It’s not what you’ve got. It’s what you do with what you’ve got that counts



At HIMSS Tablet Makers angle to edge out the iPad

Dell recently commissioned a detailed report from Principled Technologies which found that over three years, deploying Dell’s Latitude 10 tablet was 60% cheaper and 11 times faster than deploying Apple devices. “Apple has made it very clear that they are not customizing their platform for business,” Dell’s Chief Medical Officer Dr. Andrew Litt told MobiHealthNews. “If people want to use them in business environments that’s fine. Our focus is on the enterprise — how do you make an It implementation of 250 or 500 devices cost effective over time? It’s not about who’s cheaper to buy at the moment. Frankly, they’re all about the same. It’s about what’s cheaper over three years”

When you realise that staff payrolls are the biggest single expense that most hospitals have it amazes me that so many mobile device manufacturers are making such a big deal about the cost of their devices or the ease of the technical IT support.

When you know that the NHS’s decision to buy 2 in 3 Apple devices is made because they are sold on the clinical workflow offered by VitaPac – an app developed by mHealth startup The Learning Clinic – isn’t it obvious that you need to start talking about clinical workflows, productivity and personnel gains and forget having squabbles over whose tech is better or is going to make an impact on the few percent of hospital budget that’s spent on IT?

VitalPac Flow Diagram

Clarity: Healthcare actually leads most other markets on the adoption of Technology and it’s only recently been overtaken on Consumer Technology

There seems to be an abundance of confusion about this and it’s a myth widely propelled by the media eg. this Forbes article:

for decades, it has been lamented that healthcare is typically 15 years behind the rest of technology universe. Despite its status as the largest industry and medical technology often being at the cutting edge, one frequently observes healthcare tackling issues solved long ago elsewhere

Anyone who works in healthcare knows that healthcare is not actually behind on the adoption of technology (visit the imaging department at a teaching hospital and check out the fluoroscopy angiography, CT scanners, magnetic resonance imagining, positron emission tomography, dual energy xray absorptiometry, endovascular and interventional procedures, etc, etc) but it is now behind on the adoption of consumer technology and there’s a big difference and it’s only happened recently (eg. healthcare was one of the key initial markets for pagers and mobile phones).

Of course I don’t think this means the end of the day for anyone reliant on manufacturing “enterprise hardware” but I think it’s obvious that they need to change just like Apple did in transforming themselves into a mobile company when they realised the iPod was walking dead because music had gone mobile. After the convergence we saw in the Nokia Decade it should be obvious that any computing device must now compete with consumer mobile devices that are being sold in the high street and have +$100 Million R&D budgets.

The first thing that I think Enterprise Hardware people need to stop on the hard sell of the hardware. To help make the point here are the descriptive keywords I found in MobiHealthNews’s Jonah Comstock’s take aways about the mobile tablet device demos he experienced at HIMSS 2013:

“rugged, dedicated, “medical-grade”, enterprise, medical tablets, a good consumer device is not always a good enterprise device, for all the panache of the iPad it is inadequate for clinical workflows, net cost of using consumer devices in an enterprise setting, 60 percent cheaper, 11 times faster (to deploy), ruggedness, a running stream of water, reliability, security, sanitizablility, clinicians are worrying about equipment and not their patients, different degrees of toughness, sterilization, battery life, swappable battery, built-in backup, multiple options for screen-size, input devices, stylus, keyboard docks, rubber webbing, connected to vehicle docks, fresh batteries always on standby, trouble for CIOs, serious hardware problem, The Windows-based tablets are for getting Windows work done, HIPAA designed, HTML5, “operating system agnostic”, lack of enterprise features makes it hard for hospital CIOs to manage them, “The right solution will be an enterprise level solution”

Compare this to a talk by The Learning Clinic’s Roger Killen:

nurses take data down on an iPod and if that’s a sick patient it analyses that data and says ‘oh yeah they’re sick and they’ve got a lot worse since last time they were seen’ and the Doctor would see that because it sends a message straight to the iPhone of the Doctor and it doesn’t just send the message it sends the whole chart so the Doctor can see all the trends as well and they can handshake with the nurse saying ‘I’m on my way’ and the whole thing works a lot quicker – otherwise today the nurse has to do that put it on the chart which takes about twice as long then they have to walk and find a phone, bleep a Doctor, wait for the phone to ring back, it’s all complicated it takes minutes and it’s all supposed to be for patients who are very sick and in need of attention, and then they’ve got to talk it all through rather than having all the data set out in an objective way and all properly written

Know your customers

To hospital buyers a device costing $1000 is paid for in just 3 months if it can provide a measly 2% boost in the productivity of a single Doctor (who earns $200k a year) and that’s before you start adding in the cost savings from reduced need for support/admin staff.

Conversely if you have the most rugged, perfectly waterproof, HIPAA designed Enterprise Tablet with it’s own docking station and multiple input devices, if it’s not delivering you a boost in productivity it’s unfortunately the case that it may never pay for itself.

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