Healthcare Tablet Computing

In my mind, I envision a time where patients enter health care facilities and are not asked where charts and other paper items are. They are presented with an iPad that has been customized with their records for use while they are staying for service (in patient or out patient). If they are having tests or this happens to be a standard visit, the Doctor or Practitioner will use the iPad to record vital signs and results. Once the results are stored on the device they will be electronically synced to the central server in the facility. This ensures that no data is lost in the process and things are kept up to date.

This model would be beneficial to surgeons since they would be able to access scans on demand from the system and would not have to wait for copies to be created. Nurses and other staff would have a universal method of data entry and the back end EPR's (Electronic Patient Records) would be consistent. It would also save money in training once it was developed. The popularity of the iPad means that more people would either be more comfortable using it or be more apt to try it.

On the back side of things development will have to be ongoing to get this off the ground and to keep it running. Who will pay for the first install of these?  My thoughts might be Apple® itself. The proof of concept could open doors not before opened and allow access that is unprecedented. This is simply my overview wishlist, but given what the iPad has done so far, there is definitely more to come.

A little background before I post this interview. This participant has been a consumer of IT products and services but does not work in the industry. She has had previous experience in Healthcare, but on the administrative side of things.

Name:   Shequila N. Jacobs

Position / Role:   Financial Analyst, Organization Development Consultant

Industry:  Government & Non-Profit

Years Experience in technology:  12

Prior to the Apple iPad what were your feelings about the future of the tablet computing marketplace as a whole?

Slowly being integrated into the mainstream, but not very sophisticated.  People appeared to be pensive to jump on the trend. 

Where do you think the industry was headed?

Nowhere, I believe it was moving forward, but not steadily or rapidly.

After the iPad?  (Better, worse, explain)

   The industry has exploded with possibilities because it has nade the technology available to more people and is opening minds to the possiblilities and opportunities available in various sectors, particularly in the area of health care administration.

In the marketplace of tablet computing in healthcare which direction do you think things are headed?

I believe that healthcare will be adopting as many tools as possible to eliminate errors, increase quality and build efficiencies in service delivery particularly with all of the federal mandates pertainign to electronic health records. The evolution of the tablet technology would be extremely helpful and could eventually serve as a get tool for mobile research for healthcare profesionals, expanding knowledge and options while building a better long range consistency

Is the market trending up?

I believe so, as the technology required to meet the need in the healthcare industry is mandatory and immediate.  In order to meet the benchmarks for mandated outcomes, it is becoming essential to move technology forward at warped speeds.

With the development of apps for the iPad do you feel developers will make a decent attempt to break into the computing marketplace in healthcare?

Only if the incentive is available for development in the applicable areas (i.e., increased profits, tax breaks/incentives, worker and/or patient satification) or the results of such applications are mandated.

If a sizable effort was made to develop an end to end solution for healthcare with iPad integration do you feel it would be adopted?

I would reiterate my previous response, but would add that a truly integrated hands-on training process woudl be essential for true adoption of the process both for those who are adverse to ANY technology at all or to those who shun any new types of technology.

I decided with the next few posts to get some feedback from users of technology. Please read the interview below.


Name: Ross McKenzie

Position / Role: (IT Evangelist, Apple Supporter....) IT Director

Years Experience in technology: 20+

Prior to the Apple iPad what were your feelings about the future of the tablet computing marketplace as a whole? 


I have never been a proponent of tablet computing mainly due to what I considered a poor visual interface. Tablet screens have been hard to read and hard to manipulate from the beginning with little, if any, improvement over the years.

   Where do you think the industry was headed? 


I think the use for tablets would have stayed in niche industries for years had he iPad not come along.

   After the iPad?  (Better, worse, explain) 


Much better. The iPad is a clear, crisp screen with very easy to use movements that far surpasses the previous tablets and  is incredibly easy to use.

In the marketplace of tablet computing in healthcare which direction do you think things are headed?


 A connected tablet device is really the future of computing - it's less imposing that a laptop and more inclined to be used for specific clinical, reporting, etc applications.


Is the market trending up? 


I think Apple's release sales figures for the iPad speak for themselves. This is more that Apple fans purchasing the iPad.


With the development of apps for the iPad do you feel developers will make a decent attempt to break into the computing marketplace in healthcare? 


I think it will be the other eay around in the long run - healthcare providers will be developing for the iPad rather than iPad developers going into HealthCare for real productivity tools.


