You can blend an iPad
but can you dip one in TCP?
Next year, 500 doctors and nurses in Victoria hospitals will trial the use of iPads. Graduate doctors, rather than crusty consultants, will get the devices, as the "younger group of students and graduates of the health professions have grown up with technology all around them," Daniel Andrews, Victoria's health minister, said …
Those piddling little common sense issues, it's a new toy and all the management will look "'tho cool" waltzing around the hospital with such cool kit"
The likelihood of anyone who actually does the work getting one being zero. Mind you Apple might have a ruggedized one we don't know about.
Will they sue, if they find out it won't work after being scanned or x-rayed.
I've worked in IT in both, and in most cases procurement processes in the NHS are MUCH easier than Australia in government run health systems. There is of course some dependence on which NHS trust you work for and internal procurement policy, but for many items from bandages to million pound x-ray devices there is agreed pricing provided by vendors to NHS Supply Chain, and you just pick whatever you want from the shopping list. In a year as project manager in NHS I helped spend several million pounds on IT systems, medical equipment and PC hardware without once having to go to open tender. Back home in Oz and I'm about to go to my second full-blown tender for the year, this time for a system where I know there is only one potential vendor in the market...
FWIW, we trialled several Windows based tablets including the Panasonics (then in prototype) and they just didn't cut it - available apps needed keyboard & mouse input to be practical, the fact that the tablets were too chunky, too heavy and had poor battery life was the smaller part of the issue. If Apple's iOS makes development of practical touch-friendly apps simpler, that's all to the good. Much of the hoo-ha about "medical grade" devices being washable is pretty irrelevant whan A) nobody washes their keyboards and mice properly now anyway B) anything with lots of corners and crevices is never going to be easy to disinfect properly C) nurses and docs chew on pens and eat their lunch while writing in patient notes (seen it happen in a Gastro ward in lockdown mode!), poo-glove-file-pen-mouth-pen-keyboard-colleague-next patient...
Apple don't claim the iPad to be infection-control certified, but as a form factor it has a lot going for it being all smooth surfaces with minimal edges and crevices and nicely sealed. So long as the front panel can withstand some alcohol (it's glass, right?) I believe it is lower infection risk than any other tablet I have seen, medical or no.
Just don't drop it, or let it get nicked!
What the F can an iPad do that couldn't be done with other devices, just as capable, out there?
Stop this complete waste of public money. Christ, cheaper device exist, but No, its just cause it's an iPad.
If these decision makers were my employees, I'd have serious doubts on their decision making capability. They clearly need to be challenged, not alone on the point of value from money in the public sector.
What can the iPad do? Be carried like a clipboard. That, along with the battery life and connectivity in this instance, is the killer feature. Many apoplectic commentards have cried about their being cheaper devices, all fail to name them. Windows Table edition? Heavy, stylus dependant input with a woeful to the point of being pointless battery performance. Netbooks? Poor performance, lower battery life, cumbersome. As I said, skip the cappuccino this afternoon, eh?
It doesn't matter which other devices are available, or indeed if any are available - The iPad can't be sterilised and is designed to be touched, it therefore represents a rather brilliant way to transport MRSA, CDIF etc. all round the hospital.
Add to that - it's not ruggidised, had no method to add authentication systems like smart cards, commonly used in hospitals and has limited (if any) medical software available.
Cannot be sterilized? You mean like the pen and paper solutions that are already in use? What about the computer terminals and other electronic equipment? Are you suggesting ECG machines regularly go through an autoclave? Or are the coated in a layer of biocides and wiped with disinfectants, in which case couldn't the iPad could well be treated (albeit perhaps impotently) in the same manner? It not being 'ruggidised' is strawman; with a cursory glance at the Apple store, there are at least two options there, with more available if one searches, as someone that works in a healthcare authority procurement team will. The "limited" medical apps; strawman again and actually there are quite a few medical apps available for iOS; http://www.lmgtfy.com/?q=ipad+medical+apps. I accept, totally, the authentication gripes, but not an insurmountable one, which doesn't seem to have been a problem for other hospitals, military organisations, businesses, schools, et cetera. I have to ack the question; is it the fact that new tech is being proposed and introduced, or an Apple product that causes offence?
Having just booted out of office a spin-obsessed UK government hell-bent on overspending and jumping on the latest bandwagon ... I can sympathise with Australia's situation at the moment.
At least they had the good sense to off-load their Prime Minister when it looked like he was going the cost them the upcoming election (eh, Gordon?). If it doesn't work, expect the new party to start cutting off silly-bugger schemes like this forthwith.
Put all your confidential patient data on an app connecting the Ipads, revolutionise healthcare at the same time, and blow your budget!
