Category Archives for Mobiles
I’ve been pondering Apple’s new patent to identify (and subsequently humiliate) so-called “unauthorized” users of their mobile devices like iPhones and iPads. Essentially, Apple is seeking to patent technology that will detect an “unauthorized” user and use that as an OK to wipe data off of the device, activate the camera to expose and publish incriminating information to prevent them from using the device for evil. Ars Technica reports:
If the various analyses detect someone who is not authorized to use the device, it could set off a number of automated features designed to protect the device’s data, suss out the offending party, and alert the device owner. Sensitive data could be backed up to a remote server and the device could be wiped. The device could automatically snap pictures of the unauthorized user and record the GPS coordinates of the device, as well as log keystrokes, phone calls, or other activity. That information could be sent along with an alert to any useful service, such as e-mail, voicemail, Twitter, Facebook, or a “cloud service” like MobileMe.
At first, this sounds pretty good, especially if you get your iPhone swiped by a bicycle thief. The problem, though, is the shady definition of “unauthorized”: are we talking about a physical thief, a hacker who has taken control of your device remotely, or maybe just a regular user who has jailbroken their device (which is legal now by the way)?
Based on Apple’s public stance on jailbreaking, I am tempted to think that the latter will be deemed unauthorized. Coupled with Apple’s bizarre and inconsistent application approval process, in my opinion, iOS is becoming an increasingly uncomfortable platform to use.
mHealth applications designed to run on smartphones are already in a tenuous position because they have to balance the competing demands of cellular carriers, data security and platform divergence (eg iPhone vs Android vs Blackberry). But because the iPhone has been popular among physicians (and everyone else) for some time, the critical mass of users and developers has arrived. For now, the users are happy and there has been an explosion of helpful, informative and intuitive apps for the iOS platform. This is good.
Indeed, it is even argueable that the Apple’s ability to remotely seize a device is an useful security measure, especially for those devices that may have access to sensitive patient or hospital data. However, there are a number of flaws in that argument including:
- Redundancy: Patient data is stored on an external server, not on the mobile device itself. Rare would be the case that an unauthorized user, unless also armed with several username/password combinations, would have access to sensitive data in the first place (especially on an iPhone, which has very little capability for local file storage beyond what is available in iTunes).
- The Wrong Enforcers: If anyone should have the capability to seize and disarm your device it should be your employer or the institution being hacked, not the cell carrier of the device and least of all the manufacturer of the device. Imagine if all the corporate laptops in the world could be shut down by Dell or Lenovo at a moment’s notice.
- Big Brother: This sort of infringement on basic tenets of ownership is more akin to a piece of rented equipment than something you’ve actually purchased. This is partly caused by carrier agreements,but even if you purchase an iPhone outright (for $599!) you gain no extra control. Apple seems to be giving you the $199 plus $70+ privilege to rent out an iPhone for specific, pre-approved tasks. And if you fall outside of them, they have the means to shut you down. Let me put it this way: Will it be the case in the future that I can’t install Linux on my MacBook if I am so inclined? Will they seize my laptop remotely, too, and install a fresh copy of OS X (while taking my picture with the webcam and emailing it to the Better Business Bureau)?
mHealth and its potential for groundbreaking technological applications has enough to worry about with assuaging the privacy concerns of governments and care providers, not to mention patients themselves. Adding the Machiavellian policies of iOS development and, with this patent, “unauthorized” iPhone usage is an unneeded stumbling block. (Speaking pragmatically, if you don’t want to jailbreak your device, then who cares? But open software philosophy is about more than just getting the job done.)
Of course, control and “security” as offered by Apple’s patent may be just what mHealth needs, especially to convince worried stakeholders. But as other competitors become stronger in the space (eg, the Cisco Cius tablet which has some pre-release corporate promise) and Apple’s stranglehold on mobile app development gets weakened by Android, we may be seeing more diversity in the medical smartphone development space soon. However, until med schools stop giving out iPads, and until it stops being more fun and useful than troublesome to use them, it’s going to be an interesting ride.
As services that rely on GPS-tracking and location-based data — Foursquare and Gowalla come to mind — become more popular, and services like Google Latitude and the upcoming Facebook Places start vying for a piece of the traffic, will mobile health providers be able to get in on the action? ReadWriteWeb seems to think so:
From emergency to non-emergency to everyday preventative health care, location tracking technologies could make a big impact on our health and well-being in the future. While two million consumers use Foursquare today to find the best nearby coffee shops and bars, what if in the future they used it to locate the best pediatricians, emergency clinics, or even restaurants that catered to their unique health needs? Some intersection between location and health care has already begun, but what we’ve seen so far is likely only the beginning.
