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iPad: Right Time, But Not Quite Primetime — Part III

May 13, 2010
by Joe Bormel, M.D.
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iPad: Right Time, But Not Quite Primetime — Part 3 Do 11 concurrent evolutions equal one revolution?  Implications of a recently released mobile tablet

Part I of this series, and Part II.
Does the arrival of Apple's iPad really cause any revolutionary changes in the HCIT scene? In this, my final post on the subject, we'll review my last two concurrent evolutions, and draw a conclusion as to the revolutionary nature of the iPad.

10. Battery Life: Most mobile devices have touted long battery lives and usually disappointed us miserably. It wouldn't surprise me if half of the size and weight of the iPad represents its internal battery. That size and weight percentage number is between 10 and 20 percent of the notebook computers I've been using over the last three years.

In my hands, the iPad easily lasts an eight-hour day, with WiFi turned on and the screen fairly bright. I'm lucky if I get three good hours on a laptop. I do slightly better on bicoastal flights with my WiFi turned off and my screen brightness turned down. The biggest clear evolution is that the iPad isn't designed to be a lap warmer; my laptops clearly function as though they were designed keep me cozy-warm. Of course, the battery life is a nice surprise, particularly in HCIT where patient safety and quality care are non-stop necessities. So perhaps a promise kept by a computer manufacturer is a part of the evolution, too.

11. Passions: One cannot adequately capture the essence of the impact iPad has had on the marketplace without reference to the buzz. There's also counter-buzz, i.e. people who, without knowledge or experience pride themselves in eschewing new technologies. "Why would I be interested in an eBook reader? I really like holding paper."

There are people, including physicians, who align themselves with trends, luxury and lifestyle products and services, and, dare I say, ecosystems. What distinguishes Apple from the manufacturers of most other mobile devices is that the company has objectively led the way in releasing solutions rather than products.

I understand the ecosystem to include at least four elements: hardware, software, commerce (think App store, iTunes, now iBooks), and marketing a pop culture lifestyle. In contrast, Microsoft is well known for software, but doesn't generate much revenue from hardware or commerce. Meanwhile, HP, Dell, and Sony are mostly hardware providers, while Google and Yahoo derive their revenue primarily from advertising.

Those passionate about design thinking will point out that Apple has created a niche for design elegance (elegance versus simplicity) that exploits and probably requires an ecosystem model.

Don't get it? Let's say you simply buy an iPhone. You seamlessly get into a communications service contract, while Apple and its carrier partner make you aware there are software applications to connect you to major media, e.g. newspapers, brick and mortar retailers, etc.

The "store" to buy or otherwise obtain these applications is already on your phone. The software, hardware and content are an integrated system. It's a hundred thousand plus apps strong, and won't cost all your search time or degrade the stability of the device. The combination simply works and works simply. Contrast that with purchasing a BlackBerry Storm. I know lots of people who have lived that gruesome experience.

Positive experiences have created passion for the Apple ecosystem that now extends to the iPad. That is evolutionary in the broadest sense, but does it really matter when we focus on HCIT, which is where we're supposed to be focused? The simple answer is probably not much.

So here we are at the end of our week-long evolutionary journey. The path stops here — at least for the moment — and I need to present you with my conclusions. I can almost hear the Beatles now:

You say you want a revolution

Well, you know

Apple wants to change the world . . .




Dr. Bormel,
Thank you for a most interesting and informative series. I particularly like the fact that it was launched using your hands-on experience with an iPad in a HCIT environment.

I also appreciate your response to my comment to Part II. From it, I have come to the conclusion that although it is extremely tempting to buy an iPad immediately, the potential to be much more pleased with my decision in the long run is to wait two or three months to see what the competition brings to market.

At this point, I'm particularly interested in what I've read to date about the OpenTablet 7 and Notion Ink Adam products, and would like to learn more. A Linux/Android offering with Flash and USB ports sounds fascinating, if it really works! And with a full-featured (as defined by Apple) iPad WiFi-3G starting at $629.00, my impression is that a short wait to purchase is prudent for someone like me who isn't tech savvy enough to make a snap decision.

One other comment. I liked what Insightful had to say using the word "transformational," but I have the impression that it's the tablet category that is transformational, not just the first product to reach the market. Please keep up the great work!

Doc Benjamin

Joe, Thanks for your blog post. I've literally gone out and bought three after reading it. You clearly addressed the early and critical HCIT issues for me. One of the iPads is for me the other two are for subordinates. I'm a VP in a large Healthcare IT development organization.