Downsides: Apple and the app author can see all the private information no doubt, can use it to target ads and leak it on the web, has more chance of being stolen, costs more than the competition and has less battery.
And lets not forget they could remove the app the hospital is using at any time without warning (meaning bye bye to all patient data)
Hey, do you want to know a secret? You don't have to get Apple's approval for an app if you are an enterprise developer, which this Healthcare trust will almost certainly be. You can deploy your own apps on the devices without going anywhere near the App Store, all with Apple's help too and without them seeing *any* of the data (not that they *can* see any of the data; that's Google's trick)! You lot seem to forget that the individuals concerned are generally much, MUCH, cleverer than you!
Let's remember to think things through before ranting on the internets next time, eh?
So it's still okay to pay out for Ipads and then spend on apps and a new system rather than use the old one they have access to already?
The whole point was that they're introducing something there is no need for and it will suck up a chunk of that hospitals budget, meaning healthcare quality could quite possibly go down.
You gave yourself up as a fanboy when you had to attack Google there just because i pointed out the flaws in buying ipads for a hospital.
Apple has a killswitch for apps too fanboy, they could lose their access to that app for any reason apple decides
Google used the killswitch on an app, which acted maliciously, whereas apple refuses to allow an app onto the store if they don't like it for any reason.
Theres protecting the consumer and there's being a git
"So it's still okay to pay out for Ipads and then spend on apps and a new system rather than use the old one they have access to already?"
"The whole point was that they're introducing something there is no need for and it will suck up a chunk of that hospitals budget, meaning healthcare quality could quite possibly go down."
Translation: WON'T YOU THINK OF THE CHILDREN!!! What an absolute load of twaddle! What if, and here is an "outside of the box" idea, the current infrastructure is considerably out of date and isn't providing what the medical staff need? All you are crying about is the fact that iPad has been chosen and quite frankly it's pathetic.
"You gave yourself up as a fanboy when you had to attack Google there just because i pointed out the flaws in buying ipads for a hospital." Quite! I mean HOW DARE I SPEAK UP FOR APPLE! A good ol' ad hominem 'attack'; the last resort of those that have *conceded the debate*. My 6 year old nephew does the same, except he call you smelly-poo-bum, which I suppose is a step up from that. So, you accept your argument is baseless then? Last time I checked, my HTC Legend doesn't run iOS 4 BTW and although I'd love to have it, TextMate is still only available for OSX, so my Windows PC won't run it...
"Apple has a killswitch for apps too fanboy, they could lose their access to that app for any reason apple decides"
"Google used the killswitch on an app, which acted maliciously, whereas apple refuses to allow an app onto the store if they don't like it for any reason." This whole "APP STORE IS TEH EVILS" is getting tired to be honest. Yes, they've rejected some apps using the reasoning of a toddler and, yes, some guidance from on high as to what is and what isn't acceptable would be a 'Good Thing'(TM), but they've been ridiculed into reversing the more asinine ones! It's Apples shop, and in the 2/3 years it been running Apple they've yet to pull the trigger, contrary to what all the individuals like you have asserted. They have also yet to have the issues that Android has had with piracy and malware, but that's another story. Face it mate, you are talking, erroneously, from out of your bum.
"Theres protecting the consumer and there's being a git" There is also having a reasonable debate, and not resorting to name calling. Sarcasm is fine, attacking an idea is fine, being a little patronising, whilst not ideal, is OK, but resorting to name calling isn't, how ever minor it is (is it mods?). Any point that you had has been rendered totally irrelevant because you could behave in a grown up manner...
Can this be better than hanging the notes on the end of the bed that staff have access to and can add to? _Doctors' writing provides better encryption than SSL._ No authentication problems say compared to iPad: session time outs, passing the iPad on/around other staff. Who's typing is that? Who typed cl instead of ml???
Everyone who has said this is a bad idea is correct. They didn't go and buy an iPad in order to work it out either. How clever are the "individuals concerned"?
Battery life, recharging (doctors' day is longer than an iPads)
Patient identification (one bed, one pad of notes) (one iPad many patients)
Liver and bacon ice cream anyone? No bad idea.
Do you really, *really* truthfully and honestly, believe that these people are doing this on a whim? Do your really think that they haven't trialled it already?
"Battery life, recharging (doctors' day is longer than an iPads)
Patient identification (one bed, one pad of notes) (one iPad many patients)"
So what you are suggesting is that the medical staff should continue to use pen and paper? That's fine, but you should make it clear that this isn't because they chose iPad, but because they chose a digital solution to replace the existing analogue one? You do know that this is a *technology* site, right?
Is going to really become God?
What are his views on abortion for example, I wonder will he block apps that help with abortion.
