In the past two weeks, our own Joe Bormel, M.D. has written a wonderful series of blogs examining the iPad from the perspective of a clinical informaticist who can speak for other clinical informaticists on the potential usability of Apple’s new blockbuster mobile computing device. I would urge all of our readers to turn to Joe’s blogs for extremely useful insights on the iPad as a tool for clinicians. Trust me, I have no intention of trying to trump his excellent posts!

What I am interested in is the broader question around CIO strategies regarding the ever-advancing forward march of information technology, including mobile device technology. What does it mean for CIOs and other healthcare IT leaders when technology is moving forward so fast that it makes it difficult to plan even for a few years down the road? Remember, several months ago, most people didn’t even know that the iPad was about to be launched, let alone had seen any kind of image of the device. And the reality is that CIOs have to plan their IT capital budgets years in advance, especially as the costs of such capital-intensive systems as core EMR, CPOE, eMAR, advanced pharmacy, PACS, and other clinical information systems have become so large. We all know that there are numerous large hospitals and health systems around the U.S. that have spent more than $100 million (some, considerably more) on clinical IT—sums large enough to automatically compel multiple presentations of strategic plans to boards of directors, not to mention of course c-suites.

So where does the debut this spring of the iPad fit into this landscape? First of all, it’s obvious that the iPad will necessarily and inevitably go through numerous re-releases and versions. Its smaller sibling, the iPhone, already has, in its few years of existence. Second, because Steve Jobs and his colleagues at Apple have created a relatively new device space, everyone is having to rethink where the new technology might fit into their own organization’s galaxy of computing—and that’s across industries, of course, not only in healthcare.

And though I’ll leave it to clinical informaticists like Joe Bormel to give us a clearer picture of the current potential of the iPhone to be a “game-changer” in the mobile computing world in patient care, I will say this: CIOs need to think carefully about the Kindle before they lay down concrete plans and move forward. Why is that?

Think back, back, back into the mists of time past—that is to say, November 2007 (!). It was then that Amazing released its Kindle First Generation, which promptly sold out within hours of its first release. At the time, the Kindle was seen as revolutionary: here was an electronic book reader that offered the tantalizing possibility for some readers of (at least in theory, anyway) doing away with printed, paper books altogether. The Kindle and its copycat cousin, Barnes and Noble’s Nook e-reader, which debuted just under two short years later, promised a new world for leisure readers, and who hasn’t seen numerous people contentedly reading books electronically on airplanes and in cafes?

But the iPad, with its color screen, web capability, and multi-functionality (including, of course, electronic games) could potentially sweep the Kindle and Nook into the dustbin of tech history, just a few years after their debut. And isn’t that a scary thought, really? After all, if CIOs—and their clinical informaticist colleagues—are having to make choices now about what kinds of technology clinicians need years from now, how in the world can anyone be expected to plan intelligently for five years down the road? In other words, who can say what kind of device is going to be rendered potentially obsolete just a few years after its creation? Cela pose question, as the French would say! I’m no gypsy fortune-teller, but I can bet you that someone is going to come along to challenge Apple on their iTurf sometime soon; and then it’ll really be difficult to plan for device-based mobile computing.

So on the one hand, we’ve got a situation where there is a real possibility that mobile computing could be transformed in a positive way by the introduction of the first in what could be a whole new class of devices, devices that could fill a critical niche for clinicians on the move in their patient care organizations. On the other hand, the landscape for planning capital investments in this area could become hopefully muddled in the onrush of new technologies. What’s a CIO to do??

Finally, I want to take this opportunity to solicit leads from you, our readers, on an upcoming story in just this area. In the August cover story of Healthcare Informatics, we’ll be looking at the landscape of mobile computing devices, and the interoperability (and infrastructure) issues involved. If you’d like to talk with us about your experiences in this area, please e-mail me at mhagland@vendomegrp.com. We’ll be eager to hear what your plans have been and what you’ve been working on in this pivotal arena of activity.