I’ve long been skeptical of the usefulness of location-based services like Foursquare. For a while there, it was really just a game. A way for smartphone toters to annoy their friends, or shame them, on Twitter and Facebook by showing them what restaurant they visited for lunch. (Not making it any easier on those of us trying to convince colleagues of the professional usefulness of social media.) Now, however, companies like Starbucks are launching coupons, and a new company called GroupTabs is linking the popular Groupon service with location-based apps to give deals to users who can “prove” by means of a check-in, that they’re enjoying the establishment’s wares.
Moving into the health sphere, location-based stuff seems like it may translate well and, in fact, the seeds of location-based health have been around for quite a while. For those in the US who need to find a cheap doctor in-network (bless their souls) or someone in Vancouver trying to find a family doctor accepting new patients (good luck), these location-based media may find a niche. For pragmatic travellers, the application pictured above uses augmented reality to plot the location of the nearest public AED.
But there are problems to the mobile health side of things as well:
“Ultimately, I think we’re going to need to be platform independent, even device independent,” Ahier argues. “We’re going to need to be able to use an Ubuntu netbook, an iPad, etc. Our EHR (electronic health records) are going to have to run on all those.”
Compounding the compatibility problems is the fact that most health information is regulated by some form of government oversight (HIPAA, PIPEDA, you name it). So not only do mobile health developers have to join the platform wars between Apple and Android, Flash and HTML5, native and web apps (not to mention cloud computing), but they will also have to ensure that privacy and confidentiality are taken more seriously than heavy hitters and potential future partners, Google and Facebook, have previously been known for.
I don’t relish the long road ahead, but I very much look forward to seeing the innovations on the other side.
The Library of Congress just keeps on keeping on, don’t they? First they agree to archive Twitter. Then, they say it’s OK to jailbreak your iPhone and copy your DVDs for educational use. Now, they’ve released an iPhone app that will take you on a virtual tour of some of the beauty of the building and its collections. From the announcement:
The app includes highlights of exhibitions and architectural features, with photos, audio by curators and other experts, links to more detailed online exhibitions, and even a video about the history of Thomas Jefferson’s Library, which in 1815 reconstituted the Library of Congress after the British burned the Capitol in the War of 1812. The architectural photos come courtesy of Carol M. Highsmith, who has been donating magnificent collections of images to the Library copyright-free, for the American people.
The app itself is easy and fun to use, each page of the exhibits includes a description, photographs and audio or video to accompany if available. Some screenshots are below.
Most of this content is already on the myloc.gov website; the virtual tours there take advantage of Silverlight and are quite something that you just can’t replicate on a 5-inch screen. However, that doesn’t stop this app from providing a great tour experience, one that would be a fantastic companion, especially in the halls of the library itself.
From the most recent statement of the Librarian of Congress of the United States:
Today I have designated six classes of works. Persons who circumvent access controls in order to engage in noninfringing uses of works in these six classes will not be subject to the statutory prohibition against circumvention…
The six classes of works [include]…
Computer programs that enable wireless telephone handsets to execute software applications, where circumvention is accomplished for the sole purpose of enabling interoperability of such applications, when they have been lawfully obtained, with computer programs on the telephone handset…
In English, please?
In essence, this legalizes the practice of “jailbreaking” your iPhone. Jailbreaking, for the uninitiated, is the process of unlocking your mobile device (your iPhone, specifically, though the process is now also being done on Android devices) with the intention of getting better applications and user experience that can’t be done with limited system permissions.
The history of jailbreaking is a long and fun one, filled with the drama of the first hack achieved followed by the cat and mouse game played ever since with Apple, as they update their firmware and are inevitably thwarted again, usually by a group of programmers known as the iPhone Dev Team. It also used to be a very real possibility that you would end up with a dead, or “bricked,” phone in the process. As the development community has become more familiar with the iPhone platform that possibility is diminished, but has not completely disappeared.
