everything from it changing the netbook space to Grandma’s first computer being an iPad to the iPad as a gaming machine.

I’m certain that the iPad is going to be a huge gaming machine. The question I have is will the iPad be a game changer in the EMR world.

For those of you not living in the tech bubble that I live in, the iPad is most simply described as an iPhone with a much larger screen. Now I’m sure the purist out there might point out some other differences, but that’s kind of beside the point. The touch input method is the same as the iPhone and it also uses the cell towers to connect to the internet. It also runs the iPhone OS including all of the apps that have been created for the iPhone.

Back to the original question, will the iPad be a game changer for EMR. My prediction is that we really won’t see many iPad’s in healthcare much at all. Sure, there will be one here or there, but it won’t be widespread and we won’t see an “iPad EMR” that was designed to leverage the interface and technology of the iPad.

So, why would I even bring it up? Well, I don’t see the iPad EMR coming to fruition I do see the input technology that’s in the iPad and that will come out of the iPad having an effect on future input interfaces. Apple’s making a huge bet on touch interfaces with the iPad. the adpoption of touch interfaces and the technology that comes out of it is likely to have a huge influence on future EMR interfaces.

One of the biggest complaints doctors have about the various EMR systems is the challenge of inputting the data. Don’t be surprised if the future EMR input methods are heavily influenced by the introduction of the iPad and the technologies that develop around it.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

47 Comments

  • I would agree with you, John. Although a nice thought, apple did what it always did, and play up to the mass of Apple fanatics and most likely they will be main audience here.
    I think however, its technology will drive others to move in this direction and possibly be the link to making tablet computing as logical and effective as we all believe it should be.

    My main gripe with the Ipad is due to the drive space limitations and its lack of built in phone / 3G capabilities. It would be one more item I would have to lug around without the opportunity to eliminate one. I also think it is apparent that the reason they didn’t build in 3g wireless is due to the poor performance of ATT and they were afraid to commit to them with this project.

    As far as integration into EMR, I am guessing its connect-ability would be limited to web based systems as I would think most proprietary systems (other than Apple based) wouldn’t take on the additional programming costs to make them work with other OS based systems due to the limited possibility of return.

  • Bill,
    My understanding was that they did have 3G. You just had to pay extra to have the 3G model. The base model doesn’t have it. Plus, they have a monthly pricing plan as opposed to a contract one like the iPhone (and most cell phones).

    I’m sure the space limitations are based on the fact that they want most of the data stored in “the cloud.”

    I agree that EMR vendors that aren’t web based aren’t likely to develop just for the iPad. However, those that already have an iPhone application kind of already have.

  • EMR, EHR for iPad would be ideal…Houston we have a problem…
    1. No hard drive
    2. Memory space
    3. Operating system
    4. Most EMR/IHR if not all at PC base (nationaly and internationaly)
    5. Intergration of labs, radiology, pharmacies etc (all operate – PC)

    I agree the hipe and concept on the iPad will drive PCs to develop there own

  • drjimenez,
    It does have an O/S, memory and hard drive (albeit different ones). Plus, integration with all those outside entities won’t be a problem since they can run on the server or a PC in your office. Doesn’t mean you can’t use an iPad for everything else.

    Most EMR won’t have an iPad interface and quite honestly, most of them shouldn’t. The exception might be the new Epocrates EMR who’s been the leader of that type of device in healthcare for a while. So, it makes sense for them to leverage the iPad as well.

    I still stick with my previous assumption and you that it won’t be a game changer in the EMR world.

  • I can’t help and imagine physicians making rounds at hospitals, hospice, nursing homes, and seeing their patients around the world with devices like the iPad connected or in touch with the patient’s value medical information and ever changing information of medicine.

    Imagine…while actively treating a patient with an Chronic illness and getting pop up message on the iPad informing the Provider there is a cure for their suffering patient…just click here for more information…

  • Dr Jimenez,
    I would love to see the exact picture of what your active imagination has drawn, but I think as with all good stories, this is a fictional tale.

    I realize how attractive these APPLE innovations are, tempting us with having the coolest computer and we get to believe that we will be more productive and its all worth it. ( He writes from his Mac laptop while gazing at his Iphone thinking he needs an upgrade)

    The reality is, that without the proper work-flow processes in place we wont be any more productive/collaborative than we are now.
    Unfortunately I think this will add one more layer of confusion, ultimately keeping all but the technology driven Doctors from making a decision.