Other problem, What if the docs quickly need to use Youtube (flash) to help with cerebral procedure?
Oh and will it work for left handed people?
can the iHate icon be set as default for me? Please? :)
Lest than a week in and the kids are already bored and causing trouble in the summer holidays...
You don't actually have a clue, do you. Doctors tend not to perform really tricky procedures, such as neurological dissections, whilst on rounds, or refer to a video whilst performing an abortion? As for "Youtube (flash)" (Really?! It uses FLASH?! You're kidding, right..!), you are aware that there is <gufaw>an app for that</gufaw>! Has been since the original iPhone/iPod touch. It's imaginatively called 'The YouTube App'. Also, left handed people will be able to use it just fine, since it's not got the same flawed antenna design as the iPhone 4, which after all the fuss isn't *that* flawed, just if you hold it in a peculiar way. Anyhoo, hating anything is for losers, learn to love, makes the world a much happier place. Come to think of it, wouldn't the little troll icon be more fitting than the iHate icon?
While they shouldn't need a video to know how to perform a relatively common operation like an abortion; it's not uncommon to use to use some sort of teleconferencing setup to help doctors perform obscure operations in remote areas. I don't think they use Flash for that though.
Note: in this case, remote can just mean that the relevant specialist is hundreds of miles away from the hospital with the needy patient.
But no-one it seems has suggested that iPad becomes the *only* piece of digital equipment that the medics use. There are plenty of solutions (with bigger screens, which is perhaps *more* of an issue, no?), and as you have already indicated, the won't reply on Flash for that (or Skype for that matter!). I was merely mocking the OP's myopic, asinine and baseless missive.
There's a lot of hate in here, for something that looks like an experiment on the other side of the planet.
But then again, the mere suggestion of anything Apple-flavoured does seem to stir the haters in the El Reg forums into shooting their mouths off without reading (or understanding) the original article.
Perhaps some of the experts on here might like to try asking questions about the horrific IT kludge that's being forced on the NHS, rather than worry about how our antipodean cousins are choosing to invest/waste their cash.
It's all very well talking about using the ipad in the NHS, certainly many clinicians want it, but unfortunately due to the short sightedness of NHS management, it is doubtful that many, if not all, of the applications will even work on the ipads. Applications tend to be written for Microsoft Windows, and the web browser such as PACS and Choose and Book will only work on Internet Explorer. That would exclude the likes of Firefox and Safari.
You will have a hard time convincing the NHS to use open standards for applications, especially the ones in the cloud...
Someone should have been thinking open standards from the start, when specifications were drawn up, when projects were initiated.
*Cough* PACS is DICOM imagery that works on far more than Windows. Works perfectly fine on all major variants of UNIX. Just the viewers you'll frequently see are windows based, as surprise surprise, that's what the hospital has the most experience with, so vendors tend to write software for it.
With the current NHS deal with microsoft having lapsed, and the Oracle one in full force, a lot of apps are going web based (APEX is proving popular). And with web based apps.. Guess what.. The iPad works nicely with that.
Some apps, granted, don't work away from Windows (at the moment), but that could change very quickly.
Would be interesting to see what the trials say, and then see how that evolves with the Android based tablets too..
Many places historically "stuck on windoze" are looking at the iPad, and it's being driven both from the clinicians and from IT.
I know of a couple of iPad trials ongoing in my local health department, which has always been Windows to the core. iPhones have already gained wide traction across the upper echelons of IT staff in the health department, and a number of specialized iPhone apps have sprung up for the increasing number of doctors using them. IPads are a logical extension now that people have realised that the sky doesn't fall in if you don't buy it from Bill.
Our local police service (previously Windows centric) have also been using iPhones on patrol for the last year, and the avaiability of vehicle databases through an iPhone app has been credited with numerous arrests that otherwise wouldn't have happened.
Open standards are great, but there's nothing like "consumerising" a device/standard to lower costs and increase acceptance. People may think iPhones and iPads are pricey, but compare them to the custom kit that for decades has been flogged for medical use and they are dirt cheap.
I just had a look at the panasonic mentioned in the article. I want one of them SO MCUH right now.
Anyway, using something as proprietary as an iPad is a foolish idea. The trust would essentailly be at the mercy of the manufacturers for updates, tools, programs etc. With no chance to buy from a third party, the manufacturers could charge as much as they want. Don't like the price? Your patients die.
The iPad more "at the mercy of the manufacturer" than a Panasonic tablet? Have you seen how many apps there are out there that take advantage of the iPads features? Vs how many apps available from third parties taking advantage of windows tablets features? That's hilarious.
And have you seen how crippled devices like the panasonic can be by issues with custom drivers for their limited-run hardware on patch tuesday, and how infrequently such drivers are updated?
