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Doctors Love iPads. What Does it Mean? What Does it Mean?

After attending the largest annual health IT conference of the year — HIMSS 11 –  John Moore reported that “nearly every EHR vendor has an iPad App for the EHR [electronic health record], or will be releasing such this year.”

Doctors love iPads…not surprising? But, how might you explain this?

There are at least two different possibilities:

  • Coincidence Theory
  • Conspiracy Theory

The Coincidence Theory

So doctors want to access EHR software through the iPad…what’s the big deal?

Apple has built a great new hardware platform with the iPad. There’s nothing else like it in the marketplace.  While other companies are building competing tablets, Apple’s has been the only viable option in the market for over a year.

The iPad is intuitive, easy to use, reasonably priced, easy to carry around, and has a lot of apps that have been developed for the platform. People — not just doctors — love the experience of using an iPad.

Doctors just happen to be one group of zillions buying iPads. Why wouldn’t they? Doctors are smart, affluent, and many are opinion leaders. Doctors like cool new technologies just like anyone else.

Doctors also are mobile. They want to access EHRs in different exam rooms, from the hospital, from their homes. The iPad is the perfect hardware platform to take with you as as a doctor goes about her day.

Why are nearly all EHR vendors making their software work on the iPad?

Because doctors are demanding it.

The Conspiracy Theory

The iPad is Apple’s Trojan horse to create new revenues in an industry in which the company has had minimal presence — health care.

Apple has developed a very appealing hardware platform in the iPad. Recognizing the market strength and lock-in to their walled garden they are creating with consumers, Apple is targeting key market segments to create new revenue streams and business models. Health care is the next target for Apple’s aggressive smarts.

Writing in CNN Tech on February 17, Pete Cashmore explains Apple’s new rules in “taxing” publishers:

Apple this week announced a plan to levy a 30 percent fee on publishers who charge subscriptions through its App Store on the iPhone, iPad and iPod touch. The fee applies to newspapers, magazines and digital books (not to mention music and videos).

What’s more, Apple’s rules dictate that publications can’t offer these same subscriptions at a lower price outside the App Store. And in another blow to publishers, customers will have the option not to share their details — name, e-mail address and ZIP code — with the publisher.

Some publishing industry analysts are aghast at the proposal, claiming that the rate is much too steep and the terms too strict. I don’t disagree: There’s no doubt that Apple is using its dominant position in digital distribution to strong-arm publishers.

But the fact that the tech giant can propose such onerous terms without blinking points to the fact that the battle is already lost: The balance of power has permanently, irreversibly shifted from the media companies to the tech firms. (emphasis added)

You’ve probably heard the metaphor that the most expensive medical instrument is the doctor’s pen — that 70%+ of health care costs flow through a pen because doctors must prescribe pills, hospital admissions, medical procedures, tests, etc.

An EHR software app running on an iPad could become the digital equivalent of the doctor’s pen.

BUT now the scenario is much different:

  • A doctor’s pen is a commodity.  Nobody controls the pen market and there are hundreds of reasonably priced options for writing instruments.
  • The iPad is anything but a commodity — it’s a proprietary platform controlled by the #1 tech company in the world. Apps running on Apple’s platform must follow Apple’s rules.

Could Apple impose a similar “tax” on health care services and products (admissions, ER visits, devices, pills, tests, etc.) ordered by doctors using their iPad platform?  Why not — its THEIR platform. If you want to run your app on their platform, you have to follow Apple’s rules. 

What are your options?  Leave the Apple platform?  But wait a minute…its the doctors that are locked in to the Apple iPad platform — they love it, why would they want to leave?

Would Apple tax doctors’ revenues?  They could, but they probably wouldn’t…why disturb the geese as they are laying golden eggs?

The iPad is Apple’s Trojan horse into health care — and it’s being willingly carried in by doctors who love to use it.

Who’s Right?

So who’s right — the coincidence theorists or the conspiracy theorists?

It really doesn’t matter ––  the result is the same.  Apple finds itself leveraging a choke point in the health care value chain. It’s up to you to conclude whether has stumbled it’s way or connived it’s way into the hands of doctors.

