iPad Reactions

[not daSkeptic]

You say this as if there is some great dispute about that aspect of the discussion. I don't think there is.

Then why are so many who lie outside the iPad target demographic seen to criticize it as being underpowered and useless? Why don't they just say, "Meh, it's meant for someone with lesser needs than myself," and walk away? Why don't they just go out and buy that more-capable netbook if it's what they really want?

 

[not daSkeptic]

Can you use this device if you don't have a computer?

It is my understanding that the device is able to operate at least partially without any need for a computer, yes. I'm sure there will be some functions that require external support, but I would assume these to be more advanced features.

 

[Darat]

Then why are so many who lie outside the iPad target demographic seen to criticize it as being underpowered and useless? Why don't they just say, "Meh, it's meant for someone with lesser needs than myself," and walk away? Why don't they just go out and buy that more-capable netbook if it's what they really want?

Or perhaps they've just listened to Apple's marketing material and are making their criticisms based on that? For example it is Apple that is claiming that the iPad is "The best way to experience the web, ....." yet if you use the iPad you cannot even fully "experience" some of the websites that Apple shows the iPad accessing in its promotion video. (Indeed Apple rather embarrassingly had to alter their video of the iPad in action when it came to light that it showed the iPad apparently displaying Flash content! )

Now personally I have no issue with Apple making their claims - it is after a ruthlessly commercial company so wants to make the most money and exaggerated claims is part of its strategy, but you can't then criticise people who are criticising Apple based on what Apple is saying about the device.

 

[not daSkeptic]

For example it is Apple that is claiming that the iPad is "The best way to experience the web, ....." yet if you use the iPad you cannot even fully "experience" some of the websites that Apple shows the iPad accessing in its promotion video.

You mean the promotional video that was immediately pulled when it was discovered it contained screenshots taken from a desktop Mac and not the iPad? Hanlon's Razor would seem to apply.

And so what if they claimed the iPad is "the best way to experience the web?" That was a subjective claim made in the context of a marketing presentation. It's called selling a product, and as already discussed it is nothing that other companies don't do themselves all the time. Is there a big media backlash when Lexus claims they have the best luxury car? How about when McDonalds claims they have the best value for one-dollar?

 

[back2basics]

I'm willing to take you up on a wager on that last prediction.

The device won't meet HIPAA compliance because the device is unable to be centrally administered. An app that is won't change that about the device, and that will keep it out of compliance. There isn't a CIO around that's going to want to touch this in a corporate environment.

I will take you up on that bet. Would you like it to be a sportsman's bet or would you care to wager money?

Do you have an iPhone?

Just search on Haiku in the App store.

Here is a picture. You seen the patient identification?

http://histalk2.com/wp-content/uploads/2010/01/haiku_thumb.png

That application is being used across the country in large hospitals Cleveland Clinic, Northwestern Univercity and dozens of others, right now as we speak. These are huge hospital groups, with some of teh best CEO's and CIO's. Its a portal in to an EMR for rounding. There are also versions for most PDA's and versions for other vendors EMR that work on the iPhone. All HIPAA compliant. Its a view on data, central admin is done via the EMR. There is no difference between that iPhone app and the app that will run on the iPad (which is already being worked on and requested by Physicians). The only difference with the iPad is it will be on a bigger screen.

 

[GreNME]

This may be a valid statement in regard to HIPAA-compliance, but it is by no means correct about all corporations. The CIO in my own company, for instance, is very excited about the prospects of the device, and numerous uses are in development as we speak. Operations, administration, it's across the board.

Sounds to me like your own company is looking for problems that this device may be a solution for. Good luck with that, because the way you word it that's still a solution in search of a problem. Further, you're arguing from some kind of exception and not the rule I stated-- all general "rules" have exceptions, and pointing that out doesn't change the rule.

Once again, not everybody sees things the way you do. Not everything you perceive as a limitation is necessarily so for others. Everybody's situation is different. We don't all have the same needs or wishes. To think you know what does and does not work for everyone is sheer arrogance.

