The iPad and Thoughts On Usage in Libraries and Hospitals

By now it seems like everybody has weighed in on the iPad, so of course I feel compelled to add my .02 cents. 

I like the concept of an iPad, I just am not sure I like the iPad.  Personally, I think Steve Jobs needs to get over his anti Adobe Flash issues (Dude Steve, Flash works on my PC just fine, maybe it is Apple’s fault *gasp* that it is buggy on Mac platforms…just a thought.) According Adobe,  70%-75% of games and video content is Flash, I have no way to verify that data since it comes from Adobe and not a third party.  But it seems like whenever I am on my iPhone and I want to look at SlideShare, an Internet movie, or animation, I get the broken Lego that tells me Flash isn’t loaded.  Hopefully HTML5 will be the answer to our animation and video prayers for iPhone users, because I don’t see Jobs backing down.  Until there is an answer to the Flash (or lack of Flash) problem, it will be difficult to use the iPad for animation or Internet video purposes.  Why is this a problem?  there are lots of great medical animations and videos on surgeries, exercises, procedures, etc. that are very beneficial to professionals as well as consumers.

Flash is just one of the video problems the iPad suffers from.  Apparently the iPad’s 1024×768 pixels and 4:3 ratio presents some problems for videos.  If all of those numbers sounded like gobbelty gook then let me say that the iPad plays videos at the same scale as an old CRT television set.  Forget watching an HD movie, wide screen films, and movies in other formats. For examples of what happens, check out this post on TUAW. It seems most of the people upset by this are videophiles.  But combine the scaling problems with no Flash, and the iPad is limited for medical professionals and patients to view educational medical videos.

Another big problem is iPad’s 3G network, AT&T.  I swear the groan that came forth from millions of people could be heard ’round the world.  I would bet the American iPhone users already stuck on a glacial 3G network were doing more than groaning.  Luke Wilson may be able to surf and talk at the same time, I just hope his friend has no more game show questions for him to answer quickly.  Supposedly AT&T is ready for the iPad and says they can handle it.  Yet according to The New York Times, AT&T “largely expects the iPad to be used in coffee shops and at home, where users can rely on Wi-Fi, as opposed to dragging down the company’s 3G network.” Oh boy, this just has disaster written all over it.  Please AT&T prove me wrong.

Digital formats.  If you are planning on using the iPad to read books, you need to know that Apple is using the digital book formatcalled EPUB, which is different from Amazon.  I have no idea what specific medical books are available in EPUB’s format, but the TUAW reports, 0ther ebook readers use this format: Barnes & Noble Nook, Sony Reader, iRex Digital Reader, and the iRiver Story. Some of the publishers that will be on the iPad are Penguin, HarperCollins, Simon & Schuster, Macmillan, and Hachette.  Whether you believe Jobs was angry at Harold McGraw for leaking iPad information or not, McGraw-Hill has plans for its books on the iPad. In an interview on CNBC (the day before the iPad debuted) Harold McGraw stated (video link) “We have a consortium of e-books. And we have 95% of all our materials that are in e-book format on that one. So now with the tablet you’re going to open up the higher education market, the professional market. The tablet is going to be just really terrific.”

If they are opening up the higher education and professional market, there are still a lot of hurdles that need to be accomplished.  John Halamka, Chief Information Officer of Beth Israel Deaconess Medical Center, Chief Information Officer at Harvard, AND Joseph Leiter Lecturer at MLA 2010 wrote a post on the iPad and the ideal clinical device.  His ideal clinical device is:

  • Less than a pound and fits in a white coat pocket
  • Battery life for an 8-12 hour work shift
  • Sturdy
  • Built in full keyboard, voice recognition and very robust touch screen input
  • Provides a platform for a variety of healthcare applications hosted on the device or cloud.

According Halamka, no device is completely there yet, but the iPad may be closer than other devices like the netbooks, laptops, iPhones, and Kindles. 

Personally I believe the platform and applications for healthcare is going to be the biggest hurdle.  I said it once before, finding a Mac in a hospital is about as rare as finding a vegetarian in Outback Steakhouse.  They are there, but not always, and don’t count on them to work within the system.  The vast majority of regular hospital departments do not work with Macs and have no intention of working with Macs.  Despite some growth and development in the iPhone EMR app side of things (EPIC has an iPhone app), very few hospitals support iPhones because they are still viewed as a personal device within hospital IT departments.  The hospital IT world is still very much PC and Blackberry. 

Scandinavian librarian, Thomas Brevik, has an interesting short post on what the iPad might mean to libraries.  He predicts that it will “fuel reader demand for e-books.”  He also sees two main challenges for the iPad in libraries, delivery of content and reader habits.

Brevik’s perspective seems to be primarily from the public library side of things.  Even so, the content issue is big.   Thomas specifically writes about content and e-books and libraries.  I think the content issue is bigger than that.   From what I could tell from the iPad release, the only things that will run on an iPad are apps (similar to the iPhone).  So in order for you content to be displayed or used on the iPad, you are either going to have write an app (or subscribe to a library program that has an app) or have all of your programs/services/resources available through Safari web browser….and also not have Flash. 

