One in five physicians likely to purchase Apple iPad - study

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  • Reply 101 of 184
    nkhmnkhm Posts: 928member
    Quote:
    Originally Posted by Marvin View Post


    Useful yes but essential? Your phone is essential, your computer is essential to at least manage the phone. The iPad is non-essential. I don't think it being useful is enough to sell a $500 device. I would find a $500 vibrating chair useful but I'm not buying one.



    No, not essential, but then neither is a calculator, it still makes the job easier.



    Quote:
    Originally Posted by Marvin View Post


    The files are still application-centric though. If you delete an app, the files go with it. If you have a spreadsheet app and have used it to generate a large number of sheets but decide that another app does the job better, rather than what people are used to - simply switch apps and delete the old one - you have to make sure to hook up your computer, sync all the files over, then sync them back to the other app. This assumes that both apps allow sharing and they both support each others' formats. File-centric systems try to allow file types to be shared. I can open a movie in Quicktime, VLC, MPEG Streamclip, imovie, Final Cut, MPlayer and so on.



    Apple have not stated that file storage on the pad will work like this - where are you getting this information from? Deleting an app will definitely delete associated documents - are you sure about this?



    "This assumes that both apps allow sharing and they both support each others' formats."



    Well, that's what open document formats are for. I don't understand what you mean by applications "sharing". If neo-office, openoffice, microsoft office and iWork are pretty much compatible, then I think this is a non-issue for 90% of office work and general student and home office work. Graphics formats are standardised (jpeg, tiff, gif, png) text documents are interchangeable, csv files etc. All but the most specific app types produce documents which can at the very least be opened by rival software - for example, autocad enables export of dwg, eps files etc... I think you're creating issues where very, very few exist.
  • Reply 102 of 184
    hill60hill60 Posts: 6,989member
    Unless your iPad is syncing over the air via wifi or 3G all the time and files are stored remotely.



    Did you think of that possibility?



    Just like I can access work files using Citrix, I can even use programs such as Office 2007 remotely to edit them, now, from my iPhone.



    The server can do the serious number crunching all an iPad has to do is act as a display and an input device.



    Quote:
    Originally Posted by Marvin View Post


    The files are still application-centric though. If you delete an app, the files go with it. If you have a spreadsheet app and have used it to generate a large number of sheets but decide that another app does the job better, rather than what people are used to - simply switch apps and delete the old one - you have to make sure to hook up your computer, sync all the files over, then sync them back to the other app. This assumes that both apps allow sharing and they both support each others' formats. File-centric systems try to allow file types to be shared. I can open a movie in Quicktime, VLC, MPEG Streamclip, imovie, Final Cut, MPlayer and so on.



  • Reply 103 of 184
    Quote:
    Originally Posted by Mario View Post


    Surely you mean the software you use to access you EMR does not support anything but windows, and that is the fault of the software vendor or ultimately who ever made the purchasing decision in your organization.



    In any case, you can use one of the many free or very affordable remote desktop apps for iPhone/iPad to remotely access your windows desktop running your EMR software. This way iPad becomes light portable window/screen into your desktop.



    You are absolutely right about the EMR. Our EMR is a web-based practice management solution that is only accessible by Windows and will not work with Safari. We found this to be the case with multiple EMRs we considered. I get around this on my desktop and laptop with VMWare 3 and Windows 7. I would love to have this option on the IPad.
  • Reply 104 of 184
    nkhmnkhm Posts: 928member
    Quote:
    Originally Posted by jsmjds View Post


    You are absolutely right about the EMR. Our EMR is a web-based practice management solution that is only accessible by Windows and will not work with Safari. We found this to be the case with multiple EMRs we considered. I get around this on my desktop and laptop with VMWare 3 and Windows 7. I would love to have this option on the IPad.



    I'd hope that this new market place will entice developers to the platform. Is your EMR web based then (excuse my ignorance, this isn't my area of expertise). Surely if it's web-based than making it standards compliant to run on firefox or safari on the mac should be straight forward?



    Here's hoping.
  • Reply 105 of 184
    irelandireland Posts: 17,549member
    Quote:
    Originally Posted by dagamer34 View Post


    ...



