The iPad Is Tops With Doctors

Bertha Coombs at CNBC reported that there are two things Dr. Larry Nathanson can’t work without when he’s on duty in the emergency ward: his stethoscope and his iPad. Early adopting physicians have been embracing the iPad since day one and now the trial stage has moved to a rush. Not only can a doctor scroll his or her list of patients to be visited, but they can also share information with patients. Dr. Henry Feldman, a surgeon at Boston’s Beth Israel Deaconess Medical Center, told Coombs that when it comes to treating surgical patients, being able to pull up diagrams and x-rays at their bedside has been a real game changer. Feldman said that he has been told more than once “That’s the first time I’ve understood my disease”.

Does this mean that Apple will dominate healthcare tablet computing like they do music? What about the Blackberry and Android and the many other tablet entries? The market is certainly large enough for a lot of players but Apple has some distinct and relevant advantages including ease of use and a vetting by Apple before apps are made available. CNBC reported that in February, four out of five doctors surveyed by health marketing company Aptilon said they planned to buy an iPad this year. The major push by healthcare information technology currently is on the electronic medical record. This is in part because the federal government has declared this to be “meaningful use” of IT and has put billions of dollars of incentives in place to accelerate adoption.

I see a major shift ahead similar to what happened 30 years ago when enterprises were focused on solidifying their mainframe computer applications but department chiefs wanted their own solutions and they opted for local area networks of PCs. It took chief information officers a couple of decades to regain control of IT.

Dr. John Halamka, chief information officer at B.I. Deaconess, summed it up for CNBC. “I would call this a perfect storm for medicine,” he said . “You have alignment of funding; a cultural change where doctors want to use devices to improve quality; you also have new devices and new software that is much easier to use.” One of the big unknowns is how federal regulators will respond to the grass-roots demand. There are many questions to be answered. If a doctor takes a picture of a patient with the iPad, does that make the iPad a medical diagnostic device? A similar set of questions were raised in the field of aviation but the demand from pilots was so strong that the FAA found a way to certify the iPad for paperless flight charts. The FDA has already cleared a handful of apps for the iPhone and iPad including a remote patient cardiology monitoring system and a radiology app for reading of medical images.

It is common knowledge that errors are made in healthcare and patients can be harmed. A major contributing factor is imperfect information communication. Can a handheld device such as the iPad improve communications. There is no doubt about it when it comes to patient interaction. The missing link is connecting the iPad to the “backend”. For music the backend is iTunes. For healthcare the backend will be the health information exchanges that are springing up around the country. When that linkage is made, the iPad will become the window into our health and be a tool for improved outcomes. The sooner the better.

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Tags: apple, cardiology, emergency medicine, Healthcare, hospital, ipad, radiology, surgery, tablet

iPad Cover

I am now the proud owner of an iPad 2 case. Now all I need is an iPad 2 to attach it to. Not to worry; the Apple manufacturing and distribution system is in full gear. Fedex gets a lot of credit for their incredible logistics system but it appears to be Apple that sets the rules. I am not aware of any other online retailer that has a “pre-sign” feature. Much as it does with its computers and software, Apple makes things easy. There have been so many times over the years that I have come home to find a Fedex sticker on my door saying that since I was not there to sign for the package, they will try again the next day. After a few days you have to go pick up the item from one of their warehouses. Most of use are busy people, and although there may be something we are really anxious to receive, it does not mean we can sit by the door all day waiting for the Fedex truck. With Apple orders, you click the “pre-sign” link and print out a Fedex-logoed form, sign it, and tape it on your door. Seems so simple and customer-friendly. Why don’t all e-tailers do this for items requiring signature? The “pre-sign” innovation is yet one more example of what is driving Apple’s market capitalization toward making them the most valued company in the world.

Fedex is quite amazing also. When their update says “delivered”, you can go to the porch and the package is there. In this case–no pun intended–the package moved from Shenzen to Lautau Island to Ankorage to Memphis to Orlando to Daytona Beach to Palm Coast. It is just like following trackables and geocoins at geocaching.com. Instant updates along the way enable you to know exactly where the package is and roughly when you can expect it to be delivered. If you see a chance of not being home at delivery time, just get the scotch tape and put the “pre-sign” form on the door. Now all I need is the iPad 2! In the meantime I can follow the order fulfillment process from the iPad.

