Then and Now: PocketPDR & Epocrates, iPod & iPad

by Cy Caine on February 4, 2010

I started as a young associate product manager on Physicians’ Desk Reference (PDR) in late 1993.  I was quickly given responsibility for our electronic offerings. One of these was a remarkable-for-its-time product called PocketPDR.  PocketPDR included the most commonly referenced information for each of the products in the printed edition.

Pocket PDR - Late 1990s or early 2000s vintage

Pocket PDR - Late 1990s or early 2000s vintage

Upon returning to PDR in June 2008, my then and now colleague Mukesh Mehta reminded me that after leaving PDR in 1998 I called my former colleagues with some prescient advice. According to Mukesh, I said something to the effect of “I just heard about this interesting start up called Epocrates.  I think they could become a significant player and a threat to PDR.  Keep an eye on them.” Fast forward to 2010 and Epocrates claims that their user base includes more than 900,000 healthcare professionals, including one in three U.S. physicians and 40 percent of medical students. I have no reason to doubt that this is true — more than one in three of my doctors use it!

It is beyond the scope of this entry, but suffice it to say that PDR squandered the opportunity to own this space.

Of the U.S. docs that use Epocrates, over 125,000 do so on the iPhone. So I wondered whether the Apple iPad would enjoy similar success as a tool for healthcare professionals.  According to an ePocrates press release today, the prospects look good.

  • Nine percent of survey respondents plan to buy the iPad immediately when it becomes available
  • Another 13 percent plan to buy it within the year

I’m a bit of a sceptic on this one.  I do believe the following:

  • The iPad will be a commercial success.
  • A lot of doctors will buy them. After all, they are some of the most affluent consumers.
  • A lot of these docs will install Epocrates on their devices. Why not? It is either free or already paid for.

But, and this is a big but, I do not believe that applications such as Epocrates will be the driving force in adoption of the iPad. Why? Because the iPad won’t fit in your pocket, it loses the key advantage of devices like the iPhone and Blackberry. In addition, the iPad hardware has several deficiencies when being considered for use at the point of care.  This is the message that came back in a survey conducted by  The results were posted this evening in a blog entry by Chris Thorman titled “Healthcare Wants a Tablet, but Not Apple’s iPad.”  The reasons reported were sensible and believable.   But first, the research confirmed that there is demand for tablet-style devices. As shown in the chart below, 54% of survey respondents said they were either very likely or somewhat likely to purchase a tablet for healthcare use over the next year.

This chart shows how likely respondents are to purchase a tablet for healthcare use in the next year

This chart shows how likely respondents are to purchase a tablet for healthcare use in the next year

In considering key features they will be looking for in a tablet, respondents were asked what will be the “must-have” features and capabilities when you purchase a tablet? The responses are shown below.

This chart shows how likely respondents are to purchase a tablet for healthcare use in the next year

This chart shows what percentage of respondents thought a feature was a “must-have” in a tablet.

As Thorman points out, the iPad has only a few of these “must-have” items:

Unfortunately for the iPad, as we found out last Wednesday when Steve Jobs unveiled the tablet’s features, it only has a few of the top “must-have” features for healthcare use.

The iPad has Wi-Fi access; lightweight hardware (1.5 pounds); and arguably an ergonomic design. That’s it from this list.

It lacks a large number of features that healthcare professionals deemed important, such as resistance to dust and hospital fluids and disinfectants (the iPad does not have sealed ports); fingerprint access to the system (HIPAA compliance); barcode scanning (patient safety); and an integrated camera (documenting diagnosis). In fact, you could argue that the iPad’s difficulty in being disinfected or kept clean of hospital fluids is a deal breaker for healthcare workers.

Peripherals, such as an RFID reader and barcode scanner, may be available in the future. But because they’re not native to the iPad, they’re just more cables and cords a busy healthcare worker has to lug around. That’s another negative mark for the iPad.

Thorman also cites a lack of medical software, most significantly from the major EHR vendors. I see this as less of an issue.  These vendors have the wherewithal to develop for this platform if they choose to.  But the point may be moot because only Apple can address the hardware deficiencies.

So my bottom-line forecast is as follows:

  1. iPad will be successful with consumers as a media-consumption device and this includes physicians as consumers
  2. Physician-consumers will install healthcare applications such as Epocrates onto their devices because it will be both easy and inexpensive for them to do so
  3. iPad will not be a major factor in healthcare at the point of care due to the deficiencies for this setting as detailed by Thorman

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