Tuesday, May 15, 2012

Tablet Computers & Open Source in Healthcare

What follows is a brief, high level summary of the current status of tablet computer systems, their use of open source software, and how they are beginning to be used in the healthcare arena.

A 'tablet' computer is a mobile computing device, larger than a mobile phone, integrated into a flat panel screen, and primarily operated by touching the screen rather than using a physical keyboard.
Many of today's tablet computers include wireless Internet browsing functions, GPS navigation, video camera functions, have 8 to 10 inch screens, weigh les than two pounds (1 kilograms), and typically have a battery life of five to ten hours.

The tablet market has experienced rapid growth over the last two years. It has outpaced other computer devices at a similar point in their lifecycle.  In fact, shipments of tablet computer devices may exceed 350 million units by 2016 according to various estimates from various  industry experts. 

The medical community, in particular, has taken to tablets in droves over the past year and sales show no signs of slowing.  The reason is that clinicians have found tablet computer devices to be a user-friendly product that readily fits into their clinical business practices. 

Tablet Technology & Open Source

Enterprise IT Architects are now being asked to provide strategies, technologies, and specific recommendations for mobile platforms (e.g. tablets, smartphones) and mobile applications to meet the business needs of organizations.

With regards to tablet computers, selecting an enterprise solution currently comes down to three choices: the Apple iPad, Android-based devices, with Research In Motion's (RIM) BlackBerry running a distant third. However,  stay tuned for news about open source Linux based solutions for tablets.

While a large number of tablets today use Google's Android platform, which isn't entirely open,  a slowly growing number tablets are entering the market preloaded with a truly open source variant of Linux, e.g. ZaReason, Shogo, AuraSlate, VivaldiSee PC World article and check out Aaron Seigo's blog.

'Open Source' Operating Systems for Tablets
  • Android - Aa Linux-based operating system for mobile devices such as smartphones and tablets.
  • HP webOS - A mobile operating system based on a Linux kernel, initially developed by Palm.
  • KDE -  An international project providin open source software for desktop and portable computing.  
  • MeeGo  - An open software platform for mobile devices, e.g. tablets, smartphones. 
  • Mer Project - An open, mobile-optimised software solution for device manufacturers
  • Tizen  - An open source, standards-based software platform supported by leading mobile device manufacturers for multiple device categories, e.g. smartphones, tablets, netbooks. See Tizen video

Tablets in Healthcare [and examples]

Clinicians spend much of their day communicating with patients, taking notes and managing information. With their lightweight, small size, long battery life, and easy-to-use touch screens, tablets seem to be a natural fit for the healthcare environment.  Instead of using clipboards, paper files, or a cumbersome laptop, clinicians can easily carry tablets around and use them to track patient information, conduct research, and stay connected with others on the patient's primary care team. This translates into operational efficiencies and better quality of care.

There are now numerous, useful mobile apps for tablets aimed at both healthcare providers and their patients. Many of these are low cost or free &  open source mobile apps. For example, check out the following:

* Check out some of the Open Health News (OHN) articles on tablet computers at  http://www.openhealthnews.com/search/node/tablet

Example - Tablets in the VA

The U.S. Department of Veterans Affairs (VA) has been a leader in the use of health information technology for more than two decades. One area it is now focused on is development and implementation of innovative mobile healthcare (mHealth) initiatives - for both patients and healthcare providers.  One of their goals is to leverage mHealth technology to improve patient care by increasing the frequency and quality of the interactions it has with its veteran  over time.

Before diving headlong into mHealth and adopting a particular mobile platform, the VA conducted a detailed analysis of  functional and technical requirements, operating policies, standards, privacy and security issues, and their existing health IT infrastructure. The objective was to ensure that selected mHealth hardware and software solutions would mesh seamlessly with the integrated health IT architecture at the VA. The VA views the use of mHealth as just one of many modalities that will be used to deliver care and services to meet the needs of veterans. 

Finally, the VA mobile strategy includes releasing mHealth apps into the public domain and sharing them with the rapidly growing open source community. This falls in line with the VA's Open Source Electronic Health Record Agent (OSEHRA) initiative and its strategy to collaborate with the healthcare community on the development of innovative, 'open' health IT solutions to meet its needs for the future.

VA 'Clinic-in-Hand' Project
According to a notice on the Federal Business Opportunities website, the VA plans to launch a pilot program that will provide iPads to 1,000 family caregivers. The devices will be equipped with health care applications and tools to assist caregivers in delivering at-home health care services to veterans. The project will allow veterans and their family caregivers to access their demographic information, laboratory data, medications, allergies, appointments, problem list and more. It will also allow them to communicate and share information with their VA healthcare provider teams. The VA is also developing a 'VA App Store' to hold all mobile apps developed by the VA and certified non-VA apps.

Conclusions & Recommendations

The number of tablet computers sold in the U.S. and around the world will continue to grow at a phenomenal rate over the coming 4-5 years. Most of these will be iPad or Android-based devices, though a new wave of truly open source Linux-based  tablets are now entering the market.  In healthcare, the rapidly increasing use of tablets by both clinicians and their patients is exciting to watch. The number of innovative, low cost or free and open source mobile health apps that are now available is amazing. Don't look for the pace of change to slow anytime soon.

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