If a sizable effort was made to develop an end to end solution for healthcare with iPad integration do you feel it would be adopted? 


Yes I do. Many of the tools are in pace for surveying, reporting, etc. What's needed is a strategic direction and some investment and this could certainly be feasible.

In just a few weeks the market has been encouraged by the iPad and Healthcare developments.

In a quick google search I got over 11 Million Hits for the two words IPad and Healthcare.





Take a look at the following links.


iPad 3G Arrives: Should the Medical World Care? Yes!

Life as a Healthcare CIO

Science Roll : Pros and Cons

Medical Health Leaders

MedGadget: Roundup

Washington Post: Apple Just May Revolutionize Medicine

I have been thinking pretty hard on this topic and I decided to put together a fact or fiction list in order to better explain my thoughts on the iPad in Healthcare. The next post will have some links to other articles and information.

Fact OR Fiction?

1. The iPad is by itself a revolutionary device for Healthcare
  - Fiction.
While the device may be very revolutionary in its approach to communication, interface and overall usage, it is not able to stand on its own without developer support and adoption.

2. Healthcare is ready for this device
- Fact.
The overall move in the healthcare industry today is moving towards: better, faster, more efficient, and more technological care. Gone are the days where a patients chart can turn up missing. That simply is not acceptable. The government is putting millions into developing more robust systems to get the US back on track and to level the playing field when it comes to healthcare delivery across the world. The iPad with the correct support could really take things to another level.


3. Since some Universities have programs where every student gets an iPhone or iPod touch when entering, an iPad for every doc and hospital worker be accepted as well.
- Fiction (for right now)
   This could change soon. The fear here is that an institution spends the ~20 or $30,000 needed to pilot this and they turn out to be the beta video players of today's time period. While I highly doubt that is the case, people are extremely fearful of mis-investing in technology that may not yield the dividends or results that they need.

4. With the proper developer support this is a no brainer for healthcare
- Fiction.
No new technology is the slam dunk solution people want to see. There are always issues to be resolved and testing needed. The hurdle the iPad will have to face is the Apple moniker that it isn't built for enterprise or business. Perception of this as a non business centric tool will hurt early adoption, but more robust security, better backend deployment support, and a large development community will put it on the right track.

5. This is the future of Healthcare
- Fact.
While this particular iteration may not change the game it dynamically adjusts our perspective. What I like about technology like this is that it pushes the entire market. People that would have never been drawn to a tablet want to see it. Which means more manufacturers will make "iPadesque" devices. Those devices will encourage developers and programs to build specific applications and the cycle starts. Hardware development drives software development which encourages use and implementation which draw more hardware development.

Healthcare will drastically change in the near future. While I may love to see my former pediatrician out at Walmart when I visit that part of town, that is not going to be feasible soon. Doctors provide a service to their patients and with the number of patients increasing much faster than the number of Doctors, something has to give. Technology will be the elastic that keeps this going. Tablet technology will help frame the interface in which we move forward.

Please look at the following video it shows some additional functionality of iPad




This POS system touches on a soup to nuts approach to dining with an iPad and my thoughts are that systems like this will really start to show possibility in numerous markets.

Thanks TUAW.....

The above trailer is from the movie field of dreams. The basic premise is that Kevin Costner's character is driven to build a baseball field in the middle of a corn field, in hopes that people or rather "they" will come.

I felt that this trailer was appropriate for the blog for this reason. Right now infrastructure is being built to allow for major changes in the healthcare tablet computing marketplace. Once the groundwork is built will they (people) use it. That is a very interesting question that I will attempt to start answering here.

Access is a big deal. This relates to the ease of access to devices and systems by those that will use it. If a system is easy to use, but there is one terminal for 100 people, no one will be able to use it. It is imperative that enough are available for those to use it.

Is it Cool???? This is a very loaded question. One would argue that it does not matter if its cool or not, but when it comes to technology as of late the cool factor is one that really matters. For example Oprah, who happens to drive sales and use of almost anything she touches previously supported the Amazon Kindle device. She recently supported the iPad and talked of its great virtues. This will do nothing but bolster the sales and hype of the device. While some would argue that its a quip against Amazon and the Kindle, and great for Apple, it is much more than that. There is this theory in Hollywood that good or bad, publicity is still publicity. As long as they are talking about you its a good thing.

In terms of tablet computing as a whole the more they talk about any device the better everyone is in the end. As the public moves forward with the hype and buzz around the new iPad all it will take is another player to introduce something on the heels of the iPad to keep the buzz going.