    There are maybe 800,000 doctors in the US. And you want me to believe a study that sampled 350 of them? And it's not even the SLIGHTEST bit random either. There's probably a strong bias to contact people who already OWN an iPhone and USE epocrates. And the only worthwhile version of Epocrates costs $150/year to use!



    I think you can easily see the confounding variables here. I have no doubt that doctors are certainly excited to see what the iPad could do for medicine (I'm a medical student, so I'd know), but to put out such silly numbers mocks the intelligence of anyone who can read.



    To put this into perspective, the #1 use of tablet PCs is for medical use (signatures and such). But to even make the claim that 20% of US doctors want an iPad makes me want to barf.



    You can read--cause you read my mind.
  • Reply 106 of 184
    irelandireland Posts: 17,549member
    Quote:
    Originally Posted by gskidmark View Post


    I'm not a doctor but I play one on TV. And when I need to look busy I use the iPad...



  • Reply 107 of 184
    tekstudtekstud Posts: 351member
    Hardly surprising - a doctor's salary can certainly afford a $500 16Gb mobile device.

    But would they get them free under ObamaCare? Will we ever know?
  • Reply 108 of 184
    toyintoyin Posts: 58member
    Quote:
    Originally Posted by nkhm View Post


    I'd hope that this new market place will entice developers to the platform. Is your EMR web based then (excuse my ignorance, this isn't my area of expertise). Surely if it's web-based than making it standards compliant to run on firefox or safari on the mac should be straight forward?



    Here's hoping.



    If only it was that easy. I use Partners LMR which is HEAVILY dependent on IE and active-x. I would like to think that there is a standards compliant version somewhere in development but I doubt it. I never really thought about using the iPad for LMR access, but I guess using a remote desktop client, it could work in a pinch. I definitely wouldn't try to use it during time of service because I need to be able to type while looking at my patients.



    As for files being deleted by application that used it, I think this will not be the case. We've already seen that the next update to the iPhone OS is going to create a shared folder that applications will be able to access. I think you will be given the option to delete all associated files with an application.
  • Reply 109 of 184
    brucepbrucep Posts: 2,823member
    Quote:
    Originally Posted by Marvin View Post


    N





    There are certainly severe security implications involved with the iPad in this field of work. Apps hoarding contact information or diagnoses of patients without mentioning it, no filesystem encryption. I have a feeling most physicians will be opting for the HP Slate.



    give it two yrs and some obama backing of the cloud solutions type SW

    maybe even SAP/ORACLE will join apple in some top notch medical inter-active secure SW.







    I've considered that to be the one concept that could make up for most of the iPad's limitations. It looks fine on the iphone but clearly just needs a bigger screen:



    http://www.youtube.com/watch?v=-6TA5WDMRhA

    http://www.youtube.com/watch?v=IwFgO5WizGM



    This solves the problem for businesses that already have a server setup that can easily deliver this kind of experience. When it comes to home users though, there needs to be something more.



    Apple could bundle some sort of Clouded Leopard as part of MobileMe that allows users certain parts of a full desktop OS experience and optimized for touch interaction. The downside is making sure the experience works well over the user's network connection and some things are just going to be unworkable.

    e.



    my first words are other IPAD AND other slates will be crippled until all medical data and medical film is entered in computers . and the paper records burned and destroyed by other...



    I find everyone here taking an extreme myopic view of how the whole MEDICAL SW IPAD situation will play out over the next 5 yrs. .

    FIRST OFF obama is pushing very hard w / STIM money's for all medical records to be computerized in a worldwide simple readable format.I GUESS some SAP/ORACLE cloud SW that will cost $3000 per office instead OF todays $25000.



    The point is every scrap of HANDWRITTEN data once entered in electronic form will be accessible in nano seconds world wide on an any cloud based device , OBAMA wants to reduce over all heath care costs.



    SO what ever toy like baby stuff that is done now will be dwarfed by the coming titanic data influx that will soon swamp the world's net works ...



    economies of scales will reduce the per office price . <<i hope >>



    at some point DOCTORS WITH IPAD LIKE DEVICES will treat patients with their full MEDICAL histories and full treatment options including ALL drug interaction warnings and other patient instruction's EMAILED to the patient at the same time /

    >>>>>> I just finished 5 months of triple triple chemo and 6 weeks of heavy neck radiation

    My treatment files are 2 feet high at this moment. AND since I have 3 doctors and a central billing file and central back up file.THEIR IS now 5 files on me . INSTEAD OF one paper file and one electric file



    So you guys will see many medical SW programs die A WELCOME death . THE COMING CLOUD BASED STORM will save us billions of dollars ..Well thats the plan anyway .