Apple has created a technology platform that people love. That love translates to high switching costs and high levels of customer lock in.

So what’s the point?

Health care providers and companies typically haven’t looked at tech companies as competitors. Wake up!  As health care makes the transition into the digital economy, look sideways before you’re derailed by new technologies and business models.

This work is licensed under a Creative Commons Attribution-Share Alike 3.0 Unported License. Feel free to republish this post with attribution.

25 Comments

  1. Vince Kuraitis on February 26, 2011 at 5:31 pm

    Doctors Love iPads. What Does it Mean? What Does it Mean? http://bit.ly/hAc34S #HealthIT #Apple #EHR #HCSM



  2. Roger Heath on February 26, 2011 at 5:33 pm

    There is an alternative introduced at HIMSS. See: http://www.lifebot.us.com/slate/



  3. TNFORMATICS.com on February 26, 2011 at 5:49 pm

    Doctors Love iPads. What Does it Mean? What Does it Mean? | e-CareManagement Blog http://bit.ly/fzH3Yx http://f.tatsn.com/u



  4. Netspective Health on February 26, 2011 at 5:49 pm

    Doctors Love iPads. What Does it Mean? What Does it Mean? http://goo.gl/fb/jIrbo #HIT #HealthIT



  5. Aparna M K on February 26, 2011 at 5:52 pm

    Doctors Love iPads. What Does it Mean? What Does it Mean? | e-CareManagement Blog http://dlvr.it/HjJq2



  6. Just call me sire on February 26, 2011 at 6:13 pm

    RT @netspectivehc Doctors Love iPads. What Does it Mean? What Does it Mean? http://goo.gl/fb/jIrbo #HIT #HealthIT http://bit.ly/fmkrFl



  7. Charles Webster, MD on February 26, 2011 at 6:49 pm

    My response http://j.mp/cbQP2c RT @VinceKuraitis Doctors Love #iPads What Does it Mean? http://bit.ly/hAc34S #EHR #EMR #android #usability



  8. Gregg Masters on February 26, 2011 at 8:36 pm

    RT @VinceKuraitis: Doctors Love iPads. What Does it Mean? What Does it Mean? http://bit.ly/hAc34S #HealthIT #Apple #EHR #HCSM



  9. Mark Browne on February 26, 2011 at 8:37 pm

    RT @2healthguru: RT @VinceKuraitis: Doctors Love iPads. What Does it Mean? What Does it Mean? http://bit.ly/hAc34S #HealthIT #EHR #HCSM



  10. Jody Schoger on February 26, 2011 at 8:37 pm

    RT @2healthguru: RT @VinceKuraitis: Doctors Love iPads. What Does it Mean? What Does it Mean? http://bit.ly/hAc34S #HealthIT #Apple #EHR …



  11. Vinny Arora on February 26, 2011 at 9:50 pm

    RT @2healthguru: RT @VinceKuraitis: Doctors Love iPads. What Does it Mean? What Does it Mean? http://bit.ly/hAc34S #HealthIT #Apple #EHR …



  12. M. Joshua Morris on February 26, 2011 at 10:00 pm

    RT @2healthguru: RT @VinceKuraitis: Doctors Love iPads. What Does it Mean? What Does it Mean? http://bit.ly/hAc34S #HealthIT #Apple #EHR …



  13. David Doherty on February 27, 2011 at 1:49 am

    choke point?

    Personally I can’t see this happening just because of a tablets OS. First up Doctors and patients could just continue to use secure web apps or free to download apps in which content providers get their software distributed free of charge.

    Even in these early days I’m seeing most of the good stuff is already starting to be bundled as a service rather than a one of purchase. Not sure why would a software provider for doctors want to sell a app somewhere else when you’ve got so many sponsored possibilities.

    Clinical text book publishers (eg Camb/Oxford via medhand.com) are another matter but they already spend >30% with bricks and mortar stores and they should be executing on their more comprehensive digital offerings eg combination with CPD, better clinical outcomes etc which are much more valuable than the books our margins anyway.



