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. …
12 hour shifts...
...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.
... 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.
10 hours is for continuous usage of the iPad with the screen on all the time. Since it's highly unlikely this would actually occur during a shift, it would be reasonable to expect real-world battery life to be more than sufficient.
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.
iSoft were (still are?) developing an iPhone/iPad interface for their Lorenzo product...
The title is required, and must contain letters and/or digits.
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.
dont forget Motion c5's
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.
OK, OK, we get it...
Yes, we get it - The Reg hates Apple.
Grow up and move on, your obsession is unhealthy (pun intended)...
WOW! Calm down dears
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.
Who cares about the iPad?
"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?
Different country, different problems
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.
True, So True ...
... 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.
Germs and nasty things
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!
Battery life not an issue
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.
iPads for hospitals: is this a good idea?
No, because the iPad overheats like a marshmallow in a blast furnace.
Not to mention a shape that'll give you arthritic fingers in a matter of weeks and WiFi that doesn't work.
Have you used one, or just heard about this issue? You do realise that the extemely few complainants are whining that it over heats *in direct sunlight* (as most computing devices would do)? As for the arthritic fingers rubbish, doesn't this affect iPhone and Android users too?
Depends what they are using it for
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...?
The Administrator wants one
Simple as that really - can I get an app that goes "ping"?
California may have been first But a hospital on Taiwan is using i-pad routinely
for patient information in detail on theoir condition tests radiligy etc
Not for my Doctor
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???
Title? What title?
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.
Stop talking sense...
It's all about kudos and cool.
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.
Apple's sky in the pie
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).
Looks like it will make a convenient emergency handball mitten.
And not bad for back handing the occasional drunk *allegedly* found in UK ER's on a Friday night.
US -> UK
We don't have handball mittens, nor Emergency Rooms in the UK.
More likely to have cricket bats and Accident and Emergency.
Only I've know nurses remain up for 40 hours.
Damm that women could drink.
Hope it can disinfected with Alcohol. Something tells me there going to be disinfected a lot.
Monitoring Devices or Pen and Paper
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).
The medical staff should continue to use pen and paper?
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.
Buying the hardware should be the *last* concern
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!
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