    And APPLES 3RD GEN  IPAD will be the best option for the medical community to adopt in patient and other medical processes.



    The medical community has thirsted after a LAB COAT sized device for decades. I hope ipad fits the bill. Many lives will be saved if this whole thing is done right .





    peace



    9
  • Reply 110 of 184
    mactrippermactripper Posts: 1,328member
    Quote:
    Originally Posted by jsmjds View Post


    You are absolutely right about the EMR. Our EMR is a web-based practice management solution that is only accessible by Windows and will not work with Safari. We found this to be the case with multiple EMRs we considered. I get around this on my desktop and laptop with VMWare 3 and Windows 7. I would love to have this option on the IPad.





    I'm sorry, but unless the EMR software makers make standalone versions of their products, your going to be still be using work arounds like VMWare, Bootcamp or Citrix on your Mac.



    The 1Ghz processor in the iPad may not be powerful enough to run anything requiring a lot of CPU performance. It will be hard pressed to run Citrix, IE, EMR and files is my guess.



    The only thing I can see is if the EMR software makers make Apps for the iPad that complement their existing established Windows based solutions.



    Trying to access a desktop UI remotely though a iPad touchscreen UI is going to be challenging to say the least.
  • Reply 111 of 184
    I would just like to point out a couple of errors. I'm doing this more in the interest of public education than anything:



    Most people misunderstand how medical billing works. Here's the simplified version:



    Each procedure a doctor does, from an office visit to a limb amputation, has a specific code number.



    Your insurer contracts with the doctor and negotiates a price that the doctor will charge for each procedure.



    So, one person can be charged $20 for, say, an allergy shot. Another person with different insurance can be charged $200 for the same shot.



    Prices are not set by doctors but by the insurance companies. Remember also that doctors don't get to keep all of that fee. Cuts go to pay rent, malpractice, office staff, nurses, medical assistants, continuing education for the staff, license fees, utilities, etc.



    Also, % actually collected varies by office. There's lots of deadbeats out there and many offices run at around 70% collections or worse.



    Also, keep in mind that not all doctors are the "upper crust." Many Primary Care docs are really hurting right now.



    We spend 4 years in college (not partying, btw, because we need straight A's to get into med school). Then we spend 4 years in med school working our butts off and taking out loans >$50,000/yr. Then, we spend 3-7 years in residency working 80hrs a week (or more at the many programs that violate the 80hr/wk rule) for $40k/yr.



    During these 11-15 years, the rest of you have finished school, started families, bought houses, started nice stock portfolios, and are well on with your lives. We are just getting started.



    When we're done with school, most of us have over $300,000 in student loans + credit debt, and many primary care jobs (family medicine, pediatrician, etc) start out at $<150,000. Although that sems like a lot, after taxes and student loan payments it's more like $80-90k take home. After all that time and work.



    Your doctors sacrifice a lot of themselves to care for you. We do this because we want to help people, not to make heaps of money.



    Please remember that the next time you are grumbling about your doctor's prices (i.e. your INSURER'S prices) and how much money they make. Although the numbers may seem like a lot at first hand, remember that much of that gets sucked away by taxes, student loans, office expenses, malpractice, etc. Most doctors are not rich. There are exceptions, of course. Some specialties (radiology, neurosurgery) are very highly paid (>$350,000/yr), but the numbers of doctors making that kind of money are few and far between.



    Also keep in mind, in this era of health reform, that many primary care doctors are dropping Medicare (and sometimes ALL insurance) altogether because they simply can't afford to keep their doors open any longer with the current payment model. I ask you all to call your congressmen and senators and ask them to increase payments to primary care physicians.



    If we fail to do this, we face a drastic shortage of doctors, and good luck getting an appointment when you get sick. This will only get worse if reform passes and everyone gets insurance. Everyone will have insurance, but there will be no doctors to see them!



