Dr. Polack: This is Peter J. Polack, M.D.
with Medical Practice Trends and on our podcast today our guest is Mike Meikle of Hawkthorne
Group, a consulting firm of Richmond, Virginia. Welcome Mike!
Mike Meikle: Thank you Dr. Polack. Dr. Polack: So today we are going to be talking
about ‘Mobile Devices and Apps’ and we were talking earlier about a previous podcast
we had on EMR Hardware, talking about tablet computers and things like that but now-a-days
whenever someone talks about a mobile device or a tablet they are pretty much talking about
an iPad. I guess we know why most people turn to iPads
but what makes the iPad in general, so attractive to physicians?
Mike Meikle: Well besides being sleek and shiny and pretty, one of the main reasons
why physicians have been bringing this into their practice is one, because they were,
as a consumer, attracted to it. And since they were attracted to the interface, all
the applications well within it, it’s form factor and they wanted to bring it to work
and use it because they are very happy with and very pleased with how it worked.
One of the other reasons is physicians, more or less, a lot of them had previous experience
with PC tablets because of the clamshell design or some of the older widgets is where you
could do handwriting recognition – they were very clunky and they are cumbersome and
they had poor battery life and also the applications that were written for them didn’t work so
well because they were originally written for actually desktop PC.
So they are excited to use a tablet that actually functions great and next is, there’s a huge
amount of applications available for healthcare related for an iPad or an iPhone. It’s like
17,000+ and growing every day. So that’s a huge amount of flexibility for healthcare
providers and how they can treat their patients, how they can complete administrative tasks
and a huge amount of productivity available. One of the other great points is that it’s
now sort of become, at least in larger healthcare organizations, now doctors are receiving a
stipend to buy the technology that they want to use to put it on to the corporate network
and most of them are turning toward an iPad device with the stipend. They are still getting
a laptop or a desktop. So it’s an actual incentive to go out and get an i-device, iPad/iPhone.
So that’s also pushing the market forward. Dr. Polack: Now currently, the vast majority
of certified EHR systems are Windows-based or non-Mac. I know there’s a couple of Mac
systems out there but you are not necessarily talking about people who have Mac EMR systems
but just EMR systems in general, who are using an iPad as their end-user device.
Mike Meikle: That’s right and there’s, in some larger organizations, healthcare providers
are addressing the whole issue of non-Mac EMRs working on iPad by using a virtual desktop
infrastructure, and this of course in a considerable sized organization but whoever pushes out
a Windows desktop to your iPad, you can use your EMR on the iPad and then you can log
out of that virtual desktop and back to your iPad’s i-operating system interface. So
that’s one of the ways they are addressing that issue.
Dr. Polack: Well, so I have actually kind of hedged my bets, I mean we have a Windows
Server-based EMR and we have Windows devices but we also have some Apple devices so we
are always looking to see what works best in our particular network infrastructure.
What would be some drawbacks of an iPad? I mean I can think of a couple right off the
bat but I am trying to imagine typing something while you are holding this in one hand.
Mike Meikle: Right. It’s the whole Graphical User Interface or GUI which is great for viewing
but for actually entering data it’s a little dicey, especially if you are starting to do…a
lot of note taking and what not, this is a handwriting recognition which the PC tablets
had, however imperfect, whether or not Apple’s going to deal with that in the near term is
unknown but we can assume they will. But yeah, Graphical User Interface is a problem.
The second issue is that i-devices don’t have a robust security out of the box. You
got to use third-party offering’s kind of still on the security apps and if you don’t
have a concerted effort to make an iPad or iPhone secure then it’s very open for malicious
attacks and for just being generally insecure as a device. You can lay it on a desk without
a pen to lock it out or it saves all of its user names and passwords automatically. So
there’s a lot of issues with that. Dr. Polack: And especially with these recent
HITECH enforcement issues, I would imagine that iPad’s the one gadget in the office
that the doctors don’t want to take home at the end of the day. So it’s even more
critical to make sure it is secured. Mike Meikle: And that ties into ‘oh you’re
encrypting the storage media on the iPad’. Do you have a remote-type capability? Apple
doesn’t support that yet. A lot of these things have to be configured and have to be
considered before you start storing PHI on to an iPad.
Dr. Polack: Besides the iPad, I guess we can talk about some other Smart Phones and other
mobile devices – what do you see some of the future trends in this aspect?
Mike Meikle: Well, Android is making a lot of strides forward. With its upcoming Honeycomb
Tablet computer and Android tablets are also very popular, and also the iPhone and Android
phones are both very popular for applications that are written specifically for them.
Some of these applications that are very popular, something called the ‘Calculate’ or there’s
one called drchrono EMR, there’s iPharmacy, there’s Medscape, there’s Hippocrates,
these are for iPhone or Android, very popular and they are designed for that small form
factor that the iPhone has that you can accomplish the tasks that they are designed for, whereas
like EMRs on say an iPad, they have really not been designed for that form factor.
So doing the pinching and trying to expand the screen and trying to enter data into small
fields is very cumbersome because they were never developed for that. But going forward,
you are going to see a lot more of the i-device and the Android devices making Androids because
they have long battery life, the form factor is great. They don’t weigh very much and
it’s just the overall polished presentation whereas doctors had to kind of labor down,
and ‘let me drag the laptop to the next patient’. They go to the desktop and they
had to login again or okay, this is PC tablet. The battery runs out in three hours and it’s
kind of clunky with the clamshell. So it’s getting a lot of attraction just because of
its form factor alone. Dr. Polack: Very cool, so could you maybe
predict some sort of convergence of technology where these tablets get more sophisticated
and we are able to do more and more things and where basically you are just running on
a wireless network and don’t really have computers, you just have these devices.
Mike Meikle: There’s definitely a lot of prognostication around that topic and basically
with the introduction of the iPad, Apple kind of turned the tablet market on. It was here
before, it’s going to stay, now a lot of acceptance now and everybody wants them because
of the presentation. So we can look forward to seeing tablets and
then even Smart Phones becoming more and more your primary computer, even now with Smart
Phones you can buy what looks like a laptop but there’s no guts to it. You plug your
Smart Phone into it, you open up the cover and it’s the screen and your Smart Phone
is actually a laptop now. It has the keyboard and it has a monitor, and then when you want
to leave, you pull your Smart Phone out of that laptop device and you take it with you.
You can see that probably happening with the iPad adding more functionality like I said,
with handwriting and maybe a larger screen, being able to move the docket into keyboard
and monitor more effectively etc. So you are going to see more and more of that,
especially as computing power gets greater and greater and also even Apple is pushing
the iPad and i-devices as a healthcare productivity-enabling device now. So you’ll definitely see that
in the future, in near future definitely. Dr. Polack: Okay, well thanks very much.
Mike Meikle: Thank you sir, I appreciate it.