The iPad has been a regular topic on EMR and EHR since last year when we first wrote about the Apple iPad EMR. While it’s normal for there to be a lot of hype around the announcement of a device like an iPad, I must admit that the hype around the device hasn’t really slowed down any.

If you’re a blogger and want your article read, all you need to do is mention your iPad and people will click through to read about it. I’m not immune to it either. Just take a look at the list of giveaways at HIMSS. If you’re not giving away an iPad, then you probably don’t belong there.

One healthcare IT vendor on a HIMSS LinkedIn thread recently said they were giving away an iPod at HIMSS. Turns out that was mistake. Of course, he meant to say they were giving away…wait for it…an iPad. Think how lucky Apple is that hundreds of iPads will be given out at the largest Healthcare IT conference on the planet (30,000 people attending). Plus, Apple didn’t even have to pay for the promotion.

With all these free iPads hitting the healthcare IT world, I wonder how many more iPads will be purchased. Now some might wait to see what the second generation iPad will look like (I wonder if some creative vendor will giveaway the second generation iPad instead of the first generation), but no doubt there’s some mythical quality to the iPad. You see someone else using it and want one. At least I do. I’m not even sure why I want one, but I do. It’s not because everyone else has one cause I like to buck trends. However, there’s just something really nice about the form factor of the iPad tied with all its apps.

The real question is how well will the iPad do in an enterprise situation. I’ve started to see stories come out talking about the challenges of IT staff in supporting and deploying large numbers of iPads in their organizations. One such story had the CEO promise everyone iPads for Christmas. Then, the CIO had the amazing challenge to distribute and support thousands of iPads in their organization. You can’t take back a Christmas gift.

Since this is an EMR and EHR site, let’s just say that from my point of view, the EMR and EHR apps for the iPad still have a ways to go. I’ll be sure to do an informal poll of all the EMR companies I talk with at HIMSS about their “iPad EMR strategy.” I’m certain that they all have one. I’ll be interested to know EMR companies various approaches.

Of course, if you don’t like to run with the popular kids, maybe you should check out the Blackberry Playbook in Healthcare. I’ve heard it’s a great device and maybe they’ll actually care about the enterprise. I’m pretty sure the iPad is positioned that they won’t care all that much about the enterprise.

If you are going to HIMSS and want to learn about my giveaway. Tomorrow, I’ll post the details on EMR and HIPAA about how to win a 42″ HDTV. That’s over 4 times as big as the iPad’s little screen.

You know how I love to keep track of all the iPad EMR that are announced or marketed. Seems like the latest trend is to give the doctor a free iPad for selecting an iPad EMR. Not a bad strategy. Now if I could just get one of them to provide me a free iPad for reviewing their EMR *wink* *wink* but I digress.

I first read about this EMR that is available on the iPad on the Essinova site. This iPad EMR is being offered by Dr Chrono. Yes, another EMR vendor I’d never heard of before I saw this. Although, there site has them being on CNBC, Fox Business and The Wall Street Journal.

Dr Chrono’s approach is to provide a free iPad EMR app, but they take over the billing for you. Sounds a bit like Athena to me. They also say that they’re the only SureScripts certified ePrescribing app for the iPad. Maybe this was true when the video was made. I know that now there are others.

I guess maybe the next question is whether there’s an EMR vendor that won’t have something available on the iPad in the next 6 months.

At least the above is the title of the Information Week article on ClearPractice’s iPad EHR interface called Nimble. You might remember that I did a short review of the Nimble iPad EMR previously. I still stand by my comments of the Nimble iPad interface not being perfect for the iPad. The keyboard was clunky and slow to appear and the boxes were surprisingly small for a native iPad app.

Here’s the doctor in the article’s take on the iPad EMR:

Having a small office, there’s no space for a desktop in the exam rooms, so prior to recently using Nimble on the iPad, Dr. Lianna Lawson, a solo-practitioner, wheeled a laptop on cart to exam rooms.

“Laptops on carts — I don’t like that, it seems impersonal,” said Lawson, whose practice, Lawson Family Medicine and Aesthetics is based in Daleville, VA. Lawson has been using ClearPractice’s web-based EMR on a laptop for about a year. Lawson added Nimble to her practice in September.

Nimble running on the iPad, “has the feel of a [paper] chart,” Lawson. “Many doctors are traditionalists, so the comfort level with technology is difficult,” she said. “But for physicians not particularly tech savvy or reluctant of about how they’ll meet the meaningful use requirements, this gives a little more comfort and confidence,” she said.

It’s true that laptops on carts are a mess. As I recently argued in a post on healthcare mobile devices, the iPad does seem to have the right size and feel. That combined with the 3G connection helps to change the game. Although, I think we’re going to see more devices that build on top of the iPad’s innovations and provide an even better user experience for doctors.

Here’s another quote from the Doctor about the use of the Nimble iPad EMR:

Now Lawson said she brings the iPad with her wherever she goes, responding to patients “24 by 7,” when they have questions over weekends, or other after-hour concerns. In the office, she can use Nimble “while scooting around” in her exam rooms caring for patients.

There’s been other surprise perks to using the iPad-based product, namely engaging patients while using the EMR, she said. “I didn’t expect this to be the result, but patients can see” and talk about what’s on the EMR as she uses the iPad near them. The interactions can help in building a more solid dialogue between physician and patient — and can even help make records more accurate.

While Lawson was using the iPad during a patient exam recently, the patient saw that an entry on the list of medications in her health record was incorrect, and the patient reminded Lawson that she was no longer taking a particular drug. Lawson updated the information.