    Your doctors have compassion for you. Please show them the same courtesy.
  • Reply 112 of 184
    cnocbuicnocbui Posts: 3,613member
    I saw a black cat on my windowsill today



    I asked it if it intended to purchase an iPad. I think it probabaly will as it replied 'Mrrrow', most emphatically.



    Just thought everyone would want to know as I think it was highly significant.
  • Reply 113 of 184
    Quote:
    Originally Posted by digitlnoize View Post


    Your doctors have compassion for you. Please show them the same courtesy.



    I agree with most of what you've written. I for one certainly know about who sets the prices for medical care, having just received a 20% increase in my premium, along with the jolly news that they will no longer be restricting themselves to only annual increases, so now I can expect them at any time. I know that my doctor(s) won't see much if anything of that money. It goes right to profit for the insurance company. They do it because they can.
  • Reply 114 of 184
    Quote:
    Originally Posted by nkhm View Post


    I'd hope that this new market place will entice developers to the platform. Is your EMR web based then (excuse my ignorance, this isn't my area of expertise). Surely if it's web-based than making it standards compliant to run on firefox or safari on the mac should be straight forward?



    Here's hoping.



    A lot of the web enabled EMR systems embed windows forms in a web page using Active-X controls to host them. So no, not so easy to make standards compliant.



    I do predict that vendors will move to put some of their solutions on the iPad, but I'm not sure yet just how far that will go.
  • Reply 115 of 184
    Quote:
    Originally Posted by MacTripper View Post


    I'm sorry, but unless the EMR software makers make standalone versions of their products, your going to be still be using work arounds like VMWare, Bootcamp or Citrix on your Mac.



    The 1Ghz processor in the iPad may not be powerful enough to run anything requiring a lot of CPU performance. It will be hard pressed to run Citrix, IE, EMR and files is my guess.



    The only thing I can see is if the EMR software makers make Apps for the iPad that complement their existing established Windows based solutions.



    Trying to access a desktop UI remotely though a iPad touchscreen UI is going to be challenging to say the least.



    I don't think you actually understand how Citrix works. You apparently believe it is some sort of emulator that would have to run on the device, and the device CPU would then also have to support running IE and an EMR in emulation or the like - that is not at all how Citrix works.



    Citrix is a lot like a secured RDP - the applications you access and use are not actually running on your device - they are running on a server, and you are remotely using them. It isn't the ginormous resource hog you imagine, and Citrix can be used to remote enable specific applications only. The user experience of using these apps is as if they are installed locally, but as I have said, they are not running on the local machine.
  • Reply 116 of 184
    timontimon Posts: 152member
    Not to knock the iPad but I think for patient bed side use it's going to need several changes.



    1) Camera, this is a requirement. You have to be able to read barcodes and document wounds.



    2) RFID, this is also a requirement to allow for tracking of equipment and patients.



    3) Pen input. Touch input can be a problem when working with patients. Too easy to change something on the screen that you didn't want to change. Pen input is better for medical entry. You need the ability to write something which you can't easily do with iPad. Try laying part of your and on the screen while writing, doesn't work well.



    4) Cleaning and resistance to liquids. You have to be able to clean the device using normal cleaning solutions that are in a hospital. Do that to an iPad and your going to have issues when some of the liquid gets into the ports.



    5) Drop test, the iPad needs to pass the same drop tests that current medical tablets can pass without damage.



    Can Apple make these changes? Sure but it will have to be a "Medical" version of the iPad. One that has a Wacom tablet behind the screen and the ability to turn the touch display on and off easily. Will Apple do it? I doubt it or at least not for many months or years.



    To date the best tablet for medical use it the Motion Computing G5. Nothing else comes close to it in the medical field.



    I'm cheering for Apple to make a really great medical tablet but I'm not holding my breath.
  • Reply 117 of 184
    Quote:
    Originally Posted by digitlnoize View Post


    I would just like to point out a couple of errors. I'm doing this more in the interest of public education than anything:



    Most people misunderstand how medical billing works. Here's the simplified version:



    Each procedure a doctor does, from an office visit to a limb amputation, has a specific code number.



    Your insurer contracts with the doctor and negotiates a price that the doctor will charge for each procedure.



    So, one person can be charged $20 for, say, an allergy shot. Another person with different insurance can be charged $200 for the same shot.