As for the price, your panasonic tablet costs double what an iPad does. Broke one? Good luck picking up a replacement on the high street!
Your head must be scrambled if you really believe all you wrote and want one SO MCUH!
I'm confused how you can level this accusation at Apple, when ultimately the same accusation can be directed at ANY supplier of ANY piece of equipment, no matter how non-proprietary.
Also, can you explain how price has anything to do with patients dying? I presume you have seen a formal use-case for this device so you know exactly how it will be used in hospital? Presumably patients will be dying because the iPad will fail when displaying real time results from ECG sensors? Despite it not actually being able to interface with these diagnostic technologies?
My guess is though that you forgot to engage your brain before posting and just saw an opportunity to bash a technology that is trying to do something different.
I'm not sure how the iPad will be used in hospital, I'm not even sure how any required medical apps will get onto it, but I can see a fantastic use case in reducing paperwork and sharing consultation notes, updating patient records, internal and external emails and the like... and this ultra mobile use case is shared by many businesses - and not just medical ones. A lot of people have bashed the iPad as having no practical use. I agree to a point... but on the other hand, what are YOU going to do on a netbook PC whilst having a coffee in Starbucks that you can't also do on an iPad? Email - check. Web - check. Facebook - check. I doubt very much you will be trying to code a web application, or trying to remotely connect to your companies SAP system via a VPN. But then that's never been what the iPad is about.
Apple has taken the risk and produced a device that requires minimal technical support to use, can be used by just about anyone with an IQ above 50, and is actually fun. I know few people who have actually bought one, but those that have - love it.
I was resistant to the iPhone for a long time, but now I have actually used one for a month, I wouldn't give it up - it is a fantastic piece of kit.
Apple has actually done this before, way long ago. Apple's other problems at the time meant that this didn't go forward but the trial showed very positive results.
It's not the price of the device that matters. In the case of the iPad, it's actually quite reasonable. What matters is the improvement in medical outcomes, or "quality of care". For example, preventing a severe case of adverse drug interaction is a great benefit to the patient and saves a lot of care and money. The list goes on and on.
Kudos to Victoria for doing this.
why ipads? why now? what possible requirements list does the ipad meet? secure? durable? fit for purpose? battery life? environmental conditions? what about getting data on/off? integration? itunes? hahaha.
is this just some highlevel muppet who got sucked into the hype?
Windows and Android-vapourware tablets are much more suited to the task.
Virus free, un-crackable with not a chance of user/patient data being fed back to the all devouring ad broker mother company.
Nice clunky fragmented interface or if you like the super new Windows 7 which has been specially designed for err, tablet computing.
And, wait for it, with oooh "Approximately 6 hours of battery life" according to the Panasonic Toughbook blerb.
Way to go man... way to go!
We're trialling one now in my practice and so far it's dream. It meets all of those criteria that you imply it wouldn't and it gets you closer to the patient. There is nothing like sitting down next to the patient and going over their clinical data on the iPad. In addition, I wouldn't put any of my patient data anywhere near a windows machine. Despite all of their security measures our University department has emailed viruses on more than a few occasions but those of us on Apple kit of course have not had a problem. Rail against Apple all you like but if you just want to get the job done with a low cost of ownership and excellent tech support, you can't knock them.
"...Rail against Apple all you like but if you just want to get the job done with a low cost of ownership and excellent tech support, you can't knock them...."
I have to challenge that Apple is expensive and have very poor technical support, their general customer support is even worse - I speak from experience, both personally and from several people at work,
If the iPad does the job, that's fine, but this is a medical device designed to be touched and you say that you show patients their data on the device (implying they are very close to it). This would seem like an excellent way to contaminate it, how do you keep it sterile?
Have to disagree on cost as if for example you compare a MacBook with a similar machine, say a Sony VAIO the purchase price is much the same. As they need very little support the TCO is much lower than when we had Windows PCs & we buy a 3 year warranty with each machine for a fraction of what say PC World would charge (not I know perhaps the best comparison!). As for tech support we now have a dozen or so Macs & many colleagues have them as they are pretty common in medical circles. Our experience is that Apples tech support is frankly stellar. We have direct access to level 2 tech support but when travelling, anywhere with an Apple store can provide help if needed. The only time I have needed it seriously was when a motherboard went on my MacBook on a flight to Seattle & their local store had the board replaced in just over two hours. YMMV of course!
With regard to sterility we only use the iPad at consultations so it doesn't go into an environment where it has to be sterile. Clinically clean is fine and all you can achieve with any device.... I'll bet you can't autoclave a Panasonic Toughbook <g>
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"Besides ... the iPad doesn't support centralised management and doesn't have good options for bespoke app installation."
