AN IPAD FOR EVERY DOCTOR:
Victorian Labor promises

12

Victorian Premier John Brumby yesterday promised every doctor in the state’s public hospital system would be issued with an Apple iPad if his incumbent Labor Government was returned to power in the state’s upcoming election.

The pledge was listed as a minor item in Labor’s health policy released yesterday, with the Premier stating his party was committed to giving doctors the tools they needed to provide the best care to Victorian patients.

“As technology evolves, so do the tools that our doctors need. We will provide $12 million to buy iPads for every doctor working in Victoria’s public hospital system, so they have easy access to time-critical clinical information at a patient’s bedside,” Brumby said.

The Victorian Coalition was less specific in its promise of new technology for hospitals, releasing its own health policy, but its own list of promises (PDF) did contain a pledge that it, too, would implement new “mobile technology” if it took power — although the Coalition’s policy appeared to be more focused on electronic health solutions in general.

“A national e-health identifier has the potential to cut costs and provide better quality health care,” the Coalition wrote, referring to Federal Labor’s $466.7 million health identifier project, which is gradually gathering steam in the wake of the Federal Election.

“The Coalition supports the introduction of a national e-health identifier and its incorporation into the Victorian health system,” the policy document continued, with appropriate protections and ironclad privacy controls, and will support and examine the adoption of mobile technology solutions.”

According to a report published by the Victorian Government in 2006, at that stage about 10 percent of the state’s approximately 208,000 staff employed in public hospitals were “salaried medical staff” — a term which includes doctors, but not allied health professionals such as pharmacists, physiotherapists and nurses. That number was growing steadily each year — for example, in the 2005/06 financial year, the doctor workforce is listed as growing by 211.

Currently, Apple’s most basic iPad is the 16GB Wi-Fi version, which does not come with 3G mobile broadband included. If Labor were to purchase one of these iPads for each of the salaried medical officers listed in the 2006 report, it would cost about $13.08 million — meaning the Brumby camp’s estimate of $12 million is within the ballpark required to outfit the state with more than 20,000 iPads.

The news comes as Victoria’s Labor Government continues to demonstrate a great deal of interest in the iPad platform in general.

In July the state unveiled a program where 500 iPads will be delivered to a number of hospitals around the state — costing about $500,000. The trial is slated to take place in January 2011.

“The iPads will allow doctors and nurses to access any web-enabled application run by their hospital as they move around the hospital, as well as allowing them to tap into health information resources,” said Health Minister Daniel Andrews at the time. “The iPads will connect via the wi-fi networks that allow secure, safe wireless connectivity within the hospital while not affecting other important and sensitive electronic patient care equipment.”

And that announcement came several months after Brumby announced the state would buy more than 500 iPads to be distributed to schools in another trial of the tablet devices.

But not everyone in the public sector eco-system has been so enthusiastic about the new Apple technology. The chief executive of South Australia’s health department issued a sternly worded letter to all staff in late May warning them off corporate purchases of Apple’s flagship iPad device until the department’s IT team could properly assess the device.

SA Health CEO Tony Sherbon told staff that while the potential use of the iPad within SA Health might be significant, the department needed to fully assess the device before it was implemented — with concerns around the security of patient information being one potential issue.

Image credit: Inuse Pictures, Creative Commons

12 COMMENTS

  1. Didn’t Federal Labor promise a shitload of computers in schools for the 2007 election?

    How’d that work out?

  2. All well and good to promise these things when election time comes around. Just the same old lies from the pigs in the trough politicians. And if they get these iPads will the government put the money into the infrastructure, the on going costs, the training, the upgrades? If its anything like DECS over here in S.A.; once the government finally gives the schools the computers they wash their hands of any sort of backup or repairs etc.!!

  3. Ohh please, an iPad is a device, not a solution.. it doesn’t really solve any problems.. a significant percentage of clinical apps won’t run on them, and not all hospitals have decent scalable server based computing to support thin delivery -> end result = the doctors kids get a new toy to play with on the way up to Bulla
    These people are running a state ? They could not run a corner store.
    Top down analysis works every time, all the time;
    – What is the problem ?.. where are the inefficiencies, where could things be better ?
    – What are the options to solve this, how much do they cost, what is their benefit ?
    – Which solutions, when analysed, self justify (based on cost/benefit or other)
    – Prioritise solutions
    – Implement
    – Review
    – Repeat
    It’s not hard…. really, it’s not

  4. Well – why it seems strange to use an iPad in a hospital it’s actually a very valuable device. With the movement to eHealth it allows you to instantly and accurately pull up a patient’s history. Furthermore, you can look up things like drug interactions and symptom matrixes.

