12 Ways the iPad Is Changing Healthcare

The 2010 release of the Apple iPad opened many eyes in the healthcare industry. For years, physicians and caregivers shied away from incorporating information technology into patient interactions because laptops and computers on wheels (affectionately known as COWs) were so cumbersome. A 10-inch tablet, though, made it easy to access patient records and medical images, look up drug information, schedule appointments and even show patients educational videos at the bedside. (It helps that many doctors bought iPads for personal use.) The new 8-inch iPad mini, which better fits in one hand, is further poised to convince reluctant healthcare professionals to embrace IT. Here are 12 examples of iPad use in the healthcare industry today—and a look at how it may be used tomorrow.

Early tablet computers mimicked paper charts, complete with the inability to access older records (they predated Wi-Fi, after all), so it’s no surprise that the paper chart remained a hospital mainstay for many more years. The iPad is increasingly replacing the clipboard in several ways, though. Patients can fill out forms and questionnaires electronically before an appointment, giving physicians access to real-time information to better frame their discussion and make a diagnosis. Meanwhile, residents on hospital rounds can use iPads to collect patient information, place orders and prescribe drugs earlier in the admissions process than if they have to fight other residents to use a desktop computer.

Today’s healthcare providers struggle with patient engagement, in part because patient portals and personal health record (PHR) systems have failed to attract users. The iPad is changing this, both inside and outside the healthcare facility. The aforementioned digital questionnaires are a start, as are surveys taken at discharge that let staff members receive real-time feedback about a patient’s visit. Physicians can also use iPad apps to explain medical conditions—in some cases, by drawing on images of X-rays. Finally, many hospitals, including California’s Twin Cities Community Hospital, now offer free apps to track waiting times, find physicians, browse a health library and store personal medical information, including medications and allergies.

“Traditional” telemedicine has required desktop computers, telecommunications equipment and high-speed Internet, none of which are conducive to helping patients connect to physicians from their own home. The iPad, with its built-in camera and optional 3G, can bring home health to the masses. It’s not just the urban elite, either. In Australia’s sparsely populated Northern Territory, for example, healthcare workers brings iPads on house calls; this process improves the care cycle (as patients don’t miss appointments) and data integrity (it’s only documented once). In addition, the new iPad’s support for Bluetooth 4.0 means health workers can use the tablet to monitor data coming from medical monitoring devices; they don’t have to enter data, and patients can remain home.

Much medical software is built on old code (the MUMPS programming language dates back to the late 1960s) that runs on old operating systems (Windows XP is not uncommon). Users need a keyboard, a mouse and substantial training to just get started, while IT departments must maintain legacy systems to support these clunky apps. The iPad’s mobility and touch screen, on the other hand, means that today’s medical software developers have no choice but to create intuitive applications that work on the go. This is good news: a slick user interface will engage physicians as well as patients, who will need an easy way to track weight, blood pressure and other vital signs as they age.

The release of the first iPad coincided with meaningful use, a government mandate to use electronic health record (EHR) software by 2015. EHR usability remains a significant hurdle to adoption, with bad interfaces, poor data entry, over-customization and clutter turning physicians away from technology altogether. However, physicians bought iPads in droves, and before long they wanted to view and edit patient records on them. Early efforts fell flat—but it was the software, not the iPad, that was to blame; running a virtualized version of an unwieldy legacy desktop EHR just didn’t work. Native iPad EHR systems built specifically for the tablet’s touch interface should do better, but they have been slow to come to market.

The stereotypical medical students of old lugged around enormous textbooks. Today, they carry iPads, sometimes through grants and sometimes through their own tuition. This lets students take notes, view (and interact with) digital diagrams and slides and read PDF files. The University of California Irvine Medical School went the extra mile and preloaded its iPad with archived versions of faculty lectures, course outlines and handouts, digital textbooks, presentations and integration with digital stethoscopes and ultrasound units. There are also a host of medical apps, many free, available through iTunes, which schools are encouraging students to download, try and share with their peers.

The growth of digital publishing, combined with the growing number of physicians and medical students with iPads in their hands, has motivated many medical journals to create iPad apps that put digital editions in subscribers’ hands. (iMedicalApps maintains a list.) In addition to current articles, the apps typically include multimedia content, back issues and the ability to share articles. Sure, digital magazines are everywhere, but in an industry that uses research from all corners of the globe to drive advancements in diagnosing, treating and curing disease, readily available information is a huge step forward.

Surgeons and their teams need access to lots of data before, during and after a procedure. As the saying goes, there’s an app for that. Beforehand, reference apps help surgeons study the procedure, identify possible risks and tell patients what will happen. (Surgeons can even play the piano on an iPad to put a patient in the operating room at ease.) During surgery, an iPad placed in a sterile sleeve or X-ray cassette bag lets surgeons review imaging studies previously saved to the cloud. Live remote monitoring of vital signs, object recognition and videoconferencing are additional iPad surgical use cases. Afterward, surgeons can document their procedures and share relevant information with patients.

Britain’s Alzheimer’s Society estimates that one-third of sufferers go undiagnosed. This is important because early diagnosis of Alzheimer’s disease or dementia give physicians and patients more time to prepare for the future and reduces the likelihood that one will need costly institutional care. To complement the process, Cambridge Cognition has developed an iPad app to test for memory loss. Program managers piloting the app say it’s more effective than paper memory tests, which tend to be easy, inaccurate and difficult to translate to other languages. The iPad app can also detect variations in gender, age and education levels and determine if memory problems are caused by depression or by episodic or short-term memory loss, both of which are common early signs of Alzheimer’s.

For years, physical props such as dolls, balls and flashcards were mainstays of speech therapy sessions with children. Now, speech pathologists are using the iPad—and not just because kids think the tablet is cooler than a pack of crayons. There are numerous apps that target a variety of language skills, let pathologists record and save a child’s work and make quick assessments. Many apps offer free or “light” versions, too, so users can try them out before making a purchase. Finally, the availability of the apps means that parents can reinforce the pathologists’ lessons at home.

The U.S. Veterans Health Administration, already a healthcare IT adoption leader, is a pioneer in using the iPad. Last year, the Department of Veterans Affairs (the VHA’s parent agency) announced plans to buy 100,000 iPads and iPhones, largely for clinical use, and a corresponding request for a mobile device management solution. In the meantime, the Clinic-in-Hand program will distribute 1,000 iPads so veterans’ caregivers can better communicate with VA physicians; apps installed on the iPad, meanwhile, will be available in an app store the VA hopes to launch next year. Finally, Army medics are testing the iPad and other mobile devices’ ability to access soldiers’ records and place lab orders; wireless security concerns remain.

The iPad’s future in healthcare is bright, but it does brings challenges. Last year, Panasonic and BizTech Reports surveyed healthcare IT leaders and found that two-thirds deem the iPad (and other tablets) a governance challenge. Issues include incompatibility with legacy applications, concerns about device durability and sanitization, technical support and the impact on wireless network infrastructure. Security and risk management remain the biggest obstacles, though, largely because physicians bring their own device, use it outside the purview of traditional IT operations and increase the risk of a healthcare data breach. Specific security shortcomings—identity and access management, data security, remote access to and management of iPads and risk of theft—particularly trouble healthcare CIOs.

Case Study: iPad Security: How a Hospital Group Treated Trouble