There's no arrogance about it because the limitations are technical. From a technical perspective, Ducky is correct about the data security limitations of the iPhone OS and the devices Apple puts them on. Pointing out exceptions doesn't change these technical hurdles.

Then why are so many who lie outside the iPad target demographic seen to criticize it as being underpowered and useless?

Because when the "target demographic" is far smaller than the general demographic who could use such a form factor, people are going to complain.

Again, daSkeptic, I'll point out again that I'm not writing the iPad off completely in terms of having a market impact. In fact I'm fairly certain that it's going to sell, and am guessing it's going to sell well enough to at least not be taken off the market. I made my guesses at what parts of the computing market were likely to pick this up and I explained why I had those conclusions, and rather than hold that as my final conclusion on the device I also specified a "wait and see" approach. Your complaints thus far have mainly been to the effect that anyone who displays even the least amount of skepticism toward this device and its likely market infiltration is being arrogant or ignorant or some combination of the two, and with that you're not being rational or looking at the subject with a critical evaluation of what this device means for that space between smartphones and laptops. Any attempts to try to explain some of the flaws you dismiss is met with incredulity or disdain by you.

Have you stopped to consider that it's not everyone else lacking imagination that this device simply may not be for them, and that it's your own approach that is lacking in some critical thinking in approach to this device?

 

[GreNME]

I will take you up on that bet. Would you like it to be a sportsman's bet or would you care to wager money?

I actually have an aversion to gambling money, but I also strongly suspect that the definition of your prediction is likely to shift in scale.

Do you have an iPhone?

Nope, I have an iTouch, but I've administered iPhones for executive staff. I've become quite good at locking them down as far as they'll go and then opening them up to a point where the execs stop whining at me.

Just search on Haiku in the App store.

Here is a picture. You seen the patient identification?

http://histalk2.com/wp-content/uploads/2010/01/haiku_thumb.png

Yes, and I see nothing about this app that shows it meets HIPAA requirements

That application is being used across the country in large hospitals Cleveland Clinic, Northwestern Univercity and dozens of others, right now as we speak. These are huge hospital groups, with some of teh best CEO's and CIO's. Its a portal in to an EMR for rounding. There are also versions for most PDA's and versions for other vendors EMR that work on the iPhone. All HIPAA compliant. Its a view on data, central admin is done via the EMR. There is no difference between that iPhone app and the app that will run on the iPad (which is already being worked on and requested by Physicians). The only difference with the iPad is it will be on a bigger screen.

Now I'm beginning to wonder if you're just gullible to hype or if you have some type of vested interest in Epic Systems. You see, your claim that this app is already being used "across the country" is just plain false, as it has only been in a pilot program for a couple of months, tops, at Stanford. While Epic Systems has contracts with lots of other hospitals-- presumably these "dozens of others" you speak of-- but those are for its server-side EHR software. Now, you could shift over to Allscripts Remote as being another possible viability (that's been around longer than Haiku), but the first time there's an investigation into HIPAA compliance-- and there will be, just like there was with Johnson & Johnson's LifeWatch-- the question is going to be whether healthcare providers are going to keep such an optimistic view on the product (LifeWatch interest waned quickly). Even further than the software coming out for mobile devices is the use by staff of medical facilities, which saw a huge HIPAA breach last year, which also can restrict uptake of newer technologies even after they're paid for by the hospitals. With the newer presidential administration being tougher on HIPAA compliance while simultaneously encouraging movement to electronic records, you can expect more scrutiny of mobile applications that deal with patient records this coming year, and this almost guarantees the probability of the hardware they're running on having scrutiny as well.

