Lately, I’ve often been asked the question, “What type of smartphone should I get?” by my medical peers.  I’ve been asked this by physicians, residents, medical students, and others. Many of my friends are entering residency and plan on upgrading to a smart phone, while others already entrenched in residency have phone contracts finishing up.

The answer to this question is not easy. Rather, as Facebook nomenclature would demand, “it’s complicated”. From the title you can see I’ve excluded the Palm platform and Windows mobile phones. Palm is currently restructuring since being bought by HP, and Microsoft is in the process of rebooting their mobile division – so both currently do not possess vibrant ecosystems for app development – and won’t be included in this discussion.

How you use your mobile phone is key in choosing the right smart phone, and obviously, not all medical professionals use their phone in the same way. I’ll break down a few different scenarios, and hopefully this analysis will help you make a more informed decision about the right mobile platform for you.

Do you need a smart phone?

First off, you have to decide if you will actually use a smart phone. If you need to check your e-mail at multiple times throughout the day, or feel a mobile reference tool in the palm of your hand is something that would improve your workflow, then you should seriously consider getting a smart phone. However, if you find smart phones cumbersome, too complicated, and don’t ever feel the need to use mobile reference devices such as PDAs, then you probably don’t need a smart phone.

If all you plan on doing with your phone is making calls, then getting a smart phone will only complicate your work flow. To make a phone call on an iPhone can take up to 3 or more gestures – a waste of time for those who don’t plan on using all the other features the iPhone affords.

What is your contract situation?

When it comes to my medical peers, this can often times be the sticking point when making a decision about the right smart phone. Currently, the iPhone OS platform is only available for AT&T, so if you’re on a Verizon family plan or can’t switch carriers, the best option for you is an Android phone or a Blackberry.

Do you use your phone in a rural settings – and how important is a dedicated internet connection?

It’s no secret Verizon has been bashing AT&T for the quality of it’s wireless service. AT&T has 3G service in cities, but the service can literally come to a standstill at peak hours. I’ve experienced this in New York City, Washington D.C., San Francisco, New Orleans, and Las Vegas. In mid-sized cities, I’ve actually had a pretty good experience with AT&T’s 3G connection.

In those big cities I mentioned, my peers who have Verizon service almost all had a good 3G experience, unlike my own. Recently, I undertook a long road trip, and realized the 3G coverage maps of AT&T’s service that Verizon so aptly pokes fun at in commercials are true. As soon as you leave a city, AT&T’s 3G service drops off and you get the dreaded “EDGE” connection – a significantly slower internet experience. My peers with Verizon phones usually did not suffer the same fate.

This is important if your healthcare work requires you to visit remote clinics and a dedicated Wi-Fi connection is not available. You don’t want to be stuck in a remote clinic with shoddy service. Granted, most mobile medical reference apps are native to your phone and don’t require an internet connection – but if you don’t have good service, looking up key information via the web is going to be a exercise in patience.

Also, many electronic health records can be accessed via the web, and if you health care network has mobile access to these records, having a mobile phone with a strong internet access is essential.

So if you need a phone with a strong internet connection in rural settings, stick to your Verizon service, and consider an Android or Blackberry phone.  Android phones have a superior browser in relation to the Blackberry, so if you need to use the browser to access patient data via portals, go with an Android phone.

How important is security and an “enterprise” ready phone to you?

We’ve mentioned before some of the security issues with the iPhone platform. With the upcoming iPhone OS 4.0 software, Apple hopes to address many of these issues, and is promising a more robust enterprise ready platform.

However, Blackberry has dominated the enterprise market, and if you ask most IT managers at your hospital they will tell you they prefer Blackberry due to the greater access to control they have using the Blackberry Enterprise Server. On top of this, the lack of 3rd party medical applications available for the Blackberry can also be seen as a plus for those concerned with hospital IT security. These applications can be a portal to security breaches – not something a hospital system wants to deal with when they have sensitive patient information stored on their servers.

Blackberry also has a fantastic native e-mail client. It can thread together your e-mails, in a similar fashion as G-mail on your desktop browser. Again, Apple promises to deliver this functionality with the upcoming iPhone OS 4.0 release this summer, but Blackberry has had it for awhile now.

So if security is of upmost concern to you, you want a mobile phone with a great e-mail client, and you don’t mind a lack of medical applications, then going with a Blackberry would be a good choice here.

I hedge the above by saying patient data shouldn’t be stored on a mobile phone – rather, almost all patient data that is accessed is done via a cloud system – accessed from a secure server. You should be fine using an Android device or iPhone when accessing information via these systems.

Do you use medical reference apps or use a PDA often?

