Monday, April 4, 2011

Three Weeks with the iPad 2: Working, Doctoring, and Playing

I'll be honest, my initial impressions upon first hearing about the iPad last year were negative. I had been anxiously awaiting its release and expecting something that resembled a stripped down Macbook vs. a souped up iPhone. I will admit one year later that Apple may have been on to something. If we can all recall, the initial idea of a "tablet PC" which took Windows and added a touch interface did not cause the revolution that the iPad has caused. Also, now the other major mobile OS's (Palm, Blackberry, and Android) have tried to supersize their product for a bigger screen. Three weeks ago I got lucky and managed to be number 105 of 110 at Best Buy to get an iPad on its release day. What follows are my initial thoughts...

From a business-y standpoint the iPad makes a suitable replacement for a laptop when you are on the go. There is decent exchange support (although I don't think any device supports exchange like a Blackberry with BES) and using Documents to Go ($16.99) you can do some mild to moderate editing of Office documents. One other nice feature of DtG is the abilty to wirelessly sync with your desktop. i.e. you can sync your My Documents folder (or Documents on OSX) with DtG on your iPad and take it all with you. I've found that the iPad is portable enough to take around to meetings, not as conspicuous as having a laptop open in front of you, but more functional than a smart phone. I'm often in situations where I'll receive an email that warrants a longer response than I'd care to thumb out on my phone, but do not feel like waiting until the end of the day until I'm actually at a computer to sit down and compose my thoughts. Also, viewing a calendar on the iPad gives you a much clearer picture of what your day is like as opposed to your smartphone.

Many would say that taking your desktop with you is passe and the real future is in putting your files in the cloud. Most of the iPad programs support Dropbox (including Documents to Go) which seems to be at this point the frontrunner in cloud storage. (Other sites offer more storage: and even amazon, however none have the easy user interface that Dropbox has). Unfortunately the iPad has no "file manager" but GoodReader ($4.99) is an acceptable alternative since you can use it as a launch point for any other program. It also supports annotation of PDF files. Dropbox gives extra space to both the referrer and the referee so if you are interested in Dropbox, click here so we can both get some extra space. Another app that I have been using is SharePlus Lite (free). It lets you interact with Microsoft Sharepoint websites in the same way the GoodReader does for the cloud. The pro version of the program ($14.99) lets you write to the Sharepoint site, while the free version just allows you to view and edit locally.

I have tried both Penultimate ($1.99) and PaperDesk ($2.99) for note taking. Penultimate has the better writing interface but PaperDesk has more features (combining text, writing, audio, and a todo list). There are several apps out there that sound promising that I have yet to try (uPad, Note Taker HD, Notes Plus). I think the ideal app needs to combine smooth writing abilities with the power to mix handwriting with other media (to go beyond what you can do with paper.) I have still yet to find the "perfect" writing app for use with a stylus.

For my work as a doctor I primarily rely on the Citrix client for iPad (free) to connect to my hospital. We can access our hospitals electronic health record system, labs, xrays, and even view the bedside monitors of the ICU patients. Unfortunately using Citrix on your iPad involves accessing a Windows computer via an iPad interface which is clunky. (Many EHRS have iPad apps to access them, but we are not there yet). While the getting there is clunky the pay off is nice. Looking at xrays and CTs on the iPads screen is nice and the pinch to zoom is much more functional than the built in zoom tools in the xray view. Also, viewing patient monitoring on your lap in real time is pretty cool. Citrix on the iPad beats Citrix on the phone since with the phone you have a clunky interface looking at a Windows desktop through a porthole. A week ago I actually spent the good part of an hour meeting (I was only needed for about 5 minutes of it) providing patient care by looking at labs, putting in orders, reviewing x rays, and checking in their monitoring on my iPad.

One area I have yet to find perfection in is in keeping a journal collection. In my field I read two primary journals Critical Care Medicine and Pediatric Critical Care Medicine. I've found a good workflow with MDConsult (which has pdfs of the above journals available), DownThemAll (Firefox extension that auto downloads all the pdfs to your computer), and Mendeley (which then will automatically catalog the metadata for your pdf collection) to effectively have a paperless bookshelf of my two most read journals. My goal was to have a few years of searchable journals at my fingertips. I've met a FEW snags with this on the iPad. First off Mendeley only lets you sync 500MB for free to your personal space and charges you for more. Second the Mendeley app seems to crash on my iPad (I suspect due to the size of my library). I don't think Mendeley was meant to be used in this fashion but more to keep a small focused list of journals for academic folks. What I need to find is pdf viewer that searches INSIDE PDFs and lets you sync a library of PDF documents with your desktop.