Is it easy to use is another question that must be considered as well. There will be more than enough training needed for the systems to be successful, but at first glance can most people get how they are supposed to use it. That seems like a very trivial question, but it goes a long long way to gaining acceptance and then further adoption amongst those that will need to use it.

For example, I have a friend that was anti-iPhone from the day I received mine (first generation 3 years ago). He was so pro Windows Mobile, that he never really considered the iPhone as a viable option for him or his family. With each iteration that the iPhone went through he had more questions for me about if it could do X, or how was Y done, and what about A, B, and C. Eventually all of his questions were answered and when he saw just the sheer ease of use and the potential he not only bought one for himself last summer, he bought one for his wife as well. This is a huge testament to the interface and cool factor of the device, but mostly due to its ease of use. Had the device been difficult to use, he would have never considered it for his wife, and would have been much more hesitant to get one for himself.

As the infrastructure continues to be built and new items are released, if they can focus on the three questions that are posed above users will be willing to give it a shot. If they can focus on these three along with the questions that will be posed in the next post healthcare tablet computing will be the next big thing.

This spring Healthcare reform passed in the US and numerous changes were proposed and accepted. The reform document was 2500 pages long and detailed many sweeping changes in the delivery and provision of healthcare for Americans for now and for years to come. One huge resounding benefit from Healthcare reform was that IT would be a huge expenditure for years to come. For many people that is not such a big deal, but for those that are in IT its wonderful news.

Many people feel that healthcare in this country is lacking from a technological standpoint. The way that delivery is done is far behind those of other countries, and each day that sweeping change is not made we are falling further behind. Back in February US Department of Health and Human Services (HHS) awarded 760 Million Dollars to jumpstart better service delivery in Healthcare IT. This is a huge step forward. What the awards provide is the background and training needed for the impending implementation of electronic patient records to better align the US with the rest of the world in delivery of Healthcare services. This was followed by The Senate Special Committee on Aging conducting a hearing last week (April 22, 2010) on the impact of Healthcare impacts from a National Broadband Network.

These two steps are just the tip of the iceberg for where things will go in the US over the next few years. When President Obama mentioned in his state of the union address this spring, his mention of budget cuts touched most parts of government except for spending related to the war, Healthcare (HHS), and Social Security (SSA). The direct result of that statement combined with Healthcare reform means that IT in and around Healthcare in the US is about to be a huge topic for years to come.

You might ask how this impacts tablet computing within Healthcare. In looking back in time, people are very slow to adopt new things unless there is money to do so and the push from the right people to make it so. In many cases mandates or standards have always pushed things forward. That argument will bode very well for tablet computing in Healthcare along with the other technological changes due to Healthcare in this country.  NIST, the National Institutes for Standards and Technology, have released information concerning and project to develop standards to ease the implementation of advanced Health IT projects. This will provide many with the framework needed to make this IT based Healthcare future a reality.

The impact for tablet computing is both direct and indirect. When people are asked to make change, or rather forced to change they very rarely do it halfway. They typically implement the best and latest technology implementations to allow for fewer updates as time goes on. For example, when Hopkins went to implement SAP to replace its aging paper based product, they didn't install an older version of SAP, they installed the latest and most up to date. This provides for a better training ground as well as one that fosters adoption across the enterprise. If an organization decides to implement partial change rather than sweeping change, there tends to be a push from some users and clients and even management to revert back to the old systems, rather than learning something new. This can be catastrophic for future development, which is often why this method is not done often. The indirect result is that tablet computing is a well established option when implementing Healthcare IT projects. It serves as a vehicle to better bolster and support the EPR requirements and is easy to deploy.

The direct result is that tablets will be pushed to the next level from this increased interest. The iPad was mentioned in the first post and will be touched on here and in future entries as well. While this device was not designed directly for Healthcare implementations, it has the interest from both the public and private sectors as well as the public as a whole to be a serious game changer. This will allow other vendors to benefit from the interest and hop along for the ride.

The next entry will touch on this and other ideas relating to overall infrastructure changes and how adoption can be better supported and handled when change happens in Healthcare IT and computing as a whole.


Also, take a look at this link, the HHS AHRQ (Agency for Healthcare Research and Quality) has a twitter feed that updates regularly relating to interesting Healthcare related news.

Motion Computing is an industry leader in the tablet computing marketplace. They were founded back in 2001 and have helped to develop the marketplace for tablet computing in Industrial Environments. They specialize in 8 main areas including: Healthcare, Field Service, Government, Construction, Manufacturing, Point of Sale, Hospitality, and Education.