It's not that I'm simply being incredulous as to the application of the iPad for this particular use-- on the contrary, when I was contracting six years ago one of my company's EMS clients had tablet devices configured and installed in every ambulance for quick delivery of medical information-- it's that I'm aware of the difference between hype and practical use and this colors my evaluation of tools prior to being employed. All it takes is one lost device for a debacle that eventually leads to a hospital being fined and their software contract not being renewed as a result of the cost. Sure, that keeps the software vendor from facing direct blame and it tends to ignore procedural mistakes in evaluating the hardware platform, but being familiar with the infrastructure weaknesses and how to avoid them has been my job in past positions and will likely continue to be so in future ones, and the blatant weaknesses present with the iPad and the iPhoneOS are abundantly clear. Incindentally, that's why I'm not too critical of the hardware form factor-- which I do think will be a boon in the medical field-- but focus on the software limitations. I suspect one of the numerous other devices I linked to in an earlier post will meet and/or exceed the requirements for practical use in the medical field.

 

[not daSkeptic]

Sounds to me like your own company is looking for problems that this device may be a solution for. Good luck with that, because the way you word it that's still a solution in search of a problem.

Oh? And what are those problems and solutions? You seem to know so much about everybody, their situations, their goals, their desires. So please, tell us the details of what we're doing.

Further, you're arguing from some kind of exception and not the rule I stated-- all general "rules" have exceptions, and pointing that out doesn't change the rule.

Keep moving those goalposts.

There's no arrogance about it because the limitations are technical. From a technical perspective, Ducky is correct about the data security limitations of the iPhone OS and the devices Apple puts them on. Pointing out exceptions doesn't change these technical hurdles.

And the existence of these technical hurdles doesn't change the fact that not everybody considers them a problem. The arrogance is in thinking you understand everybody's situation. Oh, and if you had read further you would have noticed that I agreed with Ducky.

Because when the "target demographic" is far smaller than the general demographic who could use such a form factor, people are going to complain.

I presume you have some data to back up your understanding of the demographics in question?

Your complaints thus far have mainly been to the effect that anyone who displays even the least amount of skepticism toward this device and its likely market infiltration is being arrogant or ignorant or some combination of the two ...

No, I'm accusing people of being arrogant when they claim to know something they could not possibly know.

Have you stopped to consider that it's ... your own approach that is lacking in some critical thinking in approach to this device?

Yes, I have. Have you?

 

[HarryKeogh]

Why are guys getting heated up over a mid-priced media player/web-surfing device?

 

[not daSkeptic]

Why are guys getting heated up over a mid-priced media player/web-surfing device?

Excellent question. Looking back, I realize this debate really doesn't matter in the slightest. It all comes down to each person or each company deciding for themselves whether or not the product is suitable for them. There are a lot out there who think it isn't, and that's fine. There are many who think it is. Unfortunately, there are also many who think their views should be held by everyone (in both groups, most likely). They're just jerks and aren't worth anybody's time.

So with that said, people can whine and complain all they want. Those of us that see a useful tool will be over here using it.

 

[commandlinegamer]

As mentioned earlier, price is a factor. Apple wants to be seen, if I read the reality distortion field correctly, as a premium brand, rather than a luxury one. I think people will pay a bit more for a product like this for the reasons I outlined earlier.

Also further to my earlier post, I've noticed that the majority of my customers tend to say they only use computers for web and email. A few still want big gaming rigs or high end PCs for music production or video editing, but the majority seem to only use them for one or two specific tasks. The more I think about it the more concerned I am that it might be because they just find computers too damn' hard, even if they've been using PCs for years.

 

[GreNME]

Oh? And what are those problems and solutions? You seem to know so much about everybody, their situations, their goals, their desires. So please, tell us the details of what we're doing.

That's not at all what I'm claiming. I'm pointing out the real limitations of the device that are inherited from its predecessors, all of which are easily researchable throughout teh interwebs if you're not up on the latest IT publications.

Keep moving those goalposts.

Except that I've been pretty much staying of the same opinion since the second page of this thread.

And the existence of these technical hurdles doesn't change the fact that not everybody considers them a problem. The arrogance is in thinking you understand everybody's situation. Oh, and if you had read further you would have noticed that I agreed with Ducky.