Tags: fedex, fulfillment, ipad, ipad 2, ipad cover, logistics

Tsunami

In December 1994 I gave a talk at Internet World in Washington, D.C. about how I saw the future of the Internet. The next day I got an email from a professor of epidemiology at the University of Pittsburgh saying he was in violent agreement. Dr. Ron LaPorte insisted that I come to Pittsburgh and speak to his students and discuss how the Internet might change the world. We have been friends and collaborators ever since. Ron not only believed in the Internet and has a great Net Attitude, he put his ideas into action by creating the Supercourse. His concept was to collect lectures from professors and lecturers from around the world and put them in one place on the Internet. In the mid 1990′s that was a very controversial idea. With persistent promotion and communication on Ron’s part, the Supercourse has attracted huge numbers of contributors and users.

Last week Ron and his band of collaborators created a Just in TIme lecture about the disaster in Japan that provides an easy-to-follow overview of the disaster plus related lectures about tsunamis, earthquakes, and nuclear power. The lectures were developed by some of the major scientists in the world with the objective of attacking the epidemiology of fear.

The lectures can be found here. Just click the Start button. I found the opening lecture about the disaster to be an eye opener.

Tags: disaster, epidemiology, japan, supercourse, tsunami

Bike Week

One of the nice things about Florida–in addition to the weather–is that friends and family come to visit. This week it was my Harley-riding brother and his wife from upstate New York who visited for a few days. They trailored a new trike down and plan to take various side trips with it and then trailor it back north, and hope the snow is gone by the time they get home. My brother had been to Bike Week before, but it was a first for me. Daytona Beach is only about 30 miles away, but we took the long way, stopped near Ormond Beach for lunch at one of the many “welcome bikers” establishments, and then took a scenic ride along the Old Dixie Highway. The original Dixie Highway was part of the National Auto Trail system, first planned in 1914 to connect the US Midwest with the Southern United States. In total, it is nearly 6,000 miles of segments. The stretch from Ormond Beach to Daytona Beach is quite scenic with a cathedral of overhanging moss and live oak trees.

Daytona Bike Week is an annual motorcycle event and rally that attracts approximately 500,000 people from all over the country. The 10-day event includes motorcycle racing, concerts, parties, street festivals, and of course a huge presence of vendors selling everything imaginable — and some things unimaginable.  Biker Week is a model when it comes to diversity. You will see people old and young, tall and short, slim and obese, well-clothed and barely clothed, long hair, pony tails, short hair, flat tops, and no hair. There are many couples and this year boasted more than 100 weddings that took place on bikes during the event.  Some bikes are painted with pagan and satanic images but among the vendor booths are some that pass out “biker Bibles” and others that offer Christian counseling. Speaking of counseling, the biker attornies have a strong presence for both plaintifs and defendants.

Harley-Davidson is to the Bike Week crowd as the iPad is to the tablet computer market — dominant. Every model and color the company makes were present, but of course the hallmark of a Harley is the customization performed by or for the owners. With my normal disclosure that I am a poor photographer, there are a few pictures from Daytona here on Facebook. What makes a person a biker? There are as many reasons as there are bikes. For me, it is an enjoyable hobby wherein you see places you don’t notice when driving a car and meet some very interesting people.

I always get the question from someone who learns I am a rider, “Do you wear a helmet?”. The answer is yes. The three states that I hang out in — Connecticut, Florida, and Pennsylvania — all have no helmet law. Pennsylvania had a helmet law and repealed it. The motorcycling lobby is a strong one. The argument is that helmets obstruct your vision and hearing. I think there is an element of truth to that but it is incontrovertible that falling off of a bike without a helmet is dangerous to your head. There have been a number of scholarly peer-reviewed journal articles that reflect considerable research on the subject. There is no doubt that lack of a helmet is tied to increased mortality. The keys from my perspective are to take it as a fact that motorcycling is dangerous and to ride defensively. Assume that a car at a cross intersection does not see you and will pull out in front of you. I believe in the slogan “Ride to live and live to ride”.