The first paragraph highlights what some doctors hate about an EMR. They want to leave the office at the office. They don’t want to be proverbially chained to the office since it’s all literally at the touch of their fingertips. Maybe this is why there were so many work life balance sessions at the AAFP conference I attended recently.

Patients seeing what you’re doing in your EMR has often been seen as good and bad. Some doctors love it and embrace the participation with the patients. Other doctors hate having the patients look over what they’ve done and have to answer more questions because a patient saw something on the screen which they didn’t understand. I think we all know which doctor we’d rather see. Although, we can all appreciate the uneasy feeling of someone looking over our shoulders.

The article did remind me of the images that the Nimble EMR makes available to a doctor. That part is actually really cool and the iPad is the perfect way to display and navigate those images as a doctor describes something to a patient.

I should also remind people, the iPad still doesn’t print. Although, that should be remedied relatively soon. Or there are a few hacks out there to make it happen.

I recently had the chance to see a demo of the recently announced ClearPractice iPad EHR called Nimble. I must admit that it’s pretty slick to see an EMR on an iPad. I think it’s easy to see the potential of an iPad like device tied with an EHR.

While I loved the idea of an iPad EHR, I still think that ClearPractice was missing some of the key elements. For example, a number of the input locations were far too small. I have a feeling they were just trying to cram too much onto one screen and that necessitated the small input boxes which is just not a good design for an iPad.

I also thought it felt a little clunky for the entire iPad keyboard to come up each time you wanted to enter some data. I saw another EHR that was really designed for tablets (and supposedly works on an iPad as well) from MicroFour that did a better job of this in my opinion. For example, when you went to enter the weight, it brought up a 10 key calculator. It just felt more natural the way the data was entered.

I do think the concept that ClearPractice has implemented is going to be a popular one. Their iPad software is just another interface to the same data that’s available on the desktop computer. I’m surprised we haven’t seen this before actually. Sure, it means that the EHR vendor has to maintain 2 different software programs, but that should provide a much better user experience on an iPad than just using some remote desktop tool to access your same desktop EHR program.

ClearPractice also got it right not to implement ALL of the PMS type functions into the iPad. Most of the scheduling and billing staff don’t need to be mobile and so a desktop computer works just fine for those types of functions.

Side Note: For the internet startup nerds (like myself), ClearPractice is a division of EGHC whose primary shareholder is John Doerr, a famous venture capitalist. You can read more about the company’s story in this recent New York Times article.

i Medical Apps recently posted an article about Apple’s iPad falling short of transforming hospital Medical Care, but says it may have potential with EMR. We’ve discussed the iPad and EMR quite a few times on this blog with interesting responses.

The above article offers 3 reasons why their skeptical that the iPad will transform the way EMR software is done:
1) For a healthcare provider’s day-to-day use, the iPad doesn’t do anything better than an iPhone or a laptop/desktop.
2) Big hurdles face development of peripherals for more advanced healthcare functions
3) Safety

I guess for me the most important thing I’ve seen was a conversation I recently had with a doctor. This doctor is a HUGE Apple fan boy and always has the latest Apple gadget (like the iPad). I asked him now that he’s had the iPad for a while, what he thought about it.

He responded, “It’s a great toy.”

I think that basically summed it up for me. It is a great tool for doing a lot of things, but EMR is not likely one of them. I’ll still go back to my initial projection that the methods of input that the iPad are providing might be the basis for the future of data input. However, the iPad device itself isn’t what’s going to see the widespread adoption in healthcare IT and EMR.

It does make a great giveaway at conferences though.

I find this completely fascinating. Yes, the Apple Store is demoing various medical applications like EMR on the iPad. Here’s an excerpt from blogger Iltifat Husain walking into an Apple Store:

When I recently walked into my local Apple store to buy an iPad accessory, I saw a group of about 20 people huddled around a large LCD screen while an Apple employee was giving a workshop.

When I saw the LCD screen full of medical applications, I was shocked. This wasn’t your run of the mill “how to use your iPhone” workshop.

The people gathered for the workshop consisted of healthcare professionals in medicine, dentistry, and other fields. About a third of the group consisted of physicians.

The workshop was focused on how the iPhone and iPad can be useful for their practices and as reference tools for day to day work.

The workshop was led by an Apple employee who went through a slideshow presentation of useful medical applications, such as Epocrates, iMurmur, Airstrips OB, and many of the other useful applications we’ve featured on iMedicalApps before.
…
Along with the presentation given by the Apple employee, a MacPractice representative was on hand to demonstrate their electronic health record and how it worked from the desktop to the iPhone and to the iPad.

Pretty interesting to see Apple committing that type of resource to marketing the clinical applications.

I first wrote about the possibility of an iPad EMR back in February when the iPad was first announced. At the time my speculation was that we wouldn’t see an iPad EMR developed, but that the iPad would have a significant impact on the EMR input methods.

Well, I guess I was wrong on one account. MangoMed has developed what their website calls an “iPad based EMR EHR.” I wonder if this was just a quick shift from being an EMR like all the rest and the company quickly just decided to capitalize on the PR that an iPad EMR would have. They’ll be interesting to watch. If I had an iPad I’d try out their EMR and give you a full recap. MangoMED EMR, want to buy me an iPad and I’ll review your EMR and post it on my site as payment?

I must admit that it’s not a bad initial move. I’m actually quite surprised how many people are searching for iPad EHR or iPad EMR or some variation on those terms. The other company that I think is likely to benefit from the iPad is the Epocrates EHR that was announced at HIMSS. Epocrates has been all about this type of form factor for a while and so they should definitely capitalize on that skill.

With all of this said, I still don’t see the iPad being a revolutionary device in the EMR world. Outside of my initial assertion that it will change EMR input methods that will then be implemented by other companies as well.