Er, yes. Yes it does. Here, I'll give you the link: http://developer.apple.com/programs/iphone/enterprise/
Clearly you believe research is something that only happens to other people.
... an iPhone development site is relevant to AC's comment about iPad usage? The iPad is mentioned but maybe you'd like to post links to pertinent passages that cover the comment you find so repugnent. I mean you're in the business of defending Apple so at least make a conclusive closing argument.
yes it is, Doug. You see, Doug, the iPad is based on something called "iOS", which until earlier this year was available on the iPhone and iPod Touch and was called the "iPhone OS". If you read the attached link, Doug, you'd see that one can indeed "...deploy proprietary, in-house iOS applications to employees within your company or organization." which is relevant to the OP's missive.
...and longer are common, but none of the doctors or nurses I know (i.e. most of my social and professional circle) spend even 20% of their time in front of a computer. 10 Hour battery life is fine, and you're kidding yourself if you think better is available elsewhere on a comparable device (which of course doesn't exist).
...centralised management? app installation? health records on iTunes? You really have no clue coming up with these straw men.
we use these accross several sites for Electronic data capture in ward areas they also look alot better than the "tough books" and the new C5V has much better specs than the old ones. Doubt Ipads will take off
also @Richard 81:
"Also, if they were to start using tablets, shouldn't they have a slot for those NHS access cards?"
no, you can get them on most MCA based devises. BUT! i wouldnt really call it a secure login, as cards can be stolen and dupped. we use a mix of encryption software and AD authentication.
Is it possible to deploy your own software legally on the iPad? Don't all releases need to go through the public App store?
I don't know how this works with other operating systems such as Windows Mobile etc, but seems with most new devices the possibility for a company to develop their own in house software for most mobile devices has been taken away.
I'm sure there are some apps out there that could be semi-useful, but as said can probably done on another, cheaper, more purpose built device.
A) iPad has a battery life that will happily go through 12 hours
B) As someone mentioned above, at the enterprise level you don't need to go through App Store / iTunes so the software vendor could quite happily create what ever level of security they required.
C) This is not our NHS. This is down under.
I am not saying it will work as a concept but at least I am willing to look into the facts rather than a rather dull anti-apple rant.
"The stupidity about getting an iPad... what can it do that you can't do on other devices... waste of money... jumping on the latest bandwagon"
The interesting point isn't want Victoria are doing, but the reaction of people on techno blogs like this. Every day, all round the world, public bodies such as hospitals, ambulance services, police forces, government departments, the military etc. place orders for millions of devices of all kinds. A tiny percentage of them are made by Apple, so what on earth is all the fuss about?
"Ooh ooh look, big scandal, Nether Whingeing Health Authority just bought a load of Casio DT-X30 PDAs! How stupid of them, are they retarded or what, everyone knows they should have bought the Datalogic Pegaso or Elbit RPDA-57 instead, the DT-X30's only got one RS232 port, how shortsighted is that?"
Honestly, who gives a toss what device Victoria bought?
In the United States, doctors have such status at hospitals that it's not possible to prevent them from attaching their iPads to the network and using them to download charts and access email.
When faced with the inevitable, one must simply make accommodation.
... and boy do they sometimes make the most rediculous requests: "I'd like it to link to the computer in my BMW so it'll be running and warmed up when I'm ready to leave".
"Well what time are you leaving?"
"Oh I'm never sure, just program it to start 10 minutes before I go off shift".
Paris because, well, it fits.
I'm thinking the lack of keyboard theoretically makes these less likely to be a germ-farms (through having less places to hide, and being easier to clean), which is obviously important in these days of flesh-eating viruses and given this device will be transported all around the hospital in the hands of the docs.
Though given the state mine gets into with finger grease, I'm not convinced the screen-only option will be any more hygenic.
Besides...aren't we not allowed to use radio-emitting equipment in some wards due to the "sensitive equipment" therein? Do I sense a conspiracy by hospitals to deny us the use of phones and other radio equipment for some reason? And will the jobs-reality-distortion fields prevents such interference?
Lets hope this isn't some NHS scam to grab themselves iPads on the fiddle. Which is what we're all thinking.
thats why intel developed the MCA standard. any device that follows it must be sealed, infection proof and have a handle for easy carying. as part of our deployment all devices are cleaned before being returned to a charging dock (which can be connected to a monitor keyboard etc.
and in terms of radios. yea it is abit of rubbish, Dr's have used pagers and mobiles for years in wards, doesnt really cause any problems. the new official line in alot of places is that no phones means less disruption to sick patients etc! hell we have wifi in most of the hospitals here.
and again this is nothing to do with the old NHS lol!
