Late last month, Apple debuted the iPad Mini. In that short time, the healthcare community is already buzzing about how this new tablet will affect the industry. Physicians traditionally like using Apple devices and have for some time now used iPhones and iPads in practice. With the introduction of a lighter, smaller hybrid between the two, it’s very likely that this tablet could accelerate mobile adoption in the healthcare setting, leading to faster, more efficient and improved physician-patient encounters and care.
In this Q&A, I asked two mobile health experts to weigh in about how the iPad mini could transform healthcare. David Collins, senior director of mHIMSS, the globally-focused mobile initiative offered by HIMSS offers his insights and opinions on the integration of mobile in tablets in healthcare. Dr. Ferdinand Velasco, chief health information officer from Texas Health Resources also shares his predictions for why doctors might prefer a smaller tablet device.
I'm thrilled to have the opportunity to go in-depth with these two healthcare professionals.
1. Please tell us about yourself and your background.
My name is David Collins. I'm senior director, mHIMSS, leading HIMSS effort covering the application of mobile technologies to healthcare. Past roles with HIMSS have included oversight of the Davies Awards of Excellence, identifying best practices in leveraging electronic health records for value, as well as the patient safety/quality initiatives of HIMSS.
I'm Ferdinand Velasco, M.D., vice president, chief health information officer at Texas Health Resources. I lead the system's clinical decision support, medical and nursing informatics, business intelligence and data analytics functions across the continuum of care, including the system-wide electronic health record and also responsible for Texas Health's mobile health strategy.
2. Why the iPad mini vs. the full-size iPad or the iPod touch?
David Collins: The iPad mini offers the ideal amount of real estate. The iPod touch is too small. The full-size iPad is not convenient, (i.e., it is too large to comfortably fit in standard lab-coat pocket).
Dr. Velasco: Form factor. Unlike the full-size iPad, the mini fits into pocket of the doctor's white coat. Its larger screen size relative to the iPhone and iPod touch makes it easier to read, manipulate, and use for data entry.
3. Why the iPad mini vs. less expensive and more flexible Android devices?
David Collins: I would assume two things: 1) The greater number of available apps; 2) The ideal screen real-estate size.
Dr. Velasco: Consistency (one OS platform across all devices), ease of use, quality of health-related applications (more rigorous QA via App Store) and security (less malware than Android devices).
4. Are you concerned about having to take off glove protection so the capacitive screens can react to finger touches?
Dr. Velasco: No. The iPad (or any computing device) is typically not used when performing procedures requiring gloves.
5. How do you recommend proactively dealing with any other potential contagion issues regarding these devices which are carried from room to room and can't be washed with soap and water the way we wash our hands?
Dr. Velasco: The key isn't the device – it's the hands of clinicians handling them. The best protection against contamination is to adhere to conscientious hand hygiene practices before and after patient contact.
6. Please explain what you think the main benefits of using tablets would be, and then, specifically, iOS-based tablets.
David Collins: Tablets provide the flexibility of "instant on", lightweight mobility, and numerous features including camera and video, as well as easy access to social media, email and the Web – not to mention an outstanding pixel display to view images.
Dr. Velasco: The main benefits of tablets are portability and the intuitive user interface. Unlike the laptops (even ultrabooks), tablets are less intrusive in physician-patient interactions. They're also less expensive and can be used for all of the consumer functions that make them popular for general use. The advantages of the iOS tablets include consistency, ease of use, quality of health-related applications and security.
7. What is preventing adoption of these tablets into mainstream physician's offices?
David Collins: This is likely a result of three things: 1) becoming familiar with the technology itself, although very intuitive, 2) integration into the existing IT infrastructure, and 3) privacy and security concerns.
Dr. Velasco: From my perspective, it’s a lack of application support from healthcare software vendors.
8. What will it take to help encourage physicians to bring in these devices?
David Collins: Peer use of the devices can help increase adoption and alleviate many of the concerns that slow down adoption – such as getting comfortable with the technology, integration into existing IT infrastructures and concerns around privacy and security.
Dr. Velasco: Very few physicians need "encouragement" to adopt these devices. Many already have them and are eager to expand their use in clinical practice. What's needed is more support from healthcare software vendors.
9. Are you worried about theft, particularly since so many medical records can be stored on something so small?
Dr. Velasco: This is a legitimate concern, but is not restricted to tablets. The potential for theft underscores the need to have the technical features (e.g., secure mobile device management) and good processes (i.e., not storing unencrypted patient health information on the device) in place.
10. Where should my readers look for more information? For my readers who are in IT health, are there any industry resources you can recommend?
David Collins: www.mhimss.org has great content in both its news and blogs sections and is a good resource for technical information related to mobile health IT.
11. Is there anything I didn't ask, that you'd like to tell our audience?
David Collins: The mHealth Summit next week (December 3-5 2012) is all about the use of mobile technology. During the Summit, mHIMSS will be releasing the mHIMSS Roadmap, which will encompass the current and future state of mobile technology, including: Privacy and Security, Standards and Interoperability, ROI/Payment, Technology, New Care Models, and Policy.
Dr. Velasco: With mobile devices like the tablets and smartphones, we are entering a new era in clinical computing – one in which the technology finally supports the mobility of physicians and patients. This will help to generate and accelerate adoption of information technology in healthcare in general.
12. Finally, have you considered how a Windows 8 tablet with touch and updating tiles would help you your healthcare environment, especially since it integrates nicely into existing facility IT infrastructure?
David Collins: My gut is telling me that the integration might not be as simple as we think. I'm sure that Windows 8 could lead to a more streamlined approach; however, there are many other pieces of the puzzle to integrate between the core electronic health record and the existing legacy systems (multiple other software platforms running other applications throughout the enterprise health system).
Dr. Velasco: We plan to work with Microsoft to look into the applicability of Windows 8 Tablets in the clinical setting. It will take time for health IT software developers to update their applications to fully take advantage of the new Windows operating system. In the meantime, we expect to be able to leverage "backwards" compatibility with earlier versions of Windows.
My thanks go out to both professionals. Lots of food for thought.