The folks at the Dev Team have released a browser-based jailbreak tool called jailbreakme.com. This is a large step forward for jailbreaking because it opens up the idea of jailbreaking to a much wider audience. Instead of downloading a program and following a series of steps, you simply navigate to a web page, swipe, and you’re done. Combined with the now much-reduced possibility of ruining your device, jailbreaking has become a much more tempting possibility.
What is not so clear is the benefit of jailbreaking your device. I am not overly excited about applications developed outside of the App Store; none seem to bring major value beyond the mostly excellent iPhone experience. Perhaps this list will convince you. In my opinion, the trade-offs of security and the hassle of re-jailbreaking with each iOS update make this issue a battle of principle and a questioning of basic rights of device ownership.
Apple, for their part, discourages users from jailbreaking their devices because it destabilizes them and makes them more vulnerable to attack. For this reason, you void your warranty if you jailbreak an Apple device. But for the free-software advocates and the folks working hard to start a conversation about copyright law in the electronic age, this is a big step forward, and I look forward to continuing to follow along.
PS: Feeling technical? Curious how this all works? Try this on for size! It’s really quite frightening. Essentially a PDF file is downloaded to your phone that has an “image” embedded in it. But thanks to a bug, the “image” is actually allowed to execute a program that jailbreaks the phone. Go figure.
I remembered late last night that I could upgrade my 3GS to the new operating system version that allows multitasking among other things. So that meant I had to stay up to install it. And now it means I’ve spent a little amount of time to tell you what I think so far.
Multitasking is just OK — but it’s probably not Apple’s fault. You really need an iOS 4-ready app to make it work right. If an app is ready, it will save its complete state when you switch, so when you go back you don’t lose any data. But if it isn’t, the app’s behaviour may be unknown. For example, if you’re viewing a drug in Epocrates and switch away, the app will take you back to the start. PubMed on Tap will remember the search you completed recently, but not the article you were viewing.
As for the other features, there are a couple handy improvements. Though it doesn’t come on by default, the messaging app will now count your characters for you (go to Settings –> Messaging to turn it on). The camera will now zoom (tap the screen. Sweet). A unified inbox in the mail app will probably help for institutional users with mutiple accounts (though now I forward everything through gmail anyway…).
IMO the best immediate improvement to iOS 4 is the ability to put apps in folders. It even names the folder by default based on the type of apps you put in it (i.e. when you drag one game on top of another to make a folder, it knows). You can change the name, of course, to anything you want. I’m a neat freak, and I won’t lie to you, having all those apps scattered around everywhere with nowhere to go bothered me. Now I can just get upset about how there’s a max of 12 apps in a folder…
Overall, definitely a welcome upgrade with some excellent features. And as more apps upgrade to fast-switching it will get even better (and once Pandora comes to Canada…)
I was recently on vacation for about a week, and it always is an interesting adventure trying to come back to the blogs I read and the people I follow on Twitter and try to figure out what I’ve missed… last time this happened, Facebook revamped its privacy settings and everyone had been freaking out for days. This past week, it doesn’t seem anything similarly dire has happened, but I have seen a few interesting posts related to using the iPad in hosiptals that I thought I’d highlight.
Dr. John Halamaka (Life of a Healthcare CIO) wrote a nice piece on using the iPad while walking around the hospital at work, and compares it to laptops and other pieces of technology that he’s tried before. He also highlights some differences between iPhone 3GS/iPhone 4/iPad and what they’re each good for.
Michelle Kraft (Krafty Librarian) mentioned the above post on her blog as well, in response to a reference question she got from a doctor in her hospital trying to connect his iPad to library resources. Though I guess we knew that was going to happen sooner or later, I’m sure it was at least a little bit exciting. Unfortunately, things didn’t go so well because hospital IT won’t authenticate the iPad for use on their internal network, so the physician has to log in as though he’s off-campus just to do his research or get access to any point-of-care tools.
Dr. Felasfa Wodajo (iMedicalApps) wrote a nice introduction to bringing his iPad into the operating room, using an XRay bag to keep it sterile, and successfully navigating the touchscreen through surgical gloves. Whoa. It is just the first part of what may be a series of posts, but offers a positive initial assessment of the iPad’s use in the OR:
Where I can see the iPad being an asset in the OR will be the ability to bring in relevant medical imaging directly to the operative site, the ability to review relevant anatomy at the point of care (huge), and the opportunity to enhance resident teaching.
