When Apple launched the App Store, Epocrates had a front seat at the table, and collaborated with Apple to make sure its software would be one of the first available for iPhone users.

As medical professionals, this didn’t come as a surprise.  We expected Epocrates to be “the first”. It had been the undisputed king of medical and mobile before the word “apps” became everyday vernacular. Epocrates was dominating the medical app ecosystem before iOS existed.  Most medical professionals I knew in the early 2000s had a Palm device not because they wanted a PDA, but because they had to have the Epocrates app.

So when Epocrates was the first comprehensive medical app to make the transition to iOS, it seemed their dominance would continue.

Unfortunately, over the last few years it’s clear Epocrates is no longer the innovator it once was, and has almost become completely irrelevant to medical professionals. Here are just three reasons why.

Reason #1: Lack of an iPad app

Epocrates claims to have 50% of U.S. physicians using its software, and more than one million active members, yet it still does not have an iPad app.   I know of medical practices that refuse to use Epocrates mobile suites because of the lack of an iPad-centric app. Sure, you can technically use the iPhone app on the iPad, but if you pay in excess of $150 a year for a subscription, you should expect an iPad-optimized app as well.

This lack of functionality is borderline disrespectful to medical professionals who purchase an expensive license for the app.

Epocrates didn’t even make our Top 10 iPad medical apps list because of the lack of iPad functionality. If you want a full-featured prescription drug app, use Medscape or Micromedex on the iPad. There was a time that Epocrates used to be the most downloaded medical app in the app store; now it’s Medscape (Currently the Epocrates app is trending as the most downloaded, but that’s due to the free promotion it is running for medical students this week).

Although Epocrates does offer subtle premium features that aren’t matched by Medscape, for almost all physicians, Medscape and a combination of other medical apps easily replace Epocrates functionality.

Reason #2: Whatever happened to its electronic health record (EHR)?

We did a demo review of Epocrates’ EHR last year, and at that time were told we could expect the EHR to launch sometime this year.  Instead, Epocrates announced that it would be selling off its EHR business to focus more on their mobile business.

This focus on the mobile business has not been evident in the latest product offerings.  We haven’t seen any revolutionary changes to Epocrates’ mobile offerings. The company did do a reboot to its overall user interface (UI) almost a year ago, emulating the old Facebook UI, but that reboot was met with complaints from users about the app slowing down in speed.

Reason #3: Epocrates is making modality irrelevant

Modality is a company that takes medical resources and optimizes them for mobile form. Some of its venerable additions to the iOS app store have been Procedures consult and the Pre-Test series.

When Epocrates bought Modality, I wrote that I was worried about Modality.  At the time of the acquisition, Modality was producing great medical apps for iOS, making use of all the functionality in the iOS platform.  Epocrates had already started slipping in mindshare at that time, and I was worried it would take Modality down with it.

Unfortunately, it appears this is the case.

Modality hasn’t optimized any of its Pre-Test apps for the iPad, or, for that matter, many of its other test bank apps. In fact, it hasn’t really done much with any of the apps it has had since Epocrates acquired them.  Even more damaging is it rarely updates its apps anymore, the last updates for its apps coming more than 6 months ago. When Apple launched fast app-switching and a host of other functionality features, it took Modality more than 6 months to update its apps.  Most single medical app developers implemented the new functionality within weeks.

I know Epocrates could easily point to this article and explain that it is still signing up plenty of medical professionals, and explain how it is still making money. Company officials will point to “Doc Alerts” or some other type of functionality they have rolled out that is interesting but not essential. Blackberry had the same defensive approach when technology writers started hammering it on its lack of innovation and mobile design a few years ago, even in the midst of the company still doing fiscally well.

But what it really comes down to is mindshare.  Mindshare is often considered to be the informal measure of a product or a company’s perception.  For example, Apple has great mindshare in mobile and hardware, considered by many to have the best hardware for phones.  Your legacy crowd can still keep you floating with slipping mindshare, but a company’s perception eventually catches up to sales. Blackberry found this out the hard way.

So ask medical professionals under the age of 35 if they have Epocrates on their smartphone. Ask them if they have Epocrates on their iPad — wait, they can’t because Epocrates is still ignoring the iPad, a device that medical professionals are in love with.

You will be hard-pressed to find young medical professionals using a purchased copy of Epocrates. Most of us know we can get the same functionality with free apps, or more importantly — why would we pay for a premium app that claims to be for mobility, but ignores the iPad?

So has Epocrates become irrelevant? No. It still has a dominating market in mobile. But it needs to look at its Modality offerings and its own flagship software and do a complete reboot.  When it states it is “refocusing on mobile”, that shouldn’t be a refocus on how to maximize revenue on the number of physician subscribers it has.  Rather, it should be on how to create better software that will increase physician subscribers, a domain the company was supreme in just a few years ago. Otherwise, it need look no further than the Blackberry story.

Iltifat Husain is founder and editor of iMedicalApps.com.