As an iPad owner, this makes sense to me:
First, the iPad is effectively instantly on/off (well suspended, but why would you ever shut it down completely?). I doubt anyone is going to be using it solidly for 12 hours.
Second, presumably they will mainly access web apps with it. No local data, no windows to get confused with, nothing to tinker with. Being so restricted is actually a bonus for this case - its just a portable browser window.
I mean, some heavy duty tablet that can be steam-cleaned, etc. etc., is possibly so costly an IPad would be cheap by comparison; honestly, I figure IPad versus perhaps a *slightly* cheaper tablet is like a drop in the bucket. I think IPad is highly overrated, but *shrug* really would not lose sleep over using IPad as opposed to some other tablet.
But, I would not want my medical data piped over wireless! So if they are using it as a diagnostic aid, that's one thing. If they are using it to update and read my chart, I wouldn't want that at all!
I would've thought it would be cheaper to just bolt lots of web-terminals to the walls of the hospital -- given that the design wouldn't have to be as super slim as an iPad, and given that it wouldn't need any batteries (which really, is going to make it a lot easier to manage long term anyway), it should work out cheaper... even if you need more of them so that there's always one in easy reach. Plus they'd be less nickable!
Health Authorities love spunking tax cash on useless overpriced gadgets.
Just look at those special, over priced "Clean Me!" keyboard that were installed in some UK trusts.
They now get cleaned as regularly as a normal keyboards would (never) but with a nice LED to say it's not been cleaned.
How much were they each...?
His inscrutable scrawl could not be faithfully reproduced on an ipad.
And I can see the towering stacks of ipads on each floor taking place of the paper patient "charts" even now.
Wireless charging stations in all the patient's room to be billed back to the insurance companies???
1. It is generally considered unwise to source an item from a single monopoly supplier.
2. They are desirable, and will be stolen.
3. They cannot be sterilised.
4. For security reasons, they should really only be a dumb, WiFi connected terminal, providing an interface to mainframe software. There are simpler, cheaper ways of providing this.
1. Name a portable device that meets your criteria and has multiple sources. The Panasonic people have mentioned is a sole-source device, even if it is Windows based.
2. If it's not desirable, the staff won't use it and the money is wasted. I've seen staff revolts kill several large medical IT projects, so don't underestimate the value of "desirable."
3. True, but neither can the keyboards on the roll-around PCs currently in use at my local hospital. I suspect there are issues with the iPad not working with gloved hands too.
4. Who says they're doing anything other than this with the iPad? Using it as a way to get to web-based apps seems the most obvious approach. And what are the simpler, cheaper ways? Roll-around PCs are a complete failure as they need to be plugged in and there is rarely enough space in the room to roll the cart anywhere near the patient. And they are definitely not cheaper on a one-for-one basis.
I wish you lot would stop talking about Apple's newly created Sanitry products...
Don't see the point in having over-inflated RRP priced Apple products in public sector lines of work and you just know it'll blow up on the day the warranty expires (like most Apple products).
The real focus of IT in healthcare should be in direct monitoring of the patient, using beside devices much the same as you find in AE departments nowadays. That way, you can have a central collection point for data, and you can sit and watch your patients vital signs (observations such as blood pressure, O2 levels, temperature) and these are recorded into a database.
Currently, on non AE wards observations are recorded at most every 15 minutes and it requires an auxillary nurse to go from patient to patient with monitoring devices, run checks and then update their notes at the foot of the bed. Introducing automated monitoring would save a huge amount of time, provide an adequate overview of the patient's progress, and allow data to be stored and retrieved on a central database.
Why isn't it done already? Mainly because there currently aren't monitoring devices that are unintrusive to patients - most people don't like having wires stuck to them. Unless they are in AE of course....
But if you'd prefer not to develop less intrusive monitoring devices and would prefer to give your doctors ipads (I can see a logic in that - it makes you seem like father christmas) then you are likely going to be using an input device for more impressionistic notes than automated observations. Funnily enough I''ve just been evaluating impressionistic data input devices for a healthcare setting, and concluded that the top three devices are:
1) Pen and paper
2) Dictaphone or telephone secretary
Strangely enough, these are exactly the methods that have been in use in hospitals for the last 20 years or longer.
The optimum method is to use pen and paper, it's simple! If there's an issue with data management then get an ward administrator to type up salient notes into a PC front end database. Or buy a network OCR scanner for each ward (cost around 2-3K) so that notes can be parsed automatically (assuming that people don't mind writing everything in BLOCK capitals)
ipads and smartphones and iphones are okay, historically windows phones have been used a fair amount in wards too - but these are expensive devices and you have maintenance costs and the fact that they are rather too attractive to the ward magpies.
