Physician Demand for iPad EMRs is Growing. Are Vendors Ready?

by Austin Merritt

Chief Operating Officer,
January 19, 2011

The answer to that question is a surprisingly resounding “No!” The medical software industry is far from supporting iPad EMR software on a meaningful scale. Buyers would think that vendors eager to grow market share would quickly adopt new, flashy technologies, but software vendors are surprisingly slow to react. Electronic health records vendors need to get on board or face the prospect of losing market share to faster-moving competitors.

There is no doubt that buyer demand for the iPad is surging. A past Software Advice poll (below) found that nearly 35% of healthcare providers were “very likely” to purchase a tablet PC in the next year. Don’t forget that the iPad enjoys 87% market share of the tablet PC market. That’s a lot of potential customers looking for iPad EHRs.

However, there are very few vendors well-positioned to benefit from this trend. In fact, only two EHR systems currently on the market were built from the ground up for the iPad:

Nimble – Released by ClearPractice in October, 2010.
Dr. Chrono – Founded in 2009 with their first release in 2010.

Aside from these two companies, only a handful of other vendors (most notably AllScripts and Quest) have released iPad apps to supplement existing EHR systems. I should note there are other systems on the market that are accessible from the iPad’s web browser, but they are not native iPad apps. HealthFusion's MediTouch is one such EMR optimized for the iPad's web browser. (Some readers might be wondering about MacPractice. Their system does run on the iPad via a VNC interface, but it’s not a native iPad app either.)

So where are the 300+ other EHR software companies? They have iPad apps “in the works,” but not ready yet. This really comes as no surprise. The medical software industry is notoriously slow to adopt new technologies. Have you ever seen your doctor’s office running a system that looks like it is from the 80s? We hear from these practices every day. Plenty of software vendors are still selling outdated, DOS-based systems with Windows interfaces (we will withhold names to protect the innocent).

As a result of this slow movement, we expect a number of newer software companies to quickly gain popularity and seize market share from vendors who are slow to move. Interestingly, a number of garage-based startups are already poised for growth: medical iPhone and iPad app developers.

There are currently well over 10,000 medical apps available in the App Store. These apps range from basic ICD-9 lookup tools to more advanced apps to track patient SOAP notes. While many of these small developers won’t have the resources to scale and develop sophisticated EHRs, some just might have the ability (and the guts). These potential movers include some of the more popular medical apps. Here are our top candidates:

Lightweight EHRs

iMediNotes App iMediNotes – iMediNotes lets physicians create and track basic SOAP notes. It offers very limited templates.

Mediforms EMR – The free version of this EMR was released in early 2010 and is geared towards gynecologists. The paid version will be coming in 2011 and will be more full-featured, including templates for other specialties.

Mediforms EMR SurgiChart – Released just last week, SurgiChart allows surgeons to track and share their patient case summaries. It currently does not allow the ability to create or edit them.

Scutsheet – Scutsheet provides basic functionality for creating, editing, and tracking patient progress notes and lab test results.

Other Medical Apps

Mediforms EMR MediMobile – MediMobile is primarily a charge capture application. It also offers the ability to track patient information and PQRI requirements. It also integrates with existing billing systems. This core functionality provides a lot of the core EMR functionality and could pave the way towards a more complete EMR system.

Epocrates – One of the most popular medical apps on the App Store, Epocrates is a mobile drug information resource for physicians. It doesn’t offer ability to track patient records, but tracking drug interactions is a key component of EMRs. If they were able to build a mobile EMR, they’d be able to capture market share quickly through their large user base.

Medscape – While this app is comparable to Epocrates as a drug reference tool, the vendor WebMD is a likely iPad EMR candidate. Despite the WebMD/Emdeon split in 2006, WebMD could realize synergies with their past medical billing systems and leverage a large network of users.

Think anyone else would creep into the EHR space? Feel free to let us know in the comments below.

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David Bagby

MacPractice has both the VNC connection to a Mac, and also an iPad native interface for at least some functions.

http://www.macpractice.com/mp/ipad/
http://www.emrandhipaa.com EMR and HIPAA

I’d have to argue the opposite. I think that almost all the EMR vendors that I see have an iPad strategy. Nothing wrong with a web based version for the iPad either. In fact, watch for the web to win out on the iPad eventually. At HIMSS I’m sure that one of the most common conversations will be EHR vendors iPad approach.

Also remember that even nimble, which you mention, is only parts of the EHR and not the full EHR software. I wrote about that: http://www.emrandehr.com/2010/10/05/clearpractice-ipad-ehr/ I think that many more EHR vendors will adopt this type of approach to iPad EMR.
http://medicalconnectivity.com Tim Gee

Austin, you’ve hit upon the biggest barrier to adoption for many mobile computing devices (and why Computers on Wheels are so prevalent). Any computing device that can’t use the software vendor’s existing user interface design is dependent on that vendor to redesign their UI for the new device. Whether it’s the iPad, iPhone or the Emano Tec tablet, their smaller size requires UI changes that only the vendor can make.

In everyone’s excitement over the iPad, often overlooked are other critical requirements for use at the point of care. Here’s a brief list:
1. Battery life that lasts a full shift + commercial grade rechargers
2. Ruggedized to withstand repeated 1 meter falls onto linoleum covered concrete
3. Water resistance against patient fluids and disinfectants
4. Resistance to the harmful effects of hospital disinfectants

For all its ease of use chops and sexy design, the iPad doesn’t come close to meeting the requirements above. And adding accessories to meet those requirements takes a lot of the Apple luster off the iPad.

Certainly, there are environments and use cases where devices like the iPad could work, and I expect the device to be supported by HIT vendors, large and small.

Two other factors are likely holding HIT vendors back. The iPad is a proprietary platform. Clients for Android and Windows tablets will require significant additional work. Vendors would likely prefer to use Citrix or some other tool to write once and run on a broad spectrum of tablets.

The other issue is that with the Meaninful Use train barreling down the tracks, most vendors are fully engaged with their core product roadmap and have little bandwidth to branch out onto a new category of device.

Perhaps the tablets from Cisco or RIM will offer a better solution than the iPad from an enterprise IT perspective?
http://drchrono.com Daniel Kivatinos

Hi Austin,

Thank you for writing this great article about us.

If any has questions feel free to contact us!
http://drchrono.com/contact

Daniel, cofounder.