The first barrier relates to the device itself. To be used at the point of care, a device must be water resistant. Because of the inevitable fluids found around patients, any point of care device must be water resistant. The device must resist the ingress of splashed fluids, as opposed to surviving a drop into a toilet.

Next, the tablet must be made of materials that withstand the effects of the harsh disinfectants. Devices at the point of care (in hospitals especially, but also in ambulatory settings) must be wiped down with disinfectants to reduce the risk of spreading infections. Common plastics turn brittle and break after repeated exposure to these chemicals. And if such devices are not water resistant, they risk being damaged by disinfectant wipes.

Any point of care tablet must be ruggedized to withstand repeated drops from 4 feet onto linoleum covered concrete.

These three requirements are met by the Intel clinical tablet reference design. Yet this reference design has met with limited success in the market for two additional reasons: weight and battery life. Existing tablets must be light weight enough to be carried for a 12 hour shift. They also need sufficient battery capacity to provide a full shift’s continuous use. (These two limitations are why tablets are deployed on computers on wheels, rather than carried and used like, you know, tablet computers.)

And don’t forget commercial ganged charging stations. Connecting each device into its own wall wart plugged into an outlet is a nonstarter — there’s not enough room in already crowded central stations.

The other major barrier to adoption is application software. For a computing device to be truly nurse carried for any length of time, it has to be smaller than conventional tablets, and it should probably fit in a lab coat pocket. And remember that the average age of nurses is over 50 years — cramming a 1280×1024 or even 1024×768 display onto a small tablet is a losing proposition.

EMR vendors design their user interfaces for full sized displays deployed on desktops or computers on wheels. A number of interesting devices in the past (the OQO and Emano Tec for example) have languished because no one was willing to redesign user interfaces for smaller devices.

Sadly, Apple has almost no foot print in hospitals, or even physician offices. To get IT departments to support another platform with another operating system, a really compelling solution will be needed. Apple could put this off, if they were willing to put in a little extra effort.

As Rob notes in a comment above, a product that meets health care market requirements would also be attractive to other vertical markets – manufacturing, field service, construction, logistics. It is interesting to note that companies like Symbol approached health care *after* penetrating these other verticals. To succeed in health care they had to include resistance to disinfectants.