    Not only this but they’re good for the patients confidence – they can look at a graph of their blood work or zoom in on an xray or CT scan.

    The AMA supports their adoption – http://www.amavic.com.au/page/Media/Media_Releases/2010/Doctors_welcome_hospital_iPad_trial/

    And they’ve been used successfully elsewhere – http://www.suntimes.com/lifestyles/health/2814148,CST-NWS-health19.article

    I think this is great and – in the grand scheme of things – cheap policy

    • Laura… do you work for Apple ?
      c’mon, there are some lame arguments there…
      “the movement to eHealth it allows you to instantly and accurately pull up a patient’s history”
      …um, are you meaning the patient records stored by the hospitals themselves… ?
      – There is some sporadic adoption of consolidated patient histories accessible from a browser… certainly not uniform, probably available in less than 30% of public hospitals in Vic
      … or do you mean the nehata initiatives for a national patient record ?.. which are laudable, and will be fantastic… but .. don’t yet exist.. and are some time off …
      So no an iPad at the Alfred, St Vincent’s, Royal Melbourne, etc would not allow you to do “pull up a patient’s history” – not today, and probably not for 2 years yet.. at least

      “but they’re good for the patients confidence – they can look at a graph of their blood work or zoom in on an xray or CT scan”
      Again, there is no standard web based clinical results system in Vic public health and where there are such (point solution) web based results systems – they are generally not aimed at providing a ‘patient sanitised view’
      So again, you can’t do this today – fail

      It is interesting to note that the iPad give-away is providing devices to clinicians that can’t natively access the HealthSMART provided applications –as there is no smart-card reader on a iPad http://www.computerworld.com.au/article/349265/healthsmart_roll_e-health_smartcards/ – though there are third party solutions…(but not costed in the give-away).. I digress..

      In summary, pick the top 10 hospitals in Melbourne, walk into them with an iPad today – and go and ask the IT department what you could use it for… maybe you could do some good stuff in 3 of the hospitals, some vaguely useful stuff in another 3.. while the other 4 would not allow you to turn it on.
      And whilst in those 10 hospitals, ask what would happen if you suffered a cardiac arrest up on a non-critical ward…ask them how they would find a crash cart and appropriate staff… the answer would probably be a paging system, and hope that the cart had been returned.. and people running around….. 1 or 2 hospitals may have a proper wireless network with RFID tags and an integrated location system that can bring these things together.. but 80% would not.
      Think about it…at the end of the day, do you want the doctor/paramedics turning up to you whilst you are dying without the cart (but a nice flashy iPad in hand).. or sans iPad but the crash cart located in 2 seconds ?
      Your call…
      It’s just one slightly esoteric example, but it is a real world problem today due to lack of investment in fundamental IT infrastructure in the hospital system.
      Again, my point – identify where the areas where money could make a real world difference to patient care and save lives…cost and prioritise .. and implement.. iPads would not make the top 500 in the list.

      And finally, when we do have (if we ever do) a proper integrated eHealth system, then sure, look at devices which are enablers and assist with it’s deployment.. but by then the iPad may not be the right choice. This is a vote grabber which our taxes pay for.. nothing more.

    • Well put Laura.

      Some people need to pull their heads out and realise that mobile computing within health care, especially hospitals is a significant growth area right now, not in 3yrs as some may suggest.

      There are already a number of mobile health care solutions designed for devices such as the iPad being tested by hospitals around Australia right now… not in 2 years as some may suggest.

      Hospitals such as the Sydney Children’s Hospital in Randwick, as I understand it, have a live trial on right now with the iPad allowing Dr’s to view everything from pathology results and xrays through to what the patient is going to be having for dinner. Dr’s will be able to schedule outpatient followup and referrals to specialists right from the bedside.

      Just imagine, … Your son breaks his arm playing school sports, the Dr can explain in near instant graphic detail to your son via the iPad what he broke giving a detailed explanation rather than having to lean up against a window or lightbox to read conventional xray films with a patient.

      The iPad is a disruptive technology, a game changer, an enabler. Historically, health care has not really been interested in mobile computing due to a lack of cost effective devices…. that has now changed.

  5. Julian, or is that Laura.. are you the same people…?
    or, do you both work for Apple ?
    or do you both work for PR in Brumby’s office ?
    I bet one of the above is close to the mark

    OMG….”disruptive technology, a game changer, an enabler”..pure PR bull

    • Yes, we all work for Apple. I receive $10,000 a week just to speak highly of Apple products. Because anyone that likes Apple products must be on the Apple payroll right?