Finally, Gizmodo wrote up a short piece on new iPad cases “for germaphobes” but one look at them made me think immediately of the hospital. These cases have antimicrobial coating on them, and, according to the author, are strong enough to boil if you’re really that “paranoid.” After reading about smartphones carrying infection agents, an antimicrobial iPad case sounds just about right for conducting bedside rounds, if you ask me.
Global scientific, technical, medical and scholarly (STMS) publisher Wiley-Blackwell today announced the that its evidence-based clinical decision support product, Essential Evidence Plus (EE+), is now accessible from mobile devices. Physicians on the move can now easily find answers to challenging point-of-care questions from their iPhoneTM, IPod Touch®, AndroidTM, Blackberry® or other Smartphones.
The web display works nicely, with sections of each evidence summary cordoned off into separate pages. The “Bottom Line” section of most pages provides grades for the strength of the evidence, something that not all point-of-care tools offer.
Access to the mobile version is free for all current subscribers, but institutional members and those accessing EE+ through their library’s proxy server will have to sign up for a (free) individual account to get onto the mobile version.
One of the advantages of these large publisher-driven EBM tools is that the content is all web-based to begin with and it seems, then, to be a trend that they will develop alternate interfaces for the Web to be accessed by a mobile browser, rather than compartmentalizing their content to be an iPhone- or Android-only app. In the case of EE+, the interface and user experience doesn’t seem to suffer, and physicians can use any web-enabled phone to access the content.
If you’ve got a smartphone, these articles are available free (for now):
The PLoS Medicine iPhone app has been out for a couple months now, but as I was pondering it the other day, I thought I would use it as an example in a larger thought on mobile apps in health libraries.
AS an app, PLoS Medicine works just fine. It has the functions that most apps have established as standard now: ability to browse articles by subject; simple searching (a little too simple in my opinion); a way to save articles to an inside the app (a “Favorites” menu for quick access); and a way to get the articles outside of the app (direct link sent to email only). Full-text is available both formatted to the iPhone screen, or as the original .pdf.
The strangest thing about the app is its insistence on displaying lists of articles as title only (see screenshots below). This goes not only against most display conventions that list citations as (at least) author name and title, but it also seems to undercut the researchers involved by not attaching their names to the citations on the iPhone (author names are readily available on the web interface). This omission also
cripples impacts the search function of the app.
But my beef with these apps is a little larger than just title display. It just isn’t practical to dedicate pages of my phone’s home screen to every open access (or paid access, for that matter) journal that I love and want to read. PLoS One, PLoS Biology, NEJM, JAMA, whatever–if all these journals start producing apps like this one then we have a serious problem of selection (though it gives us bloggers a few more reviews to write…). With the blinding proliferation of individual journal apps, the fragmentation of the literature grows, and the utility of all of them decreases. We need a durable solution to finding aggregated research on mobile handsets (more on this below).
This problem is not limited to journals. E-books are often this way, with many books released as individual apps. Anyone with an iPhone or similar app-driven device knows this problem with newspaper apps, all breathlessly trying to compete for the Top News App spot. Magazines are starting to catch on as well, with the release of at least Time, Wired and the New Yorker for iPad.
So as a librarian I would recommend two things to my users: one, forget journal apps unless you love ‘em and find a way to search an aggregator instead. Mobile PubMed works OK on the iPhone; PubMed on Tap is better because you can save citations to collections in the app itself, and also email them. (Be aware that PubMed on Tap is not owned or operated by NLM; the PubMed database is simply harvested by the app.) One potentially useful app would be a PLoS Medicine-like app across all the journals in the DOAJ. That way the positives of open-access apps (full content in-app most notably) would be extended beyond a single title, into a much larger chunk of the open-access arena.
Second, I would recommend a more open and durable solution like setting up RSS Alerts for those can’t-miss journals and dumping them into Google Reader, or again a paid RSS app with a little more functionality, like Reeder.
It’s been a busy week of iPad related nonsense news. I feel overwhelmed so maybe I’m not the only one. Here’s a round up of links on early iPad reviews and issues that I have found either interesting or relevant to librarians over the past week. Warning, this is a mess in many senses of the word. Keep checking back because I’ll make it better and add more as my day/week/life rolls on:
- NBC: Doctor uses iPad to assist in surgery
- John Moore [Chilmark Reserach]: iPad in healthcare, a game changer?