I'm not challenging whether or not you agree with Ducky-- he's not the end-all-be-all of the IT world. This consensus shows up throughout the industry regarding the iPhone already (yes, with occasional exceptions), and you've demonstrated nothing to show how this new device is going to be any different.

I presume you have some data to back up your understanding of the demographics in question?

As much as you do. Or you could get yourself subscriptions to EWeek, CIO magazine, InformationWeek, and other publications and follow the general trends in business IT. Most of them have free subscription offerings you can get in on, even for the print versions, so it's not really a huge hit on your wallet.

But in all seriousness, that you're demanding data yet failing to provide anything but anecdote (lots of "my company" or "my experience" in your posts) shows that you're really not interested in going on trend information anyway.

No, I'm accusing people of being arrogant when they claim to know something they could not possibly know.

Yes, you're (ironically) shifting goalposts and using anecdote as data.

Have you stopped to consider that it's ... your own approach that is lacking in some critical thinking in approach to this device?

Yes, I have. Have you?

Of course I have. In fact, the entire reason my main conclusion about the device continues to be "wait and see" is evidence that I have. Just because I can recognize and identify the aspects that are already evident for Apple's existing devices with the same limitations or challenges doesn't change that. That you're ignoring this and demanding that exceptions be considered the new innovation is evidence that you have not.

 

[Ducky]

i'm not challenging whether or not you agree with ducky-- he's not the end-all-be-all of the it world.

oh yeah? Says you, jerk!

 

[GreNME]

Yeah, says me! You can't hack the Gibson!

 

[not daSkeptic]

That's not at all what I'm claiming. I'm pointing out ...

Wow, so many strawmen it's not even worth my time to address them. And totally unnecessary since what I really wrote is here for all to see.

Have fun putting words into people's mouths. It's what you're best at. I'm going to go be productive.

 

[GreNME]

Okay, good luck.

I'm having more fun calling Ducky names anyway.

 

[back2basics]

I actually have an aversion to gambling money, but I also strongly suspect that the definition of your prediction is likely to shift in scale.



Nope, I have an iTouch, but I've administered iPhones for executive staff. I've become quite good at locking them down as far as they'll go and then opening them up to a point where the execs stop whining at me.



Yes, and I see nothing about this app that shows it meets HIPAA requirements



Now I'm beginning to wonder if you're just gullible to hype or if you have some type of vested interest in Epic Systems. You see, your claim that this app is already being used "across the country" is just plain false, as it has only been in a pilot program for a couple of months, tops, at Stanford. While Epic Systems has contracts with lots of other hospitals-- presumably these "dozens of others" you speak of-- but those are for its server-side EHR software. Now, you could shift over to Allscripts Remote as being another possible viability (that's been around longer than Haiku), but the first time there's an investigation into HIPAA compliance-- and there will be, just like there was with Johnson & Johnson's LifeWatch-- the question is going to be whether healthcare providers are going to keep such an optimistic view on the product (LifeWatch interest waned quickly). Even further than the software coming out for mobile devices is the use by staff of medical facilities, which saw a huge HIPAA breach last year, which also can restrict uptake of newer technologies even after they're paid for by the hospitals. With the newer presidential administration being tougher on HIPAA compliance while simultaneously encouraging movement to electronic records, you can expect more scrutiny of mobile applications that deal with patient records this coming year, and this almost guarantees the probability of the hardware they're running on having scrutiny as well.

It's not that I'm simply being incredulous as to the application of the iPad for this particular use-- on the contrary, when I was contracting six years ago one of my company's EMS clients had tablet devices configured and installed in every ambulance for quick delivery of medical information-- it's that I'm aware of the difference between hype and practical use and this colors my evaluation of tools prior to being employed. All it takes is one lost device for a debacle that eventually leads to a hospital being fined and their software contract not being renewed as a result of the cost. Sure, that keeps the software vendor from facing direct blame and it tends to ignore procedural mistakes in evaluating the hardware platform, but being familiar with the infrastructure weaknesses and how to avoid them has been my job in past positions and will likely continue to be so in future ones, and the blatant weaknesses present with the iPad and the iPhoneOS are abundantly clear. Incindentally, that's why I'm not too critical of the hardware form factor-- which I do think will be a boon in the medical field-- but focus on the software limitations. I suspect one of the numerous other devices I linked to in an earlier post will meet and/or exceed the requirements for practical use in the medical field.