I don’t know if the iPad will make an immediate big splash in healthcare and or medical libraries.   However, in typical Apple form they have turned up the heat on the portable market.  They have created a really cool portable device for under $500.  I anticipate us seeing more changes due to the ripples the iPad has caused by jumping into the ultraportable pool that has been dominated by inexpensive netbooks.  It makes for interesting times.  Who would have thought in 2000 that ten years later would have one of the most popular music players that is also a phone?

6 thoughts on “The iPad and Thoughts On Usage in Libraries and Hospitals”

  1. Apple is skating to where the puck is going to be, not where it’s at now. Sure, Flash is everywhere now, but HTML5 will make it unnecessary for portables. Flash also gobbles CPU cycles and energy. This is fine for your desktop, not so great on a portable, where battery power is critical. The lack of Flash games on the iPhone doesn’t seem to have put a crimp in iPhone game sales.

    I don’t watch videos on my iPod Touch because I want to enjoy the large, wide screen. I do that at home on my 46 inch plasma. The Touch and the iPad will be used for casual viewing while in airplanes or waiting in the doctor’s office. A future iPad might come out with a 16:9 ratio, but undoubtedly people will complain that “it’s too big.”

    Another aim toward the future: wifi will become ubiquitous, at least in metropolitan areas. The much slower 3G will only be used when you’re in a car or the middle of nowhere. (And note that no contract for AT&T is required for the iPad.) Many colleges already have campus-wide wifi coverage, and more are planning for such.

    The EPUB format is a free and open standard, not proprietary like the Amazon Kindle. Given the price, size and excellent display of the iPad, publishers will be falling over themselves adapting their textbooks for iPad sales. Sure, few to no medical texts are available now, but that’s not the future. By the way, the free app Stanza reads EPUB, so publishers don’t need to write apps, only distribute in EPUB.

    Finding a Mac in a hospital is easy, if you include iPhones, the smartphone of choice for residents. The Citrix Receiver app allows Windows applications to be run on the iPhone, and Citrix Receiver will even run Windows 7 on the iPad, with their XenDesktop program. Lots of hospitals use Citrix. Today’s residents who use iPhones will become tomorrow’s chiefs, who want to use iPads, and IT will change their policies.

    I’ve read a lot of geek blogs, where people complain about features that Apple didn’t include on the iPad, because that’s what they want now. Apple has consistently ignored the pressure of “now,” and has innovated for “then.” Consider the following advances that Apple introduced (not necessarily invented), all of which were followed by other companies: mouse, WYSIWYG, 3.5 inch floppies, built-in networking, SCSI, PostScript, laser printers, dropping SCSI, Firewire, USB, dropping 3.5 inch floppies, trackpad, etc.

    Don’t underestimate the ability of Apple to change the market. Two and a half years ago there were no iPhone or iPod Touch users. Today there are over 75 million.

  2. I thought the future was supposed to be contextual delivery of information at point of need as in this promotional video

    In Higher Education wouldn’t it be great if students were issued an RFID sticker at the start of term to affix to their iPad, and when they enter a lecture hall they could hold up their iPad to a sensor by the door that would trigger automatic downloading of notes and full text readings to accompany the lecture. iPad has the screen real estate, and it’s good to read McGraw-Hill are on board, but we need the apps to make contextual delivery a reality.

  3. I am not frustrated by a lack of Flash for gaming, I am frustrate that when I go on places like SlideShare, I can view the slides. I am crossing my fingers that HTML5 will solve the Flash issues, along with other platform/software dependent web issues. However until I see it in action, I don’t know for sure if it will. I use the video and multimedia part of my iPhone a lot. It is my computer when I am away from work or my house.
    Over here we watch medical videos on the iPhone because our multimedia is block, so the 3G (when it is working) is quite helpful. The people who watch them on their phones fall primarily into two camps: 1. They are looking for something quick that they can later watch off campus at their computer 2. They are showing somebody else something and the iPhone is the only thing that can get multimedia here (because were it is blocked by IT). Personally, I use it to watch videos all the time. When I was in an hour long line with my sons to get the H1N1 shot I downloaded several movies to entertain them. We have used it on plane trips for the same reason. I could use a laptop or DVD player but when you are carrying kid junk with you it is simply easier travel with my iPhone and my old video iPod with some movies preloaded. Those small things are much easier to schelp around than laptop and DVD player.
    I am still waiting for city wide wifi. I won’t say it will never happen but I don’t think it will happen as soon as everybody keeps predicting. I also wonder if it is going to be like the airport wifi, pay to play.
    Nothing is wrong with EPUB, but people need to know the format is different from Amazon’s format. I think McGraw getting into the EPUB side of things will eventually lead us to more medical titles online…but who knows.
    Finding a Mac might be easier in academic medical setting but I still honestly believe Macs won’t/don’t fly in large way in hospital settings. Yeah the have Citrix fro the iPhone but when I have IT tell me “The iPhone is a great personal device, but is not suitable for our institution at this time.” (Yes they did use itallics for personal device.) IT went on to tell me that only approved Blackberry devices were allowed access to institutional email. I just wanted email, not patient information and they won’t even allow email to iPhones. The new 4Corners software (by Citrix) that many hospitals use for secure access is not compatible with Macs! If Macs were widely used in hospitals, you wouldn’t have a secure access software program that doesn’t work on them.

    I completely agree that Apple will change the market. I just think it will be indirectly because I honestly and truly don’t see hospital IT departments having Macs in any great quantity in hospital.

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