- Larry Nathanson [KevinMD]: iPad in the ER, hands-on physician review
- Nicholas Genes [EP Monthly]: How the iPad can change emergency medicine
- iMedicalApps: iPad app store needs to mature
- ScienceRoll: Apple iPad in healthcare, Pros and Cons
- mobihealthnews: iPad/healthcare round-up
- HealthLeadersMedia: Many docs buying iPad, effect on healthcare still in question
- Search Priniciple Blog: iPad arrives for doctors
- blog.bioethics.net: iNeed the iPad
- MagnoMED: iPad EMR
- EHR and EMR: iPad EHR or not
- Children’s Hospital Boston: Researchers embark of $15M project for a iPhone-like health IT platform
Future of eBooks (aka Kindle-Killer)
- Mac|Life: A look at 10 iPad Reading Apps
- Digital Reader: Wiley launches e-reader comparison site
- Mike Cane’s iPad Test: iTunes modifies ePub files
- Mike Cane’s iPad Test: The ePub eBooks metadata mess
- FontFeed: What the iPad is missing (no, it’s not a camera)
- Booksquare: Obligatory post on impressions, reading and wrist strength
- paidcontent.org: Spooked by iPad, ePubs custodians promise changes
- Columbia Journalism Review: Backwards steps by WSJ and NYT for iPad
- John Gruber [Daring Fireball]: The iPad
- Jason Snell [Macworld]: iPad Review
- Ars Technica: Ars reviews the iPad
- Engadget: Apple iPad review
- TidBits: Why the iPad is a blank slate and why that is important
- Dave Winer: Is the iPad a game changer?
- Paul Thurrott: iPad first impressions
Pre-launch (big-wig reviews)
- David Pogue [New York Times]: iPad from two angles
- Walt Mossberg [WSJ]: iPad a laptop killer? Pretty Close
- Tim Gideon [PCMag]: iPad review
- Andy Ihnatako [Chicago Sun Times]: iPad is pure innovation, one of the best computers ever
- Ed Baig [USA Today]: It’s a winner
- BusinessWeek: iPad components may cost $260
- iFixit: iPad teardown
- Geek.com: CPU showdown: iPad vs. iPhone 3GS
- Robert Love: Why the iPad and iPhone don’t support multitasking
- Andy Ihnatako: iPad and multitasking
If you haven’t heard, there’s another tablet PC on the market, and this one has multitasking and Flash Video. Too bad it stinks.
- Engadget: Fusion Garage JooJoo Review
A partnership between the British Columbia Health Ministry, the British Columbia Medical Association and the UBC eHealth Strategy office has produced a mobile clinical guidelines app, CliniPEARLS.
CliniPEARLS does one thing and does it pretty well: it provides clinicians with mobile access to the BC Guidelines and Protocols Committee (GPAC) guidelines. According to the home page, BC Cancer Agency guidelines are under development for addition as well. So though there is a relatively short list of guidelines available through the app right now, it is quite new (Blackberry version released 12/2009; iPhone, 3/2010) and more are on the way.
The app separates guidelines into their clinical specialties, and also presents an alphabetical list of guidelines for browsing. The structure an individual guideline is separated into many hierarchical pages (see screenshots below). This structure makes for more clicks (or pokes) than may be ideal, but it preserves the specificity of each topic page, and prevents a mobile user from getting lost in a long skinny page of text. One potential problem here is that the text, particularly the links, on these pages is quite small. This might not be a problem for the scrolling hand of a Blackberry, but requires deft aim with a thumb or index finger on an iPhone (which I used to test this out).
The search function has an intuitive interface, and will likely become more useful as the list of available guidelines grows. Additionally, you can bookmark frequently referenced guidelines and pages for quick access. A unique feature is that you can filter any of the guidelines “on” or “off,” which allows you to tailor the list of guidelines to your interest or specialty. Again as of now, filtering the list may not be necessary, but as more guidelines are added into the CliniPEARLS database, this feature will likely prove to be an excellent bit of foresight.
As the mobile marketplace continues to flood with medical applications from all variety of vendors, pharmaceutical companies and other (not-)for-profit entities, CliniPEARLS is a great example of how to enable clinicians to access localized and government-approved clinical information at the point-of-care.
CliniPEARLS is available for Blackberry, iPhone/iPod Touch, Palm and Windows Mobile. Instructions for signing up (an account is required to obtain the latest guideline updates) are available here.