GreNME could you tell me, specifically, which HIPAA requirement you think this software breaches? Something more than "centrally administrated". Maybe a link? I gotta leave for a few hours. It will help to have a frame of reference to work with. Thanks in advance.

It's used at far more places than Stanford. I named more, and I missed 2 other I helped set it, and other options, up. I also posted views of several high profile CEO's and doctors from huge institutions (including Kaiser) that disagree with your, frankly odd, assessment. I am an independent consultant, that means i work for hospitals not vendors. So your accusations of connections with EPIC are a little off and frankly not founded on anything. I am not a Apple fan boy or a hater, before you make that accusation. I have an iPhone, but would never buy a Mac. Let’s try and keep it civil, ok?

Edit : I see your in several arguments already. I don't want an argument on the interwebs, just interested in your logic here. As HIPAA visit these institutions regularly.

 

[GreNME]

GreNME could you tell me, specifically, which HIPAA requirement you think this software breaches? Something more than "centrally administrated". I gotta leave for a few hours. It will help to have a frame of reference to work with. Thanks in advance.

Sure, here are a few (from this as a general reference):

• Access to equipment containing health information should be carefully controlled and monitored. There's no way to accomplish this with the iPhone or the iPad, because there's little to no central administration capabilities set up in the devices.
• Policies are required to address proper workstation use. Workstations should be removed from high traffic areas and monitor screens should not be in direct view of the public. This is possibly unavoidable with the iPhone or iPad, due to the lack of sufficient locking features Ducky mentioned earlier.
• Documented risk analysis and risk management programs are required. The iPhoneOS has no such risk management capabilities to it, again as Ducky pointed out regarding screen locks and remote wiping. Other mobile operating systems do allow for this, which is why I would guess the company is producing this app for multiple mobile operating systems (which it claims to have done or is doing).

It's used at far more places than Stamford. I named more, and I missed 2 other I set it up at. I also posted vies of several high profile CEO's and doctors from huge institutions (including Kaiser) that disagree with your, frankly odd, assessment. I am an independent consultant. So your accusations of connections with EPIC are a little off and frankly not founded on anything. Let’s try and keep it civil, ok?

I didn't accuse you of having connections, but you're claiming that these apps are in use at other places while any publicly-available announcement I find on the iPhone app (not the server-side records management system) state explicitly that Stanford is the only one under the pilot program. Considering the app wasn't released until January of this year, unless you've "set it up" at these places since the middle of last month you're not providing any actual evidence of your claim. You're making claims that, when investigated, seem inflated compared to the information I can find on the software in question (meaning the iPhone app). Giving standard marketing boilerplate in answer to my skepticism is what led to my questioning your information here.

Edit : I see your in several arguments already. I don't want an argument on the interwebs, just interested in your logic here. As HIPAA visit these institutions regularly.

HIPAA isn't an organization, HHS is the institution that would typically have jurisdiction, though the FDA may also have some jurisdiction (with regard to the Johnson & Johnson case). My logic here is that claims like what you're making require evidence, and the only evidence I can find upon searching contradicts your claims.

 

[back2basics]

Sure, here are a few (from this as a general reference):
Access to equipment containing health information should be carefully controlled and monitored.[/i] There's no way to accomplish this with the iPhone or the iPad, because there's little to no central administration capabilities set up in the devices.

All EMR's have user names and passwords. They are setup on the EMR, this central control you seem to think is part of HIPAA. The same password works for the device. No difference. Still no quote of HIPAA regulations that backs up your claim. Where is the reference to central admin? That’s your text. Not HIPAA's. You are making this up as you go.

