iPads have won the hospital, but Android may win the patients

In wards and doctor's offices, the iPad is becoming a mainstay care device, as Android stakes a spot in patient-facing use

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Clinicians love that using an iPad is less obtrusive than a laptop or other computer, so the clinician-patient interaction is more personal yet more accurate due to the lookup capabilities. Some facilities are even contemplating using large screens connected via USB cables or AirPlay so that the patient can see what's on the clinician's screen and there's no worry about secrets being withheld.

All the EHR mobile apps keep the patient and other data on back-end servers, using HTML apps in a native wrapper that ensures caches are kept clean as users sign out. This Web approach also lets clinicians switch iPads midshift. Although iPad batteries easily last eight or more hours on a charge, many clinicians have shifts of 12 to 36 hours; at some point they'll need to swap devices. In addition, iPads are typically locked to hospitals' and medical offices' Wi-Fi networks, so they can't be used elsewhere. However, practitioners who do patient home or workplace visits or who work in mobile treatment trailers or other mobile field facilities need to be granted cellular access, either directly or via a MiFi cellular/Wi-Fi bridge device (which allows locking the iPad to a specific Wi-Fi device).

It's clear that the iPad will be the primary computer used by most patient-facing clinicians. PCs in offices, nurses' stations, and cart-based workstations on wheels will be used as a backup device for long data-entry sessions and in situations where big screens are handy, such as detailed examination of radiographs and perhaps some trending data. It was pretty amazing to see some of the charting views available on the iPad, though.

Android is not prominent on the road map for EHR providers, who want to see the market settle down in terms of screen resolution and core services, which now vary widely from vendor to vendor and even model to model. It's too much effort to design a consistent user experience in that variability, several told me. Of the major providers I spoke to at HIMSS, only Siemens was committed to an Android version -- after its iPad effort was done.

No one seemed interested in developing EHR apps for Windows 8's Metro UI. One top EHR provider even told me customers not only didn't expect to adopt Windows tablets but also wanted their providers not to divert resources into Windows 8 versions, for fear of delaying the iPad efforts -- wow.

Where Windows has a place is on the desktop, where all EHR systems already have Windows 7 versions that would continue to be accessed in Windows 8's Desktop UI. One provider that is reworking its Windows apps' UI to work like the iPad version said it saw the benefit of using Windows 8's touch capabilities for iPad-ized Windows apps.

Android considered for patient-facing uses

Mobile use in health care doesn't stop at the clinician. Over the next year, you can expect to see your medical provider offer Web-based access to your medical records in what's called a patient portal. That's mandated by federal law as part of a pool of incentives tied to getting maximum Medicare reimbursements and extra funds from the feds.

There are several goals in what's known as Meaningful Use Phase 2, all of which are about changing health care from a fee-for-service system that keeps people sick (because hospitals and doctors are paid only when people get sick and have to come in) to a system where preventive health care (aka wellness care) is encouraged and financially rewarded. The Meaningful Use requirements force medical providers to prove that the new tech is actually used to be eligible for that money, to ensure that practitioner behavior verifiably changes.

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