Tags: bike week, Daytona, harley, helmet, motorcycle, trike

iPad 2 Launched

The iPad 2 announcement was mostly as expected. Ordering it at 7 AM this morning was also as expected — easy, fast, pleasant, enticing for extra goodies, followed by immediate and precise confirming communications from Apple. The order status shows: Ships: 5 – 7 business days and Delivers: Mar 22 – Mar 29. I ran into a friend at lunch who ordered around noon and his confirmation showed April 8, so that implies a large backlog already created. Not surprising. I have heard many people say that the iPad 2 will cause them to order because of the cameras for FaceTime. I agree with them — that is going to be a really great feature of the iPad 2. I can’t wait to see my grandchildren on it. Not a substitute for seeing them in person but a great experience in between visits. I read today that a manufacturer of private aircraft is including an iPad with each airplane that will include the POH (pilot operating handbook) and all documentation associated with the plane. This is just one of many thousands of ways that the tablet computer will integrate with our business and personal lives. Even if the price was the same, who would want to buy an airplane and get a PC included with all the documentation? Nobody. It would never be considered. There are many implications of tablets. One of them is that physical media is history — disks, tapes, diskettes, CDs, DVDs, USB memory sticks, external hard drives, etc. When you combine an iPad with Dropbox you have it all — a powerful computer connected to the Internet and a cloud computing repository that will sync all of your data between the iPad, the iPhone, your Mac, your PC, Windows, Linux, whatever. Although Bill Gates’ PC is moving toward history, he was right when he envisioned information at your fingertips!

Tags: apple, cloud computing, dropbox, facetime, gates, ipad, ipad 2, pc, tablet

iPad 2

The iPad 2 announcement was mostly as expected–thinner, lighter, faster, two cameras built in, and a gyroscope! A new dual-core processor, branded the A5, is included and promises significantly faster performance. The positive surprise is that all the new features come with the same great battery life as the first iPad, and an innovative new magnetic cover with a choice of two materials and ten colors that helps keep the glass clean and doubles as a stand to elevate the iPad for typing. The only disappointment was that an upgrade to the brilliant retina display of the iPhone 4 was not included.

The new iPad comes in various models based on storage size and networking preference. As far as storage goes, I always recommend getting the maximum available for two reasons. First is that the shift toward more video in our lives requires a lot more storage. Secondly, assuming you want to get an iPad 3 as soon as it comes along, you can get more value on eBay for your prior device with the larger storage capacity. As for network options, if you want WiFi only, the iPad will work in most places but not everywhere. If you want it to work more ubiquitously, you can select a 3G model which will work with your favorite network operator– either AT&T or Verizon. Too bad there is not more competition in the network operator space as neither of these giants is great. The good news with them is that you do not need to commit to a contract. It is pay as you go. If WiFi is available where you are, then that is what you use–automatically. If there is no WiFi then the cellular connection kicks in. The cost is $15 per month for 250 megabytes of data from AT&T and $20 per month for a gigabyte from Verizon. There are significant differences between the two operators as far as what happens when you use more than your initial limit. I have found 250 to be adequate to get email in out-of-WiFi-range and to use the web moderately. If you plan to stream Pandora music or Netflix movies you will use up the 250MB in a hurry. For very heavy use of 3G, the Verizon offering looks better. I plan to stay with AT&T.

There are going to be many thousands of apps spurned by the iPad2 that will take advantage of the faster processor, the gyroscope, and the two cameras. I think the built-in FaceTime app is mot significant because of how easy it makes it to connect with friends and family. It will work with another iPad 2 or with an iPhone 4. If you have grandchildren, you need FaceTime! I view FaceTime as profound. We have a remodeling project going on right now more than 100 miles from our primary home. The builder has an iPhone 4 and can call not just to ask about a bathroom fixture but to show us the wall and point his finger at where we want something installed. He marks the wall with an X while we are looking at it. If you have an injury and need your doctor to look at it, the iPhone is the perfect way to show him or her. There are issues of scheduling time with the doctor and the doctor getting reimbursed for time spent with you on FaceTime but I am confident these issues will be worked out. FaceTime can extend our lives into other places and other’s lives into our space — if any of us so chooses to do so. As for the other apps, I can’t wait to try the new GarageBand for iPad 2.

If you haven’t watched the keynote where Steve Jobs introduces the iPad2, I found it an enjoyable 63 minutes. He is justifiably proud of this latest Apple innovation. I don’t know where the limit is, but at the current price of Apple stock, the company has a market capitalization of 1.5 times GE, IBM, or Microsoft and is catching up to Exxon, the world’s most valuable company.

Tags: apple, facetime, garageband, ipad, ipad 2, jobs, WiFi