iPads Out, “Zero Clients” In As EMR Front Ends At Seattle Children’s

It’s a good thing the IT execs at Seattle Children’s Hospital did a thorough test before they rolled out an iPad front end to their Cerner EMR.  As it turns, out going with the iPad might have been a disaster. In fact, the whole incident begs the question as to whether the iPad works as a browser-based EMR client at all.

As readers know, iPads are very popular with doctors, and many hospitals are considering using iPads as a front door to their EMR system. But in many cases, doctors are finding that the iPad isn’t a great host for desktop-sized applications.

That’s certainly what happened at Seattle Children’s, which trialed iPads with its doctors earlier this fall.  In theory, the hospital was a great fit, as it was in the process of a Citrix virtual desktop infrastructure rollout, an approach which made apps available to any Web-connected device running a browser.

But doctors didn’t like using the iPad to access their EMR. Every doctor who was asked to test out the iPad returned it, saying that it was far too awkward to use, according to CIO magazine. “The EMR apps are unwieldy on the iPad,” CTO Wes Wright told the publication.

And when you think about it, the doctors’ reaction is no surprise. After all, they were using Safari on a small tablet to access apps designed for a 21 inch monitor, an awkward experience at best, notes CIO’s Neil Versel.

So, rather than use iPads as endpoints, the hospital has rolled out 2,600 “zero client” devices from Wyze, mounting the devices on COWs sitting by the patient bedside. (It’s also beta-testing Cisco’s Cius tablets, according to Computerworld.) Seattle Children’s should save $400,000 a year by replacing 70 watt desktops with 7 watt zero clients, Wright projects.

The hospital is consolidating access to the apps on Cisco’s Unified Computing System, and virtualizing access to Cerner using Citrix XenDesktop.

Given the problems doctors face in using the iPad-plus-browser to access EMRs, I do have to wonder so few vendors seem to have developed native iPad applications yet — even giants like Cerner with huge development budgets.

Though I have no proof of this, I get the distinct feeling many vendors would prefer to wait out the current iPad development cycle and see what Meaningful Use brings next before they jump in.  If so, are they stifling the iPad market or just being smart?  What do you think?

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.


  • David Ernst,MD,FAAEM,FACEP • this is the first question from every doc that we encounter…”Does it work on an iPad?” I can’t tell you the number of Motion and other tablets collecting dust in various facilities. The issue is screen size vs data capture volume, not fitting the application to meet a tablet size. there is a mandated ever increasing volume of data necessary to capture during an encounter in the ED and you can either present it large enough to be useful on a tablet which necessitates screen after screen after screen or size it to accomodate more volume on a laptop screen which lessens the need for as many screens. either way, you will hear complaints about the application being too crowded to be useful on a tablet or there being too many screens to scroll through and its not the fault of the application, its the volume of data needed.

  • I agree, it’s pretty ludicrous to fault a tablet for handling desktop apps badly. But as far as I can tell, the hospital wasn’t planning to rewrite the app for the iPad, nor was the vendor. So under those circumstances yes, it had to play nicely on the iPad or be discarded. An unfair test, but seemingly that’s the way it had to go. Does anyone here know of desktop apps that have been nicely ported to the iPad (or any other tablet for that matter)?

  • Why focus on Ipads? There are many vendors of tablets, and to give disproportionate focus to one (probably the most expensive) provider does little to promote competition and reduce implementation costs.

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