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The Reports of My Death Have Been Greatly Exaggerated

By Paul Nerger, Senior Advisor

November 21, 2011

While traveling in Europe, Mark Twain was surprised to hear that a New York newspaper had printed his obituary. Recently, there has been a similar situation in the world of mHealth. Over the last few days I've read several articles about the failure of working with the iPad in a Seattle Children's Hospital trial. From the Gartner Group to CIO magazine, everyone is jumping on this story because it’s news when such a successful device seems to fail. “Every one of the clinicians returned the iPad, saying that it wasn’t going to work for day-to-day clinical work,” CTO Wes Wright was quoted as saying. “The EMR apps are unwieldy on the iPad.”

First, I must state that I have no first-hand knowledge of this trial. What I'm about to say is from reading the same news stories that I believe might have exaggerated the death of the iPad for hospital use.

Seattle Children’s had its doctors access their Cerner EMR using an iPad 2. They didn’t use a native iPad app, but rather had them access it via the Web using the iPad's Safari Web browser. In my experience, this is a bad idea. Let me explain.

I love Web apps and prefer them to native apps. They’re easier to manage, update, and deploy, and they run across platforms. But simply taking a PC website and deploying it blindly to a touch device such as the iPad is a potential disaster. PCs use a mouse. A mouse for Windows PCs has at least two buttons, a left and right button. The right button is often used to pop up a contextual menu. Touch devices have fingers and gestures. Apple's Safari browser on the iPad does not have a finger-based gesture that will generate a right-mouse-click event. Thus, if the website that you want to use on a mobile device has a right-mouse-click, you will have a failure. This is only one of the incompatibilities between PC-designed websites and touch-friendly websites.

Prior to the release of the new Kindle Touch devices, Amazon revamped their website to better support the needs of touch devices. You might have noticed that a lot of things changed. This is because a touch-based tablet or phone is not a PC. When deploying a website designed for a PC to a tablet, you need to go through the site and make sure that the mouse actions translate well into gestures. If they don't, you need to look at the guidelines published by other developers, including Apple, on how to alter the site. 

So, what is the lesson to be learned from Seattle Children's Hospital?  First, emulate them and run a trial. But also, look closely at reported failures and find their true cause. If you are in IT in a hospital, do what doctors do: focus on treating the disease rather than just treating the symptoms.