Part one of this two-part series examines how to meet physician demand for iPad EHR access. In part two, we explore how virtualization vendors are benefiting from the iPad's popularity in health care.
Physicians are driving iOS virtualization in health care -- because they are demanding to use iPads in the course of delivering care, and "physicians rule the roost," said Ed Rodriguez, director of health care ISV sales for Citrix Systems Inc., the virtualization vendor that he calls the "plumbing" behind large implementations such as Cerner's Web-hosted EHR offering and 92% of Epic EHRs that are virtualized.
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The popularity of iPads and iPhones has provided virtualization vendors a huge boost, because the technology not only gives docs the freedom to choose their preferred mobile device but also to meet IT's need for structure and security between servers and those devices. Before the iPad, the main purpose of virtualizing an EHR was to bring the medical record into a patient's room, Rodriguez said; since the iPad came out, it's changed the physicians' lifestyle, allowing them to accomplish care tasks outside of the hospital previously unimagined.
But that leaves IT staffers with another implementation on their hands, in the midst of the ICD-10 transition, meaningful use, new HIPAA privacy and security rules and, for some providers, ACO implementation. "[Virtualization] allows IT to embrace mobility in a [BYOD] manner and not be so concerned with security risk because everything is presented -- versus installed and running on those end points," Rodriguez said.
Apple's lock-down mentality a barrier for virtualization vendors?
All this iPad popularity comes despite an undertow of developer complaints about the Apple App Store -- in which most iPad apps reside -- as being too much of a "gated community." Developers aren't the only parties challenging the App Store model, as Apple's come under Department of Justice scrutiny for iPad e-book price fixing after U.S. attorneys settled separate suits with publishers.
There's also a general feeling among developers that Apple, a consumer company, locks down iOS and doesn't provide enough support for enterprise customers to utilize deep features that make the iPad so intuitive to use.
"What we're working toward now -- and with the iPad, it's a little different, typically how we interact with a virtual desktop is through a mouse and keystroke, so know we have to interact with touch, and we have to do that through iOS," said VMWare's Tisa Murdock, healthcare product line manager for VMware View, adding that VMWare does its best to enable health care-specific customer feature requests, such as giving radiologists better, faster "pinch" navigation through four-image sets on the iPad screen.
But making intuitive hand gestures work isn't always possible. "That's the type of features that we're looking at now -- how do we continue to enrich our iPad client and take into account these different workflows…but with iOS, Apple's not very open to helping us enable those behaviors."