With last week’s introduction of Apple’s much anticipated tablet computer, the iPad, the tech pundits are all trying to make sense of where a device like this fits in the spectrum of computer gadgetry.  Steve Jobs tried to place the iPad somewhere between the smartphone and the laptop computer; a platform optimized for the consumption of content. Others have dismissed the iPad as a device with no place, or with only limited appeal. Is it an eReader, a mobile internet device, a media player, a netbook killer?  Has the Apple iPad changed the notion of what tablet computing should be, or could be, or will it fall flat like every other tablet before it? And, from my perspective, does the iPad stand a chance as a viable platform for HIT? Obviously the iPad is not available yet, but based on Apple’s presentation and the early (albeit limited) impressions of the few who have handled one, I believe the iPad may represent the best chance yet to change the nature of tablet computing, especially as it relates to healthcare.

While many have focused on what the iPad is missing (USB ports, support for Flash, a desktop-class OS, a physical keyboard), what sets the iPad apart from other tablet computing efforts to date is its simplicity, form factor and price point. I believe that the decade-long parade of Windows-based tablets have failed to gain any significant market share because they have tried to make a desktop OS work in an environment where it makes no sense, and they have been too heavy and too short on battery life to be useful in the typical clinical setting. For example, I recently had the opportunity to visit a hospital that just opened a new pre-operative clinic, for which they purchased a small fleet of tablet computers that were specifically designed for use in healthcare applications. These much-hyped devices, costing more than $2,000 a piece, were supposed to finally integrate tablet computing into the clinical workflow of today’s modern healthcare enterprise. Well, a month into the roll-out, and no one — not one single clinician in this hospital —was using them.

So how, then, will the iPad, or a device like the iPad, succeed in the arena where so many before have failed? It will require a change in perspective more so than a change in hardware or operating system. Clinicians and CIOs need to embrace the idea that mobile computing works best when the workflow and the technology are aligned. I don’t need the full power of a desktop machine to receive a short message— my cell phone or pager works just fine for that. So then why would I need the power of a desktop computer to consume the type of content that is important to me when at a patient’s bedside? As more and more HIT vendors move their content onto Web-native platforms, a Web-centric (as opposed to an OS-centric) device makes perfect sense. The true test will be how an iPad-like device performs when I need to create content on the go, such as entering an order or documenting findings. Until Apple starts selling the iPad, there will be no way to know for sure if they can successfully make a case for the device as an HIT platform. But as I said above, it could represent the best opportunity yet for a tablet computing device to gain real traction in the world of HIT.

– Carlos M. Nunez, M.D.