    Lets not forget that the underlying purpose for this is to manage information more effectively and for that to happen there needs to be a certain amount of “buy in” from the doctors themselves.
    It almost feels as if vendors/developers just keep throwing new stuff at the doctors waiting to see whats going to motivate them to make a move.
    I personally am frustrated by the fact that I offer a refined customized version of the same online Archive that Media Spiders USA.LLC created for Stericycle’s Online manifest archive, for free. We only charge for scanning indexing and database maintenance, and I am having a difficult time getting Doctors to commit to my services, worried that there is some magical EMR just about to come to market. . This will just make them less likely to progress and keep them in “paralysis through analysis”.

  • Contrary to the PC pundits on this site, I think the iPad is a winner for medicine.

    I am able to use our hospital’s EMR system without any problems (McKesson) and it is a much better device than the Windows boxes scattered throughout the facility. Citrix Receiver (free on the App store) allows secure Remote Desktop Services.

    http://itunes.apple.com/us/app/citrix-receiver-for-ipad/id363501921?mt=8
    http://community.citrix.com/display/xa/Citrix+Receiver+for+iPad

    Multi-Touch is great for selecting items (better than a mouse, especially when on your feet) and typing is easy with the virtual keyboard (and even better with a Bluetooth keyboard).

    Some of the comments don’t make sense. Why do you need a hard drive when the iPad comes with up to 64 GB of storage memory. The operating system is based on UNIX and is very fast, stable and virus-free.

    I can use Skype as a telephone if need be (through the hospital WiFi) and the free Dragon Dictation program works great for short notes.

    Battery life is phenomenal – 10 hours+ and perfect for my long workday in the office and hospital. No Active-X and Flash – two big pluses for iPad!

  • Hmm…I don’t think I’d call myself a PC pundit. Granted, remember that I wrote this post when the iPad was first announced.

    I’m still holding out to see how much typing can be done. Not to mention how it handles check boxes through a Citrix receiver. Add in how well it will handle the rigors of a doctors office (seems like it could fall easily) and the challenge of any touch device to do strong passwords (ie. special characters) and I’ll hold out before making a final judgement.

    Even if the iPad does make big inroads (and I think the method of data entry will make big inroads), you’ll still likely need a number of desktop machines for things like scanning. At least for the forseeable future.

    The Skype feature is pretty interesting and compelling. The battery life is phenomenal. It’s always sad to see how far computers have come and battery life has lagged so far behind, but 10 hours is impressive.

  • True that “underlying purpose for this is to manage information more effectively”

    What will it take for doctors to “buy in” into EMR/EHR
    1. It must be free.
    2. Make the Drug companies pay for it. Here’s how. Instead of have Drug reps coming in. Have the Drug companies place ads, pop ups, invites (click here for samples, accept invite for conferences) it will save the Drug companies millions and will be more effective.
    3. It is well know by 2014 all Provider must have EMR/EHR. So there is still time

    True…did you know Walmart is coming out with EMR/EHR
    http://www.healthcareitnews.com/news/wal-mart-emr-debuts-virginia-illinois-and-georgia

  • Dr Jimenez,

    I apologize for the term “Buy in” I meant it in the context of “believe in” enough to make a move.
    Media Spiders offers our online digital archive software Free to Doctors and I am still not getting many to move forward.
    Granted we address the historical paper records, but I also feel this important section of records retention is being slighted by all the hoopla surrounding full EMR.

    On a side note it was announced this morning on WGN news Chicago, the a lot of people who jumped on the Ipad bandwagon are pretty disappointed in its connectivity problems and the the 3G version is not available yet. the majority of the comments revolved around how useless it is without the connectivity.

  • drjiminez,
    “It is well know by 2014 all Provider must have EMR/EHR”
    Actually, there’s no MUST yet. There’s Medicare penalties if you don’t and there’s a President’s goal to have them, but I’ll be surprised if we reach over 60 adoption by 2014. Now if the insurance companies hop on board and require an EMR, then I’ll change my opinion. Although, I don’t see them ever doing that.

    As Bob said, Practice Fusion does offer a free EMR on the backs of advertising like you described. They have a good team behind them and have made a ton of progress. Definitely one to watch.

    The Walmart EMR stuff is interesting. I’ve been writing about it for the past year. You can read my thoughts on it: http://www.emrandhipaa.com/tag/walmart/

  • I have decided to go with http://www.practicefusion.com. PracticeFusion called today and set up training for 5 providers here at my clinic in Hawaii for free. I contacted the Lab company here (Clinical Labs of Hawaii…largest lab company in Hawaii) and they told me I will be the first provider in in using this EMR/EHR. They reported they will work with me and practicefusion.