Policies are required to address proper workstation use. Workstations should be removed from high traffic areas and monitor screens should not be in direct view of the public.[/I] This is possibly unavoidable with the iPhone or iPad, due to the lack of sufficient locking features Ducky mentioned earlier.

No different from a COW. It's in the hands of a Physician and docked in safe areas. No different to a tablet PC. Still no quote of these HIPAA regulations backing up your claims.

[*] Documented risk analysis and risk management programs are required. The iPhoneOS has no such risk management capabilities to it, again as Ducky pointed out regarding screen locks and remote wiping. Other mobile operating systems do allow for this, which is why I would guess the company is producing this app for multiple mobile operating systems (which it claims to have done or is doing).
[/LIST]

That can be, and are, setup in the app. The risk requirements are completed on the EMR, not the view device. Just like a tablet PC. Still no quote of HIPAA regulation backing up your claims.

I didn't accuse you of having connections, but you're claiming that these apps are in use at other places while any publicly-available announcement I find on the iPhone app (not the server-side records management system) state explicitly that Stanford is the only one under the pilot program. Considering the app wasn't released until January of this year, unless you've "set it up" at these places since the middle of last month you're not providing any actual evidence of your claim. You're making claims that, when investigated, seem inflated compared to the information I can find on the software in question (meaning the iPhone app). Giving standard marketing boilerplate in answer to my skepticism is what led to my questioning your information here.

They are in use. They are not publicly released. They can be downloaded by anybody, used by anybody with a supported EMR and access to that EMR, via a username and password.. the strongest control we have on the web or on an EMR. That access is the same as using an EMR. User name, password. What don't you get about that? It’s not the only in pilot site. Google does not have all the information you need here. Give me your burden of proof. And still not a quote backing up your claims about HIPAA regulations.

HIPAA isn't an organization, HHS is the institution that would typically have jurisdiction, though the FDA may also have some jurisdiction (with regard to the Johnson & Johnson case). My logic here is that claims like what you're making require evidence, and the only evidence I can find upon searching contradicts your claims.

"the only evidence I can find", because you don't really work in the field that much. Hospitals don't have press releases when they buy a GE monitoring device. They don't have a press release when they buy a Baxter vent. What exactly do you want apart from a Google search result?

EMR's are not controlled through the FDA. What on earth are you talking about? They are not classed as a medical device. And you expect people to take you seriously? You really don't seem to know what you are talking about here.... and you know... still no quote of these HIPAA regulations to show the best teaching hospitals in the USA are breaking any regulations just a speculation something will happen. Stanford, Cleveland, Kaiser, Northwestern, Premier Heath Partners. All breaking HIPAA regulations and getting away with it. You should report them and be a hero.

You need to do better than this. While Haiku has only been around this year Cerner and EPIC have had PDA version of their software available for years. Still no law suit? Still no investigation by HIPAA?

 

[GreNME]

Dude, you're making claims of authority that can't be verified. You even claim that there's some kind of secrecy involved. I've not once argued that there haven't been PDA apps out for years-- I've actually installed some for healthcare clients-- I'm saying that other PDAs and smartphone devices have controls that the iPhone just doesn't have, to which you respond that they do. The burden of proof here is on you, and all you make are anecdotal and "not publicly released" claims.

As for demanding the actual text of the HIPAA requirements, now you're just moving goalposts around because you know that the software/hardware manufacturer isn't a covered entity (under title 45)-- the hospital is. As such, it wouldn't be Apple or Epic Systems who needs to ensure HIPAA compliance, it would be the hospital, clinic, medical office or other covered entity who would need to bear that onus. You're taking commentary about the technical failings of the devices themselves with regard to meeting a covered entity's needs to maintain compliance and asking me to prove how the device itself is not compliant. Sorry, but because I am familiar with the field outside of using Google (so much for being civil, eh?), I'm not biting on that one.