The evolution of tablets for pharmacy

Everywhere I look these days someone is showing off a new tablet; in the media anyway. Out in public I typically see mostly iPads with the Galaxy tablet coming in a distant second. I’m not sure that this will change anytime soon, but it’s clear to me that tablets will become mainstream devices for many people over time. The technology is simply too good to ignore. No one knows if the tablet will ever replace desktop machines, but I have an idea that they will for many, especially as the tablet market matures and hardware vendors begin to meet the needs of consumers. Case in point is the growing number of iPad keyboard cases you can find floating around on the internet. People want the iPad experience, but they also want a solid keyboard to work with so vendors obliged consumers by creating things like the ClamCase.

To the best of my knowledge the next twelve months will bring tablets of all shapes, sizes and OS flavors to the market. I’ve seen information on tablets with screen sizes ranging from 7-inches to just over 10-inches, and operating systems including Android, Windows 7 (8?), WebOS, BlackBerry, and of course iOS. Did I miss any? It’s possible that I did as I’ve seen a few others thrown in the mix over the past several months, but I believe these constitute the bulk of what we’ll see.

With that said, what impact do I think these devices will have on pharmacy practice? That’s a good question. Because I’m a tablet enthusiast I’d like to think they will revolutionize pharmacy practice as we know it, but in reality it probably won’t make much difference at all. Why? Site back and I’ll tell you.

I spent quite a bit of time pondering the use of tablet PC’s in pharmacy well over a year ago. After painstaking deliberation I concluded that “the evaluation and implementation of tablet PCs into pharmacy workflow is a daunting task and several questions must be answered and barriers addressed prior to moving forward. I believe it’s worth the effort as the tablet PC offers unparalleled access to patient data and drug information resources in a mobile platform. It is clearly a tool worth further investigation.” I took my own advice and spent the better part of a year investigating ways to better utilize tablets in pharmacy practice. And here’s what I found out:

1. Pharmacists are painfully slow at adopting new technology. Paper and pen appear to be the technology of choice for many pharmacists. This is incredibly frustrating. Nurses and physicians are quicker to accept new technology. Why? I have no idea.
2. Pharmacists, in general, are not the most tech savvy bunch. I can’t tell you the number of ridiculous questions I got regarding the use of tablets. Pharmacist: “Hey Jerry, how come the screen is blank?” Me: “Umm, because it’s turned off?” Pharmacist: “Oh.”
3. Pharmacists, in general, don’t care what technology they use as long as they can do “clinical work”. Unfortunately this equates to rarely trying anything new.
4. Not everyone takes care of equipment like they should. We utilized 4 tablet PCs and 6 iPads over the course of 18 months. They took a lot of abuse. Failure to charge the device was the biggest issue though.
5. Tablet hardware just isn’t quite ready for prime-time use in the pharmacy.
6. Pharmacy applications are not designed for use on a small screen. This caused more issues than you can imagine.
7. The pharmacists loved the iPad…until they started using it. The touchscreen is great, but pharmacists wanted to use a pen. You can use a stylus on the iPad, but they aren’t very good. Lack of native applications or applications optimized to run on the iPad was also problematic. Android, WebOS and BlackBerry will have similar issues (see #8 below)
8. Most healthcare applications are designed for use on PCs. Yeah, a virtual desktop works for use on non-PC based tablets, but it’s not optimal. It’s like looking at the moon through a window. Sure, you can see it, but it looks a lot better if you just walk outside. Many pharmacists found it difficult to work in a virtual environment; not to be confused with a cloud environment.

Some things that need to be improved to make tablets more usable for pharmacists:

1. A hybrid tablet that allows full desktop functionality while docked, but uses a smaller, optimized OS when in tablet mode. This is more important than you might think. Pharmacists don’t need a bloated desktop when they’re on the go, but they do need a core set of functions.
2. The Motorola Atrix 4G is a great concept that should be explored further. I’ve thought about this for a long time. I’d like to see some changes to the Atrix Lapdock though. Instead of having the Atrix dock on the back of the keyboard I’d like to see it slide into the side of the monitor. Kind of like a PCMCIA card. Then take the Lapdock design one step further and have the monitor portion of the dock come away from the keyboard. Instant tablet.
3. Tablets need to replace pen and paper. Yep, it really is that simple; small, light, easy to carry, quick on/off, ability to take notes on the screen with a pen, note storage and easy sharing, etc. Until tablets are as easy to use as legal pads, pharmacists will be hesitant to adopt.
4. Technology ecosystems. We’re starting to see this already with the WebOS, Android, Windows and iOS. The ability to utilize a host of devices across a single platform is advantageous. I’m interested in what HP is doing with the WebOS on the desktop. I look forward to seeing how this works across the full spectrum of desktop –> tablet –> smartphone. Microsoft had the chance of a lifetime to develop an incredible ecosystem, but somehow let it slip past them. Just sayin’. Note: don’t you find it odd that we’ve gone from a single ecosystem, i.e. Windows, to a completely fragmented group of ecosystems? I’m not sure if that’s a good thing or not. The one positive is that it will force adoption of cross-platform applications and the cloud model. I remember talking about the need for cross-platform development 15 years ago. I was talking about Linux and Windows at the time, but that’s beside the point. People, including my brother openly scoffed at me. And why shouldn’t they have, I was just a dumb pharmacist after all; what the heck did I know about software engineering. Now here we are in a position where cross-platform development is important. I feel somewhat vindicated. Dorry, I digress.
5. Investment in cloud based solutions. As mentioned above, the number of new operating systems in use today makes this a must.
6. Improved hardware:
   1. Battery life needs to be improved to allow more than 24 hours of continuous use.
   2. Optimal screen size needs to be studied. I’m not certain that 7-10-inch screens are the best option. I’d like to see at least one vendor experiment with 11,12,13-inch screens. Think about this, typical notes are written on paper that is 8.5 x 11 inches. Wouldn’t that be an optimal size for a tablet? Not sure, but it’s worth a look. Note: ProLink makes a tablet with an 11.6-inch screen, but I haven’t heard much about it.
   3. Wireless HD video out. This is important for viewing x-rays and other images.
   4. Support for Flash. Yeah, yeah, Apple, iOs, blah, blah, blah. Look, until the internet in its entirety stops using Flash you need to support it. Period. Remember, healthcare IT is at least five years behind the consumer market.
7. Software designed to work on multiple platforms. Healthcare is definitely Windows centric. Unless Microsoft takes over the world and eliminates their competition in the next 18 months things will have to change to support all the new OS ecosystems. *cough* cloud
8. Option for pen driven or touch interface at the same time. Pen is king in this environment, but using your finger to navigate quickly is awfully convenient at times. “Pinch-to-zoom” is also important for viewing images.
9. Ability to seamlessly move documents back and forth and quickly share information. Hmm, sounds like that whole cloud thing again.
10. The ability to keep information safe even when your tablet is utterly destroyed. See Google Chrome Notebook video below to get the gist of what I’m saying.
11. Better enterprise integration. Let’s face it, a tablet shouldn’t require special treatment. Any healthcare system should be able to purchase one and have it fully integrated in a matter of minutes.

Ultimately I think tablets will see significant growth in healthcare over the next several years, but I don’t expect to see the same growth of tablet use in pharmacy practice. While a tablet seems like the perfect device for a pharmacist at the bedside, the response from pharmacy practitioners hasn’t been great. As for me, I will continue to pursue mobile technology, especially tablets simply because I find them interesting.