    My journey in EMR/EHR has been interesting. After a while it seemed like I was interviewing a bunch of con-men or rip off artist charging outrageous prices for just providing a few templates some programing. It was laughable…It still amazes me that these EMR/EHR just don’t get…Primary care Providers can barely afford the high cost of doing medical business.

    The last guy was the best….He told me I needed a server. I responded…okay…how much is that $ 6000.00. And that was just the beginning. He was eager in hooking me and attempted to show me this magical EMR/EHR. I look at him and said….You guys are just way off base….Any provider who would sign up for any EMR/EHR with up front costs and monthly fees are just setting him or herself up for disaster. It really is all a big joke, but thank god for practicefusion.com

    Dr.Alfonso Jimenez
    American Board of Family Practice
    Fellow, American Academy of Family Physicians
    Former, VP, Chief of Medicine of Hawaii Medical Center-West

  • This thread just shows the tip of the iceberg as to what is going to happen in medicine with the iPad.

    A lot of old school IT Pros and companies won’t know what hit them until it is too late.

    New start ups like Practice Fusion will become the Facebooks and Twitters of medicine.

    Even Allscripts is getting on the bandwagon:

    http://www.allscripts.com/remote/

  • We will make our EHR free if your hospital adopts our EMR. Our strategy is conquer the villages and then the town will fall. Having said that security is a big issue… https is broken when it comes to man in middle attacks and dns spoofing… Wait till Asian hackers get into your data and then ask for ransom like they are doing in several places. Also who should own the data – doctor, hospital or patient. We are targeting patients who travel and have a global perspective. Thanks John for all you comments. BTW http://iphone.mangomed.com a hospital that we beta tested with and with over ten million patient records. If you use MS as a client the hacker owns you!
    Warm Regards
    Azmat Anis

  • Think about this – many more MDs as a percentage use apple products as compared with the general population. We will go with the platform we are most comfortable with, especially if it is a superior product. For this reason, iPad is a winner for EHR/EMR. Most EMR’s are also web-based. This favors iPad.

  • The iPad has been the most revolutionary device Apple has come out with, even more so than the iPhone, based on my unscientific survey at our hospital.

    Almost every doctor I’ve seen wants one and the hospital even bought a half dozen of them to try out (First Apple products bought by our very Microsoft-centric Hospital IT Department!)

  • Tell you what if you have invested in microsoft emr, send me an email and I will make your switch free for the ipad. i.e i will give you a free emr. you would have to demonstrate proof of how much you spent. Also those who don’t like the ipad should consider moving to israel because that’s where it is banned http://biz.yahoo.com/ap/100415/ml_israel_ipad_ban.html?.v=10

    just kidding!

    I think the iPad is best thing since sliced bread and everyone in IT should take this device very seriously!

  • I agree EMR/EHR should only be web base…..No need to buy any hardware…All you you need is a ‘cloud’ in cyberspace to store all your information.

  • drjimenez some food for thought –
    There is still a single point of failure. Let say there is a natural disaster, and there is a network outage. You better have something to work from ! This will happen when you start relying on your computer’s to provide critical data. Specially in a remote plant or outlying clinic – they need a replicated database running and since you started relying on your emr – it is now gone from being business critical to mission critical.. something that most systems can’t address.

  • Azmat,
    I couldn’t disagree more. We have been up 100% of the time since our inception. We also have the data in 2 different locations so if we are doing maintenance the data is still available.
    I think the trade for in house maintenance versus out side maintenance is less than fair for the doctor.

    A lot of what you are referring to can be avoided by bolstering your procedures around record keeping.

  • Bill,
    I agree with you about manual procedures for record keeping and your uptime capability. And also that the doctor should not have to build an assembly line to drive the car. .i.e. buy servers, ups and scanners for document entry.

    Here’s my view –
    Today’s laptop specially an unix based one call kill, let’s say 200 thousand dollar server with let’s 50GB of storage from say 1995.
    And having a laptop eliminates the need for your UPS for the Server farm. My old company Sun Micro coined the phrase the network is the computer. Well Apple has those network computers. Sun used to have a laptop called tadpole it’s cost was 20,000 dollars. We used to sell expensive pacs workstations. Well you can run pacs client right from your apple laptop.

    Regards,
    Azmat

  • I’m all for the cloud for EMR.

    If you have an ‘office’ server, you have 3 main failure points: 1) the sever and back up; 2) local electric; 3) Internet accessibility.