The Texas based company has had a good relationship with the healthcare industry and has helped to develop the current tablet infrastructure and over the last decade has become the go to company for healthcare tablet options. I work for Johns Hopkins University and the use of tablets in my environments is very light. On the contrary within the Hopkins Medical Institution (JHMI) tablets have been used for many purposes. Motion computing units were seen throughout the environment when I made visits to Hopkins Medicine, and were used for not only data entry but also to interface with many different types of medical equipment.




















The above examples of the screen captures from the Motion site show some of their latest creations for the healthcare environment. The C5 is a ruggedized tablet that is carried above by the healthcare worker that can use it to replace paper and pen based charts that are used for recording information. The MCW is the upright computer work station (cart) that interfaces with the C5 and other equipment.

The workflow for these two products would allow for a worker to take the tablet to a bedside, record all of the necessary vital signs and information from a particular patient and then wirelessly send that information to the EPR (electronic patient records) that are used in the healthcare environment. This digital workflow allows for more accurate patient record keeping and faster response times when performing these tasks. Historically workers had to record all this information by hand, then transcribe it to a computer via a keyboard and mouse and the hospital or other healthcare provider was responsible for keeping cabinets and cabinets full of paper for years to ensure all the records were available.

Motion also utilizes its own backend EPR systems to interface with their hardware solutions. This approach with an encompassing solution to provide the front end (hardware and software) and backend (EPR databases and servers) allows them to be a very attractive solution in healthcare.

I have used motion tablets and found them to be very reliable. My last experience was with a 3 year old unit. Personally I was concerned with how sturdy the tablets would be when used in a fast paced hospital. What would happen if they fell or were dropped or submerged in fluids? Motion answered that when they introduced ruggedized units that withstand drops and falls and are water resistant. This has allowed them to be used not only in local healthcare, but also around the world in numerous installations.

Look at this link for information about the various partnerships Motion has been able to establish with current healthcare service providers.

Motion computing products are not the only solution in the healthcare tablet marketplace, they just happen to be the current industry leader. As time moves on other partners will be able to come into the fray as well. The next entry will look in further detail at the push that local and national agencies are providing to tablet computing and other computing products in the healthcare industry.

The choice to cover tablet computing was very easy for me. I have always had a very interesting relationship with the tablet computing form factor since college (~2000). Since that time the tablet form factor has changed significantly.

The first tablet I ever experienced was an HP convertible (convertertible because it could be setup like a traditional laptop and then folded / contorted to appear like a screen only tablet as well) very similar to the one pictured here. This machine was given to students studying mechanical engineering at MIT so that they were able to better design elements of their engines for an applied project. At that time I was able to use tablets that friends obtained through the project, but often the issues I encountered then back in 2000 continue today. Those issues are: speed, performance, interface, and reliability. I wanted the table to be more than it was able to be back then. I tried the pen interface and handwriting recognition, but often got frustrated with its ability to discern what I wrote effectively. Also the necessity of carrying and using both a pen and a keyboard got frustrating for me as well. So soon after using the full laptop tablets I resorted to the PDA devices that were much more common at the time.

Moving forward 5 - 6 years, my experience with computers expanded as did the tablet computing options. At this time the idea of UMPC, or the Ultra Mobile PC, became very prevalent. I researched this topic for a paper written while at Johns Hopkins University that I will post excerpts from later in PDF format to the blog that will show how the early UMPC's were nothing more than smaller tablet PCs. The UMPC was to be the next big thing in computing, but unfortunately it never took off. It never gained the foothold in the industry needed to garner support and widespread distribution. One website, UMPC Portal, still operates and is able to offer those interested in UMPCs information and places where they can be purchased and upgraded.

Currently tablet computing is really big. It seems to get larger daily and with the recent introduction of the iPad from Apple it will only get larger. A quick Google search revealed 7.2 Million entries for tablet computing when searched and the iPad was the first device mentioned.

So here is where the real question gets asked. Why Healthcare Tablet Computing? Well the answer to that is not that simple. The Healthcare industry as a whole is in a great transition currently. When looking at what has just happened in Washington concerning Healthcare reform, much more integration of technology is required for the future. Tablets and other devices will play a large role in this transition and I felt that this topic should be covered in much more detail than it is currently.

This blog will examine the current trends in healthcare computing related to tablets, and what the future could and should be.