Alternatives include the Anoto pen, which is used extensively in healthcare settings. It uses a paper that is printed with tiny dots that tell the pen where on the page it is - and this is especially good for forms. However, the pens cost around £300 each and require looking after.
The point is, when people spend all their time looking after patients, at the end of the day they don't feel like looking after IT equipment.
I'm very confused that people on here keep on about the form factor of the device and it not being easily sanitised etc etc. Surely a conversation like this would take place:
Aus Med: We're looking to deploy several hundred iPads in a clinical environment, assuming we can't use one off the shelf (http://www.mobilemag.com/2010/04/30/commuter-and-defender-rugged-ipad-cases-by-otterbox-coming-this-summer/) could you make us a case that allows us to clean the device and protects it from everyday knocks? If you could also add a handle so it's easier to carry that'd be super.
Case Manufacturer: Yes.
I'd be more interested if Victoria are planning to develop their own touchscreen apps for the device as they could well provide a solid base for other hospitals to develop their own. I hope they're not just planning on using Safari to access kludgy web applications (which I'm only too familiar with at my own workplace).
In one word, yes.
I'll use a few more to explain. I've worked in the Air traffic management sector and I have seen first hand how the lowly a block of wood, paper and pen can beat millions of £'s worth of equipment, it's called a 'Flightstrip':
When a plane enters the ATC area, it gets written on a bit of paper and stuck to a bit of wood. This is then passed to the controller handling the flight. Once the aircraft has left the controllers area, they will physically pass this block of wood down the line to the next controller. No bugs, power issues, virus, network outages will ever stop this from working.
The operators have all of these expensive, complicated systems to track aircraft, but even in this day and age, most ATC centres will use flightstrips, I'd expect something as safety critical as a hospital to realise that sometimes, simple is better.
Do you have to store a record of all the traffic control decisions and observations for 30+ years?
I thought not. I believe you do keep copies of radio transmissions, but I'm not sure for how long, and suspect that they're all stored digitally now.
The expense of paper records is the storage and retrieval costs. And in the litigious US, overly-detailed record keeping and being able to locate said records quickly is extremely important for doctors to defend against (often spurious) malpractice claims. And for patients when the docs do screw up.
Seriously while iPads are expensive by netbook standards they will be *peanuts* to the price of the various ruggedised gadgets different vertical markets (FedEx, Field repair staff, even drinks machine service people)
It's the whole *system* that delivers benefits, and how well the back end uses its features.
Trouble is the iPad does not seem to have many built in peripherals to help in this market as standard.
*so* when you factor *all* those bits in (and of course their integration), and the deterioration in ability to be sterilized being stylish may turn out to be a *very* poor investment (dual internal mono speakers output through 3 narrow sound tubes. Can you say dirt and bacteria trap?) .
Marky hearts points are well made. I think the expression is "Management by exception." But to do so you don't want to substitute a human taking readings and putting them on a chart with tapping into a box, you want the human *out* of the loop entirely for routine data gathering.
BTW IMHO The UK NHS manages to kill a hell of a lot of people with misheard/misread/misapplied drugs every year. I'd expect *any* hospital laptop wotsit (whatever you want to call it) to have bar code reader (and possibly) RFID as *standard*.
I'd also prefer *no* personal data *ever* be kept on such a device, but that assumes adequate *secure* bandwidth *all* the time. More likely it would require something like Truecrypt, ideally with automated key management, using 2 factor (card + finger print or card + pin) authentication. At end of shift any unsent file updates are sent to the server and the personal files zeroed.
As a concept I believe these systems (with *whatever* terminal device you use) have *huge* potential to allow a smaller team to support the same sized patient population with *better* care than at present. The devils in the detail.
Amateurs buy hardware. Professionals buy *systems*.
Full disclosure. I worked on solid state heart recorders (black box for humans). They don't save your life but they make the coroners job easier.
What a lot of people may not know if that dell where working with a hospital on a slipstreamed windows based touchscreen that had 16+ hours battery life, full wifi with direct access to hospital records, with multiple logons and workflows similar to crm. that was 2 1/2 years ago, it was in trial stages at that point dont know what happened since then. but as for ipad's, please it's like saying i only swim clean water then diving into raw sewage. i do have an iphone as yes it's a good enough device for what i use it for, outside my iphone usefulness i'll grab my laptop or mac depending on what i'm doing.
The phrase is "fit for purpose", in this instance the ipad doesn't live upto it however as a pretty mantle peice orniment that makes visitors go ooooo and aaaahhh maybe (anyone with any sense is likely to say "nice digital photo frame, wheres your real web access. you know the one you can use flash with?") , but not in a hospital!