The iPad really shines here. I'm a big fan of RSS feeds and find Feedler (free) to be a great way to thumb through my Google Reader stream pretty quickly. Apps like Flipboard (free) and Pulse (free) change this experience from pointing and clicking on a browser to a truly hands on interactive experience. Also, many web apps like Yelp, TripAdvisor or the IMDB for example have iPad specific versions which are more robust than their smartphone equivalents. As far as games I've found there are 2 kinds of games: 1. Supersized smartphone games: games like Angry Birds and Cut the Rope take a game initially made for a phone and upsizes it for the iPad. These games are fun, but other than making things bigger do not change the gaming experience. There are a whole slew of games that really take advantage of the iPad's UI to make it a more immersive experience. For example, recently I've started playing Drawn (free) which is a Myst like adventure game that lets you interact with paintings and solve puzzles on a quest. Also Contract Killer (free) which puts you behind a sniper scope to take out bad guys and is very reminiscent of the Hitman series of games.

I think there are three things that to me hold the iPad back. One is lack of file management and storage. There's no user accessible file system inherent in the iPad. Apps like Documents to Go and GoodReader provide their own file system that you can access via iTunes, but it's not like you can just drag and drop any file on to your iPad from Windows or OSX w/o going through iTunes and the above programs. One other quirk is that you cannot "attach" a file to an email. You can start in the programs mentioned above and then send the document (which opens mail with the document attached) but you cannot start in the Mail app and decide to attach a document. Also, the iPad has no way to easily add external storage. You can use the Camera Connection Kit ($30) to pull in media (just photo and video), there's AirStash which allows you turn any SD card into a portable NAS (but it's $100 and requires that you disconnect from your network to the AirStash), Sanho Hyperdrive ($100 for a drive casing that holds a 2.5 inch HD, $200 to $400 for 320GB to 1TB of storage) is another option that gives you up to 1TB of storage (but here again only photos and video). My music collection alone is 50+GB so to take this with me would fill my 64gb iPad. However, if a good external storage option existed i'd take all my movies and music.

The second negative is the lack of a customizable dashboard. My phone of choice has been a Droid X and I LOVE widgets and being able to set up my home screen with certain apps on certain screens and widgets. Now, I think Apple with its minimalist approach would not allow a UI cluttered with Widgets but I think this is where the Android folks could shine if they play their cards right.

Finally the camera is just crappy. It gets the job done for using face time, but does not work well for quality pictures and video. I'm not really complaining since I don't find the tablet form factor to be the best for taking pictures or video and I would imagine that most folks who own the iPad also have a smartphone with a decent camera and video capture.

I think at this point in the tablet world there really are no other players . Android's Honeycomb is fresh out of the gate and clearly has what is on paper a more powerful device in the Motorola Xoom (SD card input, HDMI out, 1080p). Unfortunately there are just SO MANY apps for the iPad that I think it will take Android a while to catch up. I suspect they will though, just like Android phones are now running in a dead heat with iPhones. Blackberry and Palm are getting out their devices as well but again Apple has such a large headstart with the iPad, especially in the medical arena. For now I think you cannot go wrong with an iPad.

The other option is to just get a full fledged laptop. If you get the iPad with 64gb +3G you spend about $850. For $150 more you can get a Macbook Air. Or if you are into Windows you can get a netbook for around $300 - $500. I think this choice is really dependent on your needs. i.e. if you want to do the EXACT same things that you would do on your computer on the go then you will fall short with the iPad. For example, you cannot do full fledged Photoshop editing or Aperture with your iPad. However, on the flip side try working with a laptop crunched between two people on the train.

Should I get one?
If you are looking for something smaller and portable that has a unique interface consider getting an iPad since you can do 90% of what a laptop does and has some unique features your laptop doesn't (longer battery life, touchable UI, ability to just click on and start using w/o waiting for the computer to boot up). I'll be honest I'd hardly call an iPad (or any tablet for that matter) a necessity but it definitely has a role to fill.

Which one should I get?
The iPad comes in a total of 18 flavors. There are 3 sizes (16, 32, 64gb) x 3 network options (wifi, AT&T 3G, Verizon 3G) x 2 colors (black and white). Personally I'm partial to the black, I think for movie watching having a black border is a nice touch (imagine if your TV had a white bezel instead of a black one). As far as size I think if you are going to just put on some apps and keep a lot of documents in the cloud then the 16gb is the right size. However, if you want to take A LOT of documents then you may need to think about the 32gb and if you want to take pictures, video or music as well then get the 64gb. As far as networking, rather than having a data plan for just your iPad, I think it makes more sense to have either a MiFi device OR WiFi hotspot on your phone which then allows you connect ANY device to the internet. Only negatives here are that WiFi hotspots KILL your cell phone battery AND it does require the extra step of turning on your MiFi or the cell phone's hotspot before connecting your iPad

Good laptop replacement
Screen great for PDFs
Intuitive UI
Fun to use as a "toy" (games and web)

Lack of a file system
Lack of a customizable UI
Weak camera


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