If you use one of those old Palm PDA’s, you could definitely save some pocket space by having a smart phone. Many forget Palm was at the forefront when it came to having medical apps – physicians and medical students loved their Palm PDAs because they could download custom designed medical apps from the internet, upload them onto their PDA, and use them as mobile medical reference tools in practice. I can speak for the medical community at large when I say we’re all hoping Palm makes a comeback under the leadership of their new parent company HP.

Just as Palm was at the forefront of medical apps back in the early 2000s, its clear Apple is taking the lead now. They literally have thousands of more legitimate medical applications than the Android and Blackberry platforms. Apple certainly didn’t create the App Store with the mindset of developing an ecosystem for vibrant medical apps – they didn’t even have a medical apps section on the launch of the App Store.

Rather, the set up of the App Store and the tens of millions of iPhones and iPod Touches sold can be given credit for this huge success. Developers are given a seventy percent cut of the sales of their Apps, and with the huge number of potential customers – one can see the huge incentive to develop quality apps on the iPhone OS platform.

The key difference between the iPhone and Android App eco system is the lack of a streamline operating system on the Android. The Android operating system is severely fragmented, with certain apps only working on certain phones and certain versions of the operating system. Apple has avoided this by having a uniform operating system on their iPhone and iPod Touch. Even the iPad can run apps that are on the iPhone and iPod touch – although not on a full screen.  It’s easy for Apple to do this since they make both the operating system and the actual hardware, while Google (Android) does not.

A developer I recently spoke to who has popular applications on both the Android OS and iPhone OS said the following:

I know what to expect when I develop an app for the iPhone. I know the devices it will run on, and I know I’m instantly reaching millions of customers. With Android, I don’t know how my applications will run on all the different types of phones, and I know my some of my applications won’t run on the older versions of the software. When Android updates its operating system again, there is a good chance my applications won’t run on the newer phones. So when it comes to spending time developing applications, it makes financial sense to focus on the iPhone.

Just look at our top 10 list of free medical apps on the iPhone verse the top 5 list of free medical apps on the Android. We struggled to find quality free applications on the Android. We set out to find 10 free medical apps for the Android, but had to stop at 5 because of the lack of quality free apps.

Granted, you can access Epocrates, Skyscape and other large medical reference companies on your Android and Blackberry, but if you look at our top 10 list of free medical apps for the iPhone, you’ll find extremely useful apps that are almost all only available on the iPhone, such as iRadiology. Even with Epocrates, only recently did they come out with a free version for the Android – and they still don’t have premium versions of Epocrates available for the Android! Further showing the issues the Android platform presents for medical developers.

So if you want a smartphone that delivers quality medical apps, then the iPhone is clearly your best bet. Notice how Blackberry wasn’t even mentioned here – if you ask developers they will tell you Blackberry doesn’t make it easy for them to develop apps for their phones, plus their user interface isn’t as dynamic as the iPhone or Android operating systems.

Do you want to use your phone as a multimedia tool?

Medical professionals are often on the move, going to conferences or giving talks in different cities. If you have music you want to access, then the Android and iPhone devices are your best bet. The iPhone is great because it allows syncing with your personal iTunes library – just like an iPod, but you can access your music relatively easily on Android devices as well. When it comes to navigating a new city, I would go with the iPhone or Android. There are a plethora of third party applications on these platforms that can make a new city experience fun and both offer a great Maps / GPS function built in.

So what smartphone is best for medical professionals?

Again, the decision is complicated because it depends on your circumstance and what you’re looking for. First, determine if you would actually use a smartphone or not.

The case for a Blackberry: If you want a phone that has a great e-mail client and great security, and don’t mind a bare medical apps selection, then go with this phone. Plus, the tactile keyboard is essential to some – touch keyboards can drive people crazy.

The case for Android: The Android operating system is fragmented with different versions of their operating system, this leads to many medical apps being incompatible on older devices.  However, if you’re stuck with a carrier that is not AT&T, an Android phone is your best bet if you want to have your choice of medical applications. Plus, in Androids newest iteration of their operating system, Flash capability is being built in, while Apple has made it clear their mobile devices will not have Flash support.

The case for the iPhone: The iPhone offers a huge choice of quality medical applications. Once you buy a medical app, you don’t have to worry about it being compatible down the line, unlike the other smart phones I’ve mentioned. Just by looking at the list of our top 10 free medical apps for the iPhone, you can tell there are plenty of quality medical apps available in the App Store. The knock on the iPhone is it’s exclusive nature with AT&T and the lack of a strong dedicated 3G internet connection, possibly problematic for medical professionals who work in or visit rural clinics.

At the end of the day, go the store, and play around with different smart phones. It’s important to understand the roadblocks to quality medical apps that I mentioned above, along with reception and security issues.  Each of the phones I’ve mentioned has its pitfalls.  Take all this into account and make a decision that reflects what you hope to gain from having a smart phone in medical practice.

Iltifat Husain is founder and editor of iMedicalApps.com.

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