By Martha C. White
Sunday, April 11, 2010; G03
Steve Jobs got a new liver, the rest of us got an easier way to watch Hulu in bed, and the health-care industry just may have gotten the big break it needed to launch into the 21st century. Following his hush-hush surgery last spring, it's easy to imagine the colossus of Cupertino, Calif., staring at the ceiling tiles in his hospital room and wishing for a way to hop online without having to bother with a laptop.
It's also no stretch to picture him watching doctors, nurses and orderlies peck away at a bevy of poorly designed, intermittently integrated and just plain ugly devices and thinking there had to be a better way.
So while the rest of the world texts, tweets and generally fawns over the thing, that's muted compared with the reception the iPad is getting in the health-care universe.
Medical-technology trade publications are getting positively Tiger Beat in their enthusiasm. Kaiser Permanente is testing uses for the device, a honcho at one of Harvard's main teaching hospitals has weighed in on his facility's iPad pilot program, and executives at Cedars-Sinai were rumored to have gotten prototypes last year.
This isn't just hot-new-toy fever sweeping the mediverse, though: If the iPad becomes as ubiquitous in medical facilities as the iPod is everywhere else, it could usher in billions of dollars in savings, according to Blackford Middleton, chairman of the Center for Information Technology Leadership and corporate director of Clinical Informatics Research & Development at Partners HealthCare System.
The new Patient Protection and Affordable Care Act created an urgency to make providing and managing health care more affordable, with the White House pointing to Congressional Budget Office predictions that 25 percent of our gross domestic product would go toward health care in 2025 if the status quo persisted. Digitization and interconnectivity between medical facilities is widely viewed as one major way to generate those efficiencies.
A recently published report from PricewaterhouseCoopers points out that health care is "playing catch-up" when it comes to innovation, especially technological. It says the ubiquity of wireless mobile devices such as smartphones creates both an opportunity and a need for medical practitioners to overhaul how they deliver medical care.
When health-care pros talk about the iPad, one phrase that crops up often is "form factor." The iPad's pretty. At a pound and a half, it's lightweight compared with most netbooks, fast and can plug along for up to 10 hours on a charge. It's easy to read, and it's intuitive to use. This is Apple's secret sauce, and it might lead to the tipping point here.
The iPad's superb visual quality makes it a natural for reading such diagnostic images as patient X-rays and MRIs, according to Gerard Nussbaum, director of technology services at consulting firm Kurt Salmon Associates. Its big, bright touch screen is a massive improvement over illegible paper charts or chunky desktop computers when it comes to recording and reviewing patient data.
It's not that no one has tried to bring medicine into the YouTube age; it's just that no one has succeeded on a grand scale. Developers have created medical iPhone apps for doctors as well as for consumers, but that device's small screen size can make the apps a hassle to use. If a doctor wanted to compare two EKGs, for instance, it would entail a lot of scrolling and zooming.
The federal government has devoted roughly $19 billion in stimulus funds to digitizing medical records, but the initiative has gotten off to a slow start. There are already plenty of vendors in the medical IT space, and even a handful of mobile or handheld devices on the market, but none of them has achieved critical mass. They're generally more cumbersome to use and cost two to three times as much as an iPad.
Health-care experts like John Halamka, chief information officer Harvard Medical School, say the combination of lower hardware acquisition costs and relative lack of a learning curve (since many people already have smartphones) could foster widespread adoption of the iPad in health-care settings and pave the way for electronic health records to become the norm.
The potential savings are huge. Implementation would clear up a lot of the errors and redundant testing that currently plague medicine, an improvement that the Center for IT Leadership estimates could save $44 billion a year.
The iPad's not without its flaws. For starters, it's fragile. In a rough-and-tumble emergency room, it would be dropped, scratched and generally abused. But aftermarket products like a rubberized skin and a hand strap could be developed that would protect it, Harvard's Halamka pointed out.
Early reviews indicate that touch-typists may be frustrated by the iPad's smallish keyboard, but voice-recognition software would let doctors dictate notes. Another issue is that privacy regulations and rules for prescribing controlled substances require added security. Some have suggested that a biometric device such as a fingerprint scanner could be added to later versions.
These are all relatively small steps, though, given what Apple's already managed to deliver: a reasonably lightweight, user-friendly, power-sipping link between a doctor and the rest of the medical universe. While the jury's still out on the iPad's appeal to the status-updating masses, it appears to be the booster shot the health-care industry needs.
-- The Big Money
Martha C. White is a freelance writer in New York.