Hurdles remain for iPad use in healthcare
A handful of clinicians at Seattle Children’s Hospital gave iPads a test run, using them to tap into the corporate network and run critical apps in a virtual desktop environment. The results weren’t good: iPads came back with a poor bill of health.
“Every one of the clinicians returned the iPad, saying that it wasn’t going to work for day-to-day clinical work,” says CTO Wes Wright. “The EMR (electronic medical record) apps are unwieldy on the iPad.”
Even though hospitals have emerged as early iPad adopters-tech-averse doctors supposedly love them, many hurdles remain for the iPad in healthcare. Chief among them is the legacy app world that clinicians depend on to get their jobs done. Apple’s new iCloud storage service is also cause for “trepidation,” Wright says.
Apple claims over 80 percent of the top hospitals in the U.S. are either testing or deploying iPads. Doctors and nurses swear by the iPad app Epocrates. Boston Scientific just came out with CardioTeach, an iPad app that helps doctors educate patients about their heart ailments. At Texas hospitals, iPads and iPhones sever the desktop computing cord, allowing doctors and nurses to spend more time with patients.
Seattle Children’s Hospital seemed like a perfect fit for the iPad. After all, Wright’s team was in the middle of a massive virtual desktop infrastructure, or VDI, rollout that would allow personal computers to run apps and access patient information and other corporate assets with only an Internet connection and a Web browser.
On the iPad, a clinician could open up Safari, log into Seattle Children’s VDI website using two-factor authentication, and fire up the popular Cerner EMR app hosted on Wright’s servers—but that’s when the trouble starts. EMR apps are just not built for touch-based devices with tiny screens.
One app was designed to be used with a 21-inch monitor. “The clinical app takes up a lot of screen real estate so you can get the big picture view of the patient,” Wright says. “The app is very point-and-click, mouse-and-keyboard driven.”
Many CIOs have complained about the user experience of a Citrix virtual desktop on an iPad. Simply put, desktop apps are made for desktops. Meanwhile, iPad users have to pinch and zoom field screens, input data with finger taps and the virtual keyboard, and then repeat this maddening process over and over. The end result: Employees use Citrix on the iPad as a last resort, these CIOs say.
It’s important to note that Citrix isn’t at fault for a poor user experience of a virtualized Windows app on an iPad. Independent software developers are responsible for optimizing their Windows apps for the iPad. Citrix, however, did release a software developer kit recently to help software vendors convert their Windows desktop apps to the iPad, complete with suggestions on how to use touch capabilities, deploy bigger buttons and optimize data for the iPad’s 10-inch screen.
Case-in-point: Cerner is developing a way to render its app on mobile devices, such as the iPad. Seattle Children’s Hospital is taking a hard look at the new Cerner tool, which takes select information from a patient’s record and presents it in a view-only, iPad-friendly format over VDI. (Cerner could not be reached for comment.)
In this way, the data continues to reside on Seattle Children’s Hospital’s servers. “It gives you the iPad look and feel without the iPad needing native access to our data,” Wright says. “I want to keep the data in my cloud, not iCloud.”
Wright’s virtual desktop infrastructure environment does allow file transfers from Seattle Children’s Hospital servers to local storage on a computer via Accellion’s mobile file sharing app and encrypted file container. Wright is able to monitor and track files flowing through Accellion’s system.
Of course, confidential files can make their way to iPads and iCloud through nefarious means. “There’s always a way around things,” Wright admits, adding, “iCloud certainly presents trepidation, with data getting out there and being moved around so many devices.”
Nevertheless, Wright is hopeful that Citrix VDI and Accellion will staunch potential security leaks, and critical healthcare app makers such as Cerner will deliver a better iPad experience. This could open the doors to the iPad at Seattle Children’s Hospital.
“I need to facilitate a way iPads can be used without endangering the corporation or patients’ health information,” Wright says. “It’s not a matter of whether I want or don’t want iPads in the environment, it’s a matter of inevitability.”