  14. Jeremy Windmiller on February 27, 2011 at 6:30 am

    RT @2healthguru: RT @VinceKuraitis: Doctors Love iPads. What Does it Mean? What Does it Mean? http://bit.ly/hAc34S #HealthIT #Apple #EHR …



  15. hivsnp on February 27, 2011 at 6:30 am

    Doctors Love iPads. What Does it Mean? What Does it Mean? http://bit.ly/hWIsTs



  16. Merck Manual Apps on February 27, 2011 at 7:49 am

    RT @VinceKuraitis: Doctors Love iPads. What Does it Mean? What Does it Mean? http://bit.ly/hAc34S #HealthIT #Apple #EHR #HCSM



  17. Stacy Nicholson MD on February 27, 2011 at 8:10 am

    RT @2healthguru: RT @VinceKuraitis: Doctors Love iPads. What Does it Mean? What Does it Mean? http://bit.ly/hAc34S #HealthIT #Apple #EHR …



  18. Paul de Roos, MD on February 27, 2011 at 8:53 am

    RT @MerckManualApps: RT @VinceKuraitis: Doctors Love iPads. What Does it Mean? What Does it Mean? http://bit.ly/hAc34S #HealthIT #Apple …



  19. Suleman on February 27, 2011 at 10:19 am

    RT @VinceKuraitis: Doctors Love iPads. What Does it Mean? What Does it Mean? http://bit.ly/hAc34S #HealthIT #Apple #EHR #HCSM



  20. Steve Hards on February 27, 2011 at 10:55 am

    “Could Apple impose a similar “tax” on health care services and products (admissions, ER visits, devices, pills, tests, etc.) ordered by doctors using their iPad platform?…What are your options? Leave the Apple platform? But wait a minute…its the doctors that are locked in to the Apple iPad platform — they love it, why would they want to leave?”

    One option would be to deduct any such charges a doctor incurred from his or her own salary 😉



  21. Donna Cusano on February 27, 2011 at 2:05 pm

    Interesting extrapolation of Apple Arrogance. It’s hard to imagine a faster way to block adoption of the iPad by hospital CIOs and to stimulate adoption of Android or proprietary tablets. Simply, doctors accessing the hospital or system EHR must use the approved OS. Too many drug companies, device manufacturers, labs etc. are not going to add to cost in a regulated environment. They are not publishers, who are 1) unregulated and 2) in dire straits.

    And adding to Steve’s thought, non-salaried (not on staff) admitting doctors can be charged back!



  22. twttimestop on February 27, 2011 at 2:52 pm

    Doctors Love iPads. What Does it Mean…: http://bit.ly/eAdkIy most discussed on @leclercfl/pharma-companies-6 (http://bit.ly/hfADUA)



  23. CIR on February 28, 2011 at 12:15 pm

    Doctors Love iPads. What Does it Mean? What Does it Mean? http://bit.ly/hAc34S #HealthIT #Apple #EHR #HCSM (via @futuredocs)



  24. Nadja Specht on February 28, 2011 at 6:10 pm

    Doctors Love iPads. What Does it Mean? http://ow.ly/44S9N (via @VinceKuraitis)



  25. Leonard Kish on March 13, 2011 at 3:16 pm

    Another great post.

    They’re both right, Apple for the business model and iPhone, docs for finding what works best for them. Apple figured out long ago that the real money was in content distribution controlled through their devices. Perhaps they noticed that docs first loved iPhones, and maybe there would be an opportunity with a tablet. The reasons docs want it, though, is because they liked the iPhone and could see the potential for a bigger one.

    Some content Apple will find a business model for, other’s they won’t, but they know they’re opening the door for opportunity.

    What could be troublesome is that with the iPad, they won’t just control the distribution, but also the creation of (some) medical content. I don’t see this as competition from technology companies (not many had business models around health data, aside from the most famous, Kaiser,etc.), I see it as wedging a new niche where none existed before.

    Fortunately, I think with the Direct Project, data will find it’s way onto a variety of of different platforms and used in many new ways and business models to create value.