    Prices are not set by doctors but by the insurance companies. Remember also that doctors don't get to keep all of that fee. Cuts go to pay rent, malpractice, office staff, nurses, medical assistants, continuing education for the staff, license fees, utilities, etc.



    Also, % actually collected varies by office. There's lots of deadbeats out there and many offices run at around 70% collections or worse.



    Also, keep in mind that not all doctors are the "upper crust." Many Primary Care docs are really hurting right now.



    We spend 4 years in college (not partying, btw, because we need straight A's to get into med school). Then we spend 4 years in med school working our butts off and taking out loans >$50,000/yr. Then, we spend 3-7 years in residency working 80hrs a week (or more at the many programs that violate the 80hr/wk rule) for $40k/yr.



    During these 11-15 years, the rest of you have finished school, started families, bought houses, started nice stock portfolios, and are well on with your lives. We are just getting started.



    When we're done with school, most of us have over $300,000 in student loans + credit debt, and many primary care jobs (family medicine, pediatrician, etc) start out at $<150,000. Although that sems like a lot, after taxes and student loan payments it's more like $80-90k take home. After all that time and work.



    Your doctors sacrifice a lot of themselves to care for you. We do this because we want to help people, not to make heaps of money.



    Please remember that the next time you are grumbling about your doctor's prices (i.e. your INSURER'S prices) and how much money they make. Although the numbers may seem like a lot at first hand, remember that much of that gets sucked away by taxes, student loans, office expenses, malpractice, etc. Most doctors are not rich. There are exceptions, of course. Some specialties (radiology, neurosurgery) are very highly paid (>$350,000/yr), but the numbers of doctors making that kind of money are few and far between.



    Also keep in mind, in this era of health reform, that many primary care doctors are dropping Medicare (and sometimes ALL insurance) altogether because they simply can't afford to keep their doors open any longer with the current payment model. I ask you all to call your congressmen and senators and ask them to increase payments to primary care physicians.



    If we fail to do this, we face a drastic shortage of doctors, and good luck getting an appointment when you get sick. This will only get worse if reform passes and everyone gets insurance. Everyone will have insurance, but there will be no doctors to see them!



    Your doctors have compassion for you. Please show them the same courtesy.



    Oh my God you are killing me.



    My last primary care physician, who retired at the age of 55, drove a Ferrari. That was his summer vehicle. I know he also had a $50K-$60K Infiniti SUV, among others. He lived in the most expensive suburb of our city. My friends brother-in-law is a doctor. He trades his cars in like I change clothes and is constantly buying toy after toy after toy. He spends money like a drunken sailor. Neither of these guys are brain surgeons. My co-workers wife just became an anesthesiologist, rather late in life I might add. Loans? The first thing they did was buy a million dollar home and a Lexus because that's what her "colleagues" drove.



    When I visit the hospitals that I work with, and peek into the HEATED GARAGE that only physicians can use, sure, I see some average vehicles, but those are the minority.



    And really, I could care less, but when I hear about the constant whining from clinicians who claim the system is breaking them, it makes me ill.



    The point is, for people under such financial pressure, a lot of you sure have large amounts of disposable income. And again, more power to you, but please stop bitching about your problems. We all have them.
  • Reply 118 of 184
    rnp1rnp1 Posts: 175member
    Quote:
    Originally Posted by MacTripper View Post




    The only thing I can see is if the EMR software makers make Apps for the iPad that complement their existing established Windows based solutions....



    Why should they bother? If they wanted ease of use, better security and consistent programability, they'd had been with Macs a long time ago! It's just easier to have a lot of IT guys making hourly wages keeping these W based apps going, all because the computers can be gotten for a cheap price! (all though we know that they are replaced at a rate of three or for times that of a Mac based medical system)
  • Reply 119 of 184
    Quote:
    Originally Posted by Timon View Post


    Not to knock the iPad but I think for patient bed side use it's going to need several changes.



    It's actually perfectly designed for any bedridden patient though. Think about all the tons of magazines they can now read, watch movies, Apple shop,etc.
  • Reply 120 of 184
    Quote:
    Originally Posted by TEKSTUD View Post


    It's actually perfectly designed for any bedridden patient though..



    So long as it's sterilizable and fluid resistant. It'll have to withstand constant cleaning with alcohol and other compounds.



    Although for what a hospital stay costs, an iPad could almost be disposable.
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