In the age of EMRs, EHRs and PHRs, doctors and hospitals alike have embraced Apple's products, from iPads to iPhones, as part of their daily lives. This, in turn, is ushering in a mobile medicine explosion whose future we can scarcely imagine. Even now, as you read this, next generation Apple pioneers like Ochsner Health System and Duke University are testing data platform HealthKit, whose mobile focus is the product of Apple's ongoing dance with the healthcare industry.
The Apple revolution in healthcare happened at astonishing speed, over a period of just a few years. This is due to neither luck nor a miraculous marketing effort. Some believe that it is no coincidence that Steve Jobs—?after his cancer diagnosis—?spent huge amounts of time talking to healthcare executives and physicians about Apple's tech applications for healthcare.
In his final years, I believe Steve Jobs did not view the healthcare industry as just another vertical market for his company's technology products. He viewed it as a crucible, a way for technology to make a difference in the mission of reducing suffering and saving lives.
When you see what healthcare professionals have to say about how Apple has impacted their ability to deliver patient care, it's difficult to see Jobs' interest as purely self-motivated.
"What Steve has done is enabled our imagination," Dr. John Halamka, CIO, Beth Israel Deaconess Medical Center told Information Week back in 2011. "CIOs and doctors are now envisioning solutions that would not have been possible without Steve's innovations."
The iPad was released on April 3, 2010, without much of a bang as consumer launches go (though the prerelease keynote in January did mark the point at which Steve Jobs officially dubbed Apple a "mobile devices company"). While it won some early admirers, such as Wall Street Journal tech reviewer Walter Mossberg, the iPad was also slammed by critics as nothing more than a puffed-up iPhone—which had the audacity not to include a camera!
But the iPad's critics were silenced quickly. Early on in the its development, medical schools saw the device's potential, with several gifting iPads to all their medical students as a matter of routine. For example, in 2011, Yale School of Medicine gave each of its students an iPad 2 and instead of printing course materials, asked students to download them onto the mobile device instead. Yale followed in the footsteps of several other medical schools, including the University of California at Irvine, Stanford University and the University of Central Florida.
This trend, which can only have been helped by Apple's sterling reputation in the education market, ensured its influence on the very culture of medicine. When a student learns how to be a doctor, with an iPad as a critical tool, that student is highly unlikely to rely on anything else when he or she finally dons the labcoat.
Within a year or so, iPad adoption in enterprise settings was already reaching an astonishing 70%, according to an HIMSS survey.
And by 2012, a health IT survey by Aruba Networks found that 85% of those surveyed supported BYOD and 83% reported iPad use, making iPads the most commonly-used personal devices. (In comparison, iPhones or iPod touches came in at 65%.) Corporate acceptance of new technology rarely comes so fast, but in this case, it seems, Apple won before a single shot could be fired.
Best of all from Apple's standpoint, the device practically sold itself. "I believe docs with an iPad ran to the iPad," said Lewis Hofmann, MD, a family physician in the Washington area to American Medical News in 2012. "Most docs on an EHR right now were probably dragged to it. No one had to pay me to buy my iPad."
Now, with EHRs of paramount importance in the industry, every major EHR and EMR vendor must get off their duff and see to it that their platforms are Apple-compatible, according to a Black Book Rankings survey from last year.
"A mandate has been issued and progressive vendors are reacting," said Doug Brown, Managing Partner of Black Book Research. "A full 100% of practices participating in the follow up poll expect EHR systems that allow access to patient data wherever physicians are providing or reviewing care."
One hundred and twenty-two vendors told Black Book that they planned to introduce fully-functional mobile access and/or iPad native versions of their EHR products by the end of 2013. Another 135 EHR product vendors claim to have mobile applications on their near strategic horizons.
Despite some issues in connecting to EHRs, clinicians continue to adopt Apple devices. Today, with more than 1,000 iPads and 1,600 iPhones connected to the Beth Israel Deaconess Medical Center network—?all purchased by doctors and staffers—??Halamka said the wide acceptance is because staffers liked the size, shape, weight and battery life of the iPads. While those seem like little things, it took years of research and engineering to match the device to what the healthcare industry wanted and needed.
But with that kind of adoption already having happened, is there more room for the Apple mobile device sales to expand? According to analyst firm Manhattan Research, the answer is "no," at least where physician smartphone uptake is concerned. Manhattan Research Director of Physician Research James Avallone says that iPhone purchases by doctors have plateaued at about 85% or so of the population. (Avallone is now focusing on how doctors use the devices.)
But that obviously won't stop Apple from fighting for the front seat in the mobile health race, with products like its planned iWatch health monitor and HealthKit data management platform. In these arenas, it faces competition that could intimidate even the confident Apple leadership, including Microsoft, Samsung, Google, LG and hundreds of well-funded health monitoring startups. That being said, few people have gotten their clocked cleaned betting on Apple.
Still, it's hard to argue that Apple lit the spark that started the mHealth juggernaut rolling, and continues to change the way the healthcare industry cares for patients.
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