That said, with all due respect, I think you may have framed the question wrong. The question shouldn't be evolutionary or revolutionary. That's overly harsh. The question should be, "Can the iPad be transformational in my organization?" I think that's more relevant and I think the answer is overwhelmingly yes. You captured the essence in your 11 implications. I'd reduce that to mobility and ease-of-use (referring to the Patterns) as related to the multi-touch experience.

Nice post. Thank you.

Thank you for the positive feedback, as well as the notion of transformation.

I think you have a good point and many people agree with you. This mobile, web-connected, tablet device is one that many people will prefer to use for the Triangle tasks over a comparable sized traditional laptop.

In an interesting article, Will the iPad Make You Smarter? (link above), the usability created by the one-app-at-a-time focus in the iPad is elaborated.

This captures a dimension of the evolution that the iPad is part of, perhaps leading to less shallow computer interactions, and less disorientation dulling our thinking, or at least making information access unnecessarily fatiguing. Here are some excerpts:

  The Internet is scattering our focus?

This idea challenges the conclusions of web cynics like Nicholas Carr. In his new book, The Shallows, Carr draws on a plethora of studies that collectively conclude the internet is shattering our focus and rewiring our brains to make us shallower thinkers. However, these arguments may not apply to the newest wave of devices.

  Overlapping windows bad, ie disorienting?

... his study, Demirbilek found that subjects using the tiled-windows interface were significantly less disoriented than subjects using an overlapping-windows interface. He also found that participants working with overlapping windows were substantially more likely to experience cognitive overload than those working with tiled windows.

In conclusion, students using the tiled-windows interface were able to find specific information more easily and engage with it more deeply, whereas students working with overlapping windows struggled to see how parts of a knowledge base were related, and they often omitted large pieces of information. Students using the tiled-windows interface were able to learn considerably better than those working with overlapping windows.

   So what's the message for HCIT professionals trying to create the most effective environment for their end-users:

Demirbilek’s conclusions don’t contradict Carr’s assertions, but they suggest that the gap where information is lost between short-term memory and long term-memory is not due solely to hyperlinking, but also to the disorienting nature of the interface used. Carr is correct that the traditional PC computing environment (such as Windows or Mac OS X), which uses an overlapping-windows interface, is conducive to shallower learning.

However, Carr’s cited studies focus on interfaces that will soon be out-of-date. Newer mobile devices such as the iPhone, iPad and Android smartphones abolish the traditional graphical user interface we’re accustomed to. Gone are the mouse pointer and the mess of windows cluttering our desktop. On these mobile technologies — especially the iPad with its bigger 9.7-inch display — all the emphasis is placed on the content, and each launched app completely takes over the screen. The only pointers are our fingers. And going forward, we can expect future tablet computers competing with the iPad to replicate the single-screen interface.

I had lunch with a friend today who said, quite simply, what makes the iPad distinct, compared to PCs, notebooks, netbooks, and even Android phones and tablets, is that the iPad was the first device designed specifically for digital content consumption.

Not an original thought, but a very clear one!

Readers might find value in this blog post:

Thanks Guy for sending me the link!

In part 2 of this series, item nine, I discussed cloud computing and the iPad:

9. The Cloud Computing World: ....

Yesterday, I shared several huge presentations with friends, one across town and the other, across the country. In both cases, I simply dragged the folder into a dropbox (from the company of the same name, Then, I right-mouse clicked (on a laptop), selected share-this-folder, entered an email address and message and, voila, done. In one case, an hour long, high definition video would have simply appeared on my friends iPad. I say would have because she had to first install the app.  It works on iPads and PCs (and Macs) seamlessly.

That "cloud computing" aspect hid all of the underlying complexity and reliability issues. Similar to how email is close to magic. In the case of the cloud, box and the iPad, it's better than the prior processes we had for sharing. Better, faster, cheaper.

The only thing that's left as an additional step is file conversion.  The original video was over 2 GB.  I scrunched it down to a smaller mp4 file, ultimately 535 MB without loss of clarity.  It was, however, extra steps and time.  Rising expectations never stop!

Thanks for your comment. You might find value in Mark Hagland's post here "The iPad, the Kindle, and the Future of Mobile Computing in Patient Care."

You'll see in my comment that I concluded as you did:

"... an iPad and it's congeners can transform a project, program, and related clinical transformation at any institution."


Joe Bormel

Healthcare IT Consutant

Joe Bormel