Comments on: The iphone, a poor HIT platform analogy

By: Fred Trotter » Hello World with Indivo X

Fred Trotter » Hello World with Indivo X — Fri, 29 Jan 2010 19:43:13 +0000

[...] for Indivo X is almost entirely based on the notions first outlined in now-famous NEJM article. I had criticized the article because it does not fully consider the implications of the proprietary trap for health [...]

By: Fred Trotter » Away from iphone and towards a better platform analogy

Fred Trotter » Away from iphone and towards a better platform analogy — Tue, 29 Sep 2009 03:14:06 +0000

[...] I wrote a rebuttal saying that, among other platforms, the Google android platform was a better fit. Frankly, I thought that would be the end of it. Most of the time I write a blog post, I get some hits, and maybe a comment if I am lucky. But mentioning the iphone is great for getting attention. Apparently, just saying the word iphone brought the readers out of the wood work. iphone iphone iphone <- (just to be sure…). [...]

By: ftrotter

ftrotter — Tue, 15 Sep 2009 17:07:29 +0000

I think what separates the iphone platform from the other proprietary ones you mention is the fact that it is approaching an Internet/cloud based operating system/platform…. But I agree that there are FOSS ways to achieve the same thing…

-FT

By: Martin

Martin — Tue, 15 Sep 2009 09:58:40 +0000

While I agree with everything you say, Fred (I hate my iPhone for all those reasons and more), I think you’re sucked into the same trap as the original authors – as an example the quote:

……uses a software platform with a published interface that allows software developers…..

Can be applied equally to Windows, GNOME, KDE, (+whatever the Mac thing is called) to name a few. Yes, they are orders of magnitude more complex, but for…..

….a consumer can download a calendar reminder system, reject it, and then download another one…

..read ‘apt-get’. Or Firefox.

Having said that, there is a (just as proprietary as iPhone) health-specific app platform in Oracle HTB.

By: Lydell Anderson

Lydell Anderson — Wed, 02 Sep 2009 17:26:35 +0000

Fred,
I’m not necessarily an Apple hater, I even bought an iTouch (iPhone without a ball & chain monthly contract) for my partner–who btw rarely uses it except for easy WiFi access)

I might add that one reason the iPhone is successful though flawed is the Apple brand advertising (the supposedly intuitive interface is only partially so, the rest comes from paid clever informative ads that demonstrated how to use it). Success (iPod) breeds success (iPhone & other Apple products) breeds monopoly like behavior breeds loss of freedom (need to jailbreak etc).

I own the Nokia N800 tablet and believe it (and its N815 big brother) are woefully underrated and under-advertised in the US. Sure it has a slightly ‘under development’ feel, but it is Linux based, wide open for development, and when used as a platform for voice Skype (video Skype not yet feasible – at least on my old 2007 OS) is indistinguishable from a regular computer. It has all the great optional features (except cell phone feature) but lacks market share. It is just waiting for Health IT app development.

With the Nokia model you can choose whether you want to open yourself to independently developed applications or stay with the ‘official’ repositories. I love freedom.

By: Piyush Daiya

Piyush Daiya — Tue, 01 Sep 2009 00:55:45 +0000

Fred,
Nice article. Surprised how this kind article didn’t come up earlier. I blogged about how Android platform was better fit for Healthcare than Apple. It is available on http://www.androidmedapps.com/index.php/2009/06/ten-principles-for-fostering-development-of-platform-for-healthcare-information-technology/, if you are interested.

By: ftrotter

ftrotter — Mon, 31 Aug 2009 22:48:10 +0000

David and Didier,
Both of you have made the same error. You assume that the issue is whether the corporation is successful is the relevant question. I do not care whether a single company thrives or fails. I am quite sure that Apples business model would function just fine in the Healthcare space. The problem is that this is not what Healthcare needs. You both are focused on what the software does, whether it pleases the end user. But we need more from healthcare software than just happy users. We need to have an ethical way of handling health information. That means that putting one party in a position of absolute control is inappropriate. The position that Apple and Facebook enjoy over their users is probably morally wrong in their respective space… but it is clearly wrong to have that role in healthcare IT.
Consider, Apple is happy to lock customers to one cell network. Would you be happy to be locked in to one doctor? Would you be happy to locked in to one heart monitor for patients?

What is ethical in IT is not always ethical in Health IT. These kind of back room dealings result in a dominant monopolistic player. That is exactly what medicine does not need. We already suffer because we have essentially superfelious insurance companies involved in Health finance. We must avoid those kind of power dynamics moving forward with health information.

-FT

By: David Doherty

David Doherty — Mon, 31 Aug 2009 22:22:30 +0000

Good points but i disagree.

As a niche (albeit rapidly growing) Smartphone OS, Apple would be wise to continue to play favorites as it enters the mHealth market, particularly as the media darling status of the platform will ensure it can take its pick of the major players (eg. JnJ Lifescan) and get their genuine commitment.

Playing favorites is an effective strategy when the biggest barrier is not technology (it’s easy to piece that together) but the user experience and the delivery of a coherent/comprehensive offering.

By: Shorts: Continua and IHE; Pages for pulses | mobihealthnews

Shorts: Continua and IHE; Pages for pulses | mobihealthnews — Mon, 31 Aug 2009 19:23:29 +0000

[...] iPhone : EHR as Platform is to? Remember when the iPhone platform was suggested as a model for EHR development? This commentator points out where that suggestion falls flat. More [...]

By: Didier Thizy

Didier Thizy — Sun, 30 Aug 2009 14:28:20 +0000

Very interesting read! In particular much of the health industry discussions around iPhone talk about it in terms of the new paradigm for mHealth and mobile usability (http://tinyurl.com/mqbtqp), so considering that other aspect about the platform as an open marketplace is refreshing.

Just want to point out Apple is not the only platform that is guilty of these things. Regarding “playing favorites”, Facebook does the same by allowing Blackberry access to unpublished APIs for BB’s native Facebook app. You can bet Microsoft will allow Amalga to access non-published areas of Healthvault, etc, etc.

This is a recurring pattern, and criticism always follows. Yet those businesses are still successful at promoting a some substantial level of innovation with their platforms.

I’d like to know your opinion in more detail – what distinguishes Health IT from other industries to the point that a lack of true “openness” would result in failure?