  6. David, I am sure if you pull your head out long enough you may actually see that the deployment of the iPad is already happening in real world environments within multiple verticals in Australia and the rest of the world.

    Health care is one of the big mobile computing growth areas especially within hospital environments as they already in the vast majority of cases 802.11 networks in place and functional, this is a fact that I am sure you will be hard pushed finding anyone credible that is willing to dispute.

    In regards to enabling the consumption of existing data via devices such as the iPad, well get out and have a look around. Not hard to build an app, not hard to manipulate data into an SSL session.

    Let me suggest that you might be one of those individuals still clutching their Nokia 101 claiming there is little need for anything more than basic text based or even WAP mobile technologies.

    I agree that in the past, the desire for hospitals to deploy extensive mobile computing platforms has been restricted but this is probably more related to the fact that there has been a lack of cost effective devices in which the data may be delivered to. Sure tablets have been around for some time, but when Apple launched the iPad, a sub $1000 device things changed.

    I agree with Simon, we must all be employee’s of Apple and paid ridiculous amounts of some valuable foreign currency into our foreign bank accounts. Failing that we are all suckers who like many hundreds of thousands or better still millions of people have fallen for the brainwashing PR tactics of Steve Jobs and that evil institution Apple, and for whatever reason see the significant merit in the iPad for what it is, what it can do, and more importantly the change in the way people look at media consumption at business and personal levels.

    David, do yourself a favor and pull your head out long enough to consume some oxygen as the lack of seems to have done some damage.

    • Ouch.. no need to get so nasty.. Julian…… just resorting to personal criticism and evangelism…not really very good debating techniques ehh ? and ignoring the opposing points completely..
      I’m loath to fill in the blanks here and respond to your cr_p… but I’m going to..

      FYI, I work in multiple public hospitals providing IT services around a number of areas, so I have some background here, and your assumption that “vast majority of cases 802.11 networks in place and functional” is wrong.. some do , some don’t.. it might be over 50%…. just.. I don’t have a full list and knowledge of them all.. I won’t name the names of the several major CBD hospitals that I know don’t have this yet…..
      ..and I am actively involved in a couple (one health, one corporate) of projects using iPad’s for information delivery.. so I’m active in making these things happen…I think you believe I have something against the iPad (it’s odd that you want to defend an inanimate object..).. it’s a good device that is better than the ones before it, but not without its limitations– but my initial comment, and those since is about the process – or lack of it.

      Again…identify where the areas where money could make a real world difference to patient care and save live, then cost and prioritise .. and implement. Even if you insist that “mobile computing” must be on that list.. then the analysis would indicate what is lacking is a project to ensure all public hospitals put in place flexible and scalable information delivery mechanisms that enables mobile computing – regardless of platform (the wireless networks, the application middleware, the front-end presentation systems, the management and security)… that would make sense.. then the iPad, the Samsung galaxy, the next Windows tablet (if they ever make a good one)..Blackberry’s.. could all be used to different extents.. once you have that infrastructure the end device is just whatever is the best at the time, and you are free to move with the technology as it evolves

      Dumping end-devices into multiple, very different environments, is just arse-about. Either the hospitals won’t have the money or budget to setup for them properly, then they do become video screens for the Bulla trip.. or the hospitals have to shell out significant $$ in a rush to get things in place.. leaving possibly more important projects on the sidelines

      I think the Gartner crew seem to agree.. according to the new article up ehh..?
      .. for the record, my phone is an iPhone…..

  7. Hi David (and others),

    I think we can both agree that there are potential benefits for patient care in hospitals. By having more information close at hand Doctors are more likely to make accurate diagnoses and are more likely to know of things in their patients history that is relevant.

    Furthermore, as I’m sure you know all Victorian hospitals are making progress in regards to eHealth with more and more information being moved into ‘the cloud’.

    You are right to the extent that dropping iPads into hospitals today would achieve little but that is not the Labor policy. It is a 12 million dollar capital program – that pays for a whole lot more than just iPads. It will presumably also lead to investment in many of the areas that you spoke about.

    Also, the AMA put out a new release supporting this policy – http://www.amavic.com.au/page/Media/News/Doctors_welcome_Brumby_health_promises/

    David, whilst I’m sure you know a bit about public hospitals in Victoria I’m still going to defer to the Doctors on this one.

    (This is a joke) – If you’re an IT guy, do you just hate this policy because it uses a Mac product? I’ve never met an IT guy that likes apple.

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