Apple is warning that lockdowns of factories in Shanghai due to COVID-19 and industry-wide silicon shortages will hurt its sales by between $4 billion to $8 billion in the next quarter.
On an earnings call, CEO Tim Cook said the "constraints are primarily centered around the Shanghai corridor" but "on a positive front, almost all of the affected final assembly factories have now restarted."
Cook added: "So the the $4 billion to $8 billion range reflects various ramps of getting back up and running. We're also encouraged that the COVID case count that's been reported in Shanghai has decreased over the last few days."
This week Apple released software revisions for its desktop, mobile, watch, and TV operating systems, along with application updates and security patches.
MacOS Monterey got bumped to version 12.3, bringing with it 60 security fixes, eight of which involved potential arbitrary code execution.
The desktop OS update also includes some useful features like Universal Control, a way to use a single mouse and keyboard across multiple Apple devices such as a macOS computer and an iPad. If you've ever wanted to copy data from one bit of kit in order to paste it to another with a mere mouse movement, your ship has come in.
Apple has updated its operating systems for the Mac, iPhone, iPad, Watch and TV boxen, correcting dozens of security issues along the way.
Full details of Apple's bugs aren't available at the time of writing, but plenty of them sound more than worthy of rapid remediation.
CVE-2021-30986, for example, means a device running macOS Monterey "may be passively tracked by its Bluetooth MAC address". That is not good.
A component shortfall is reportedly forcing Apple to divert supplies of essential innards to the iPhone 13 at the expense of the iPad – though European suppliers are not yet seeing elongated lead times for buyers in all but the basic models.
iPad volumes produced by Apple’s contract manufacturers were down 50 per cent for the past two months on the company’s earlier forecasts, according to the Nikkei – both hardware shares common components, including core and peripheral chips. The financial paper cited multiple sources saying the firm was taking parts from iPad Peter to build iPhone Paul.
The apparent decision by Apple was in anticipation of demand for the latest handset, released in September. The Christmas quarter – Apple's Q1 – is typically the busiest of its financial calendar and the iPhone is the biggest seller.
Interview As Apple's devices continue to find favour with enterprise users, the fortress that is Windows appears to be under attack in the corporate world.
Speaking to The Register as the Jamf Nation User Conference wound down, the software firm's CEO, Dean Hager, is - unsurprisingly - ebullient when it comes to the prospects for Apple gear in the world of suits.
Jamf specialises in device management and authentication, and has long been associated with managing Apple hardware in business and education environments. In recent years it has begun connecting its products with services such as Microsoft's Azure Active Directory as administrators face up to a hybrid working future.
iFixit has published a preliminary teardown of the M1 iPad Pro, touted by Apple as a potential crossover, combining the portability of a tablet with the unbridled power of the same processor used in the MacBook Pro. But take a look at its innards and you'll find things largely appear the same.
As was the case with previous iPad Pro tablets, the avenue of ingress was through the display. This required iFixit to melt the adhesive flanking the sides with a gentle application of heat, and pulling it up using a heavy-duty suction cup, taking care to keep the display open with a few carefully placed plectrums.
The tagline for today’s Apple product launch event was “time flies.” How ironic given 2020 feels like it's been a decade long.
Expectations were inevitably raised. And what did we get for our patience? New watches, a refreshed iPad and iPad Air, and… that’s about it.
Review While Apple saw fit to bestow its wallet-crushingly pricey Magic Keyboard on the iPad Pro and Air, no such love was given to the entry-level 10.2-inch iPad, which is a favourite of schools and hard-pressed parents alike. Filling the gap is Logitech's newest Combo Touch keyboard case, which, for the first time, adds a trackpad to the mix.
And while it lacks the sophistication of the Magic Keyboard (and, in fairness, the steep price tag), it nonetheless elevates Apple's cheapest tablet into something more than a humble Netflix machine.
While UK parents looked forward to weeks more of home education for their poppets, iDevice management service Jamf School has taken a tumble for some users.
"Our Jamf School MDM has been down for days," grumbled one Register reader trying to deploy a fleet of Apple fondleslabs at an academy in the north of England.
The borkage, which appears to have started in the eu-central-1 region on 28 January and is still ongoing, days later, is a "service interruption for the VPP service (used for licensing apps and books) that is preventing app assignment within Jamf School", according to the company's status page.
Microsoft has finally introduced trackpad support for Office Microsoft 365 on the iPad.
The update – which covers Word, PowerPoint, and Excel – is designed to help these apps more closely resemble their desktop counterparts when it comes to things like selecting text, resizing page elements, grouping spreadsheet cells, and so on.
The tweak fulfils a promise made by Microsoft earlier this year to add improved cursor support in its iPadOS Office apps, and will roll out to customers over the coming fortnight.
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