Vince Kuraitis
First published on e-CareManagement on 2/26/11
After attending the largest annual health IT conference of the year —HIMSS 11 – John Moore reported that “nearly every EHR vendor has an iPad App for the EHR [electronic health record], or will be releasing such this year.”
Doctors love iPads…not surprising? But, how might you explain this?
There are at least two different possibilities:
- Coincidence Theory
- Conspiracy Theory
The Coincidence Theory
So doctors want to access EHR software through the iPad…what’s the big deal?
Apple has built a great new hardware platform with the iPad. There’s nothing else like it in the marketplace. While other companies are building competing tablets, Apple’s has been the only viable option in the market for over a year.
The iPad is intuitive, easy to use, reasonably priced, easy to carry around, and has a lot of apps that have been developed for the platform. People — not just doctors — love the experience of using an iPad.
Doctors just happen to be one group of zillions buying iPads. Why wouldn’t they? Doctors are smart, affluent, and many are opinion leaders. Doctors like cool new technologies just like anyone else.
Doctors also are mobile. They want to access EHRs in different exam rooms, from the hospital, from their homes. The iPad is the perfect hardware platform to take with you as as a doctor goes about her day.
Why are nearly all EHR vendors making their software work on the iPad?
Because doctors are demanding it.
The Conspiracy Theory
The iPad is Apple’s Trojan horse to create new revenues in an industry in which the company has had minimal presence — health care.
Apple has developed a very appealing hardware platform in the iPad. Recognizing the market strength and lock-in to their walled garden they are creating with consumers, Apple is targeting key market segments to create new revenue streams and business models. Health care is the next target for Apple’s aggressive smarts.
Writing in CNN Tech on February 17, Pete Cashmore explains Apple’s new rules in “taxing” publishers:
Apple this week announced a plan to levy a 30 percent fee on publishers who charge subscriptions through its App Store on the iPhone, iPad and iPod touch. The fee applies to newspapers, magazines and digital books (not to mention music and videos).
What’s more, Apple’s rules dictate that publications can’t offer these same subscriptions at a lower price outside the App Store. And in another blow to publishers, customers will have the option not to share their details — name, e-mail address and ZIP code — with the publisher.
Some publishing industry analysts are aghast at the proposal, claiming that the rate is much too steep and the terms too strict. I don’t disagree: There’s no doubt that Apple is using its dominant position in digital distribution to strong-arm publishers.
But the fact that the tech giant can propose such onerous terms without blinking points to the fact that the battle is already lost: The balance of power has permanently, irreversibly shifted from the media companies to the tech firms. (emphasis added)
You’ve probably heard the metaphor that the most expensive medical instrument is the doctor’s pen — that 70%+ of health care costs flow through a pen because doctors must prescribe pills, hospital admissions, medical procedures, tests, etc.
An EHR software app running on an iPad could become the digital equivalent of the doctor’s pen.
BUT now the scenario is much different:
- A doctor’s pen is a commodity. Nobody controls the pen market and there are hundreds of reasonably priced options for writing instruments.
- The iPad is anything but a commodity — it’s a proprietary platform controlled by the #1 tech company in the world. Apps running on Apple’s platform must follow Apple’s rules.
Could Apple impose a similar “tax” on health care services and products (admissions, ER visits, devices, pills, tests, etc.) ordered by doctors using their iPad platform? Why not — its THEIR platform. If you want to run your app on their platform, you have to follow Apple’s rules.
What are your options? Leave the Apple platform? But wait a minute…its the doctors that are locked in to the Apple iPad platform — they love it, why would they want to leave?
Would Apple tax doctors’ revenues? They could, but they probably wouldn’t…why disturb the geese as they are laying golden eggs?
The iPad is Apple’s Trojan horse into health care — and it’s being willingly carried in by doctors who love to use it.
Who’s Right?
So who’s right — the coincidence theorists or the conspiracy theorists?
It really doesn’t matter –– the result is the same. Apple finds itself leveraging a choke point in the health care value chain. It’s up to you to conclude whether has stumbled it’s way or connived it’s way into the hands of doctors.
Apple has created a technology platform that people love. That love translates to high switching costs and high levels of customer lock in.
So what’s the point?
Health care providers and companies typically haven’t looked at tech companies as competitors. Wake up! As health care makes the transition into the digital economy, look sideways before you’re derailed by new technologies and business models,
Vince Kuraitis is an attorney and CEO of Better Health Technologies. He writes at e-Care Management..
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