    Server maintenance and back up is beyond the capabilities of most doctor offices (and there are failures even in larger organizations). Plus the $200,000 up front cost is ridiculous and a big nut to crack.

    Our electric company touts 99% uptime. That means you’ll be out of service about 1 day every three months.

    Internet rarely goes out and is probably the most reliable of the 3.

    Using EMR on the ‘cloud’ essentially solves #1 and #2 (just get a long battery backup for you router and you’ll have 10 hours of use with the iPad).

  • Bob,
    Were most of the purchases of the iPad at the hospital you’re talking about for clinical use or for social/personal use? Basically, I see a lot of them buying these iPads as fun gadgets to play with, but not as many planning to use them for actual clinic uses (beyond the standard Epocrates like program). The question remains in my mind how much the iPad will break out beyond a fun toy.

  • iPads were purchased by the hospital for clinical use. A few of the IT people have them and they are going to make them available for physicians to use as well. Acceptance has been great.

    I have been using an iPad on hospital rounds over the last week. I can log on to the hospital quite easily (they have free WiFi all over) and it has been wonderful to be able to bring up med lists, labs, vitals, notes etc. right in the patient’s room while speaking with them (and not having to go find a chart or unused computer).

    The iPad is great because it has instant on/off sleep, stays signed in (no need to log in repeatedly like I did in the past) and is just as fast as using a desktop computer. Plus, the long battery life (without the constant drain when asleep) is fantastic.

    Bottom line: The iPad is much more than a ‘toy’ and may be one of the best devices around for practicing physicians.

  • Good point on back up. What to do if their is a power failure or network failure.

    I guess go home early…or just go back to paper. I should have back up on hard drive (battery laptap) with blue tooth to battery printer to print on significant medical problems, medications, allergies…this of course will be on temp. situations and hopefully uncommon situations. This should be on some plan set up somewhere in the office…or maybe a program that “NETWORK FAILURE OR POWER FAILURE PLEASE RESORT TO EMERGENCY BACK UP UNTIL SYSTEM IS UP..THANK YOU” (female voice like the one you hear on one those Sci-Fi shows )

  • Just purchased one of the first EHR, EMR, practice management, eprescribing and clearinghouse software that is completely touch and compatible with the ipad from a company called Healthfusion. It is EXACTLY what I had been waiting for and is EXACTLY what I wanted. The ipad and tablets like it are the future or medicine and will replace the old paper charts and the bulky computers in the exam rooms. The only downside is the fact that one cannot print from the ipad yet, thanks for that one Mr. Jobs…

  • Dr. Anonymous,
    I was going to completely disregard your comment as a spammer until you acknowledged at least one bad part of the iPad (it can’t print). Mostly because nothing is perfect (except my wife) and so it’s hard for it to be exactly what you want.

    Since you sound like a reasonable person that just loves the iPad, I’d love to hear the reasons that the iPad is exactly what you want. What features set it apart for you as a doctor?

  • The printing is definitely issue with the ipad however, the efaxing services and internet capabilities it is able to compensate for the shortcomings that is the lacking of the ability to print. The main advantage of the ipad that I have found is that it has eliminated the awkwardness in my patient encounters. Even just the ‘clicking’ noise that the desktop keyboards made during exams made comfortable conversations with my patients very difficult. They would always stop talking while I was typing. I just find that the ipad (and the software) are very intuitive and are infinitely better than the old clipboards we used to carry around before computers and significantly better than the desktops or even the majority of the tablet PCs. It’s amazing to be a doctor today and see all the different technologies and transformations that are occurring. LIke I said, the ipad is far from perfect but it is a ‘one giant leap’ in trying to improve the efficiency in the doctor’s office. Not to mention my patients like fact that I have an ipad, they think I’m very hip now.

  • Couldn’t agree with you more. The software we purchased does e-prescriptions and order entry electronically as well, but printing seems like a pretty basic feature that should have been included in the first place. And thank you John for the pcmag article, I might try to integrate one of their solutions until Apple comes up with a solution of their own. Until then, keep the posts coming!!

  • Dr. Anonymous,
    It’s amazing what a challenge printing actually can be. The number of drivers required is tough and would have likely delayed the roll out of the iPad.

  • Hey Dr. Anonymous,

    That sounds like a cool system — we are finally looking into EHRs now that the regulations are finalized. What’s your speciality, and what state are you practicing in? Did they provide templates in the EHR?

    Thanks,
    John in AZ

Click here to post a comment
   

Categories