By Bertha Coombs, CNBC Reporter

NEW YORK ( CNBC) -- There are two things Dr. Larry Nathanson can't work without when he's on duty in the emergency ward: his stethoscope and his iPad.

After nearly a year using the tablet, it has become an integral tool for treating patients.

"As I am walking from room to room, I know who I need to see next," he explained, scrolling through the virtual emergency room patient board on the iPad.

"I definitely feel lost when I don't have this on a shift," he said.
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As the director of emergency medicine at Boston's Beth Israel Deaconess Medical Center, Nathanson was among the first doctors at the hospital to buy an iPad the day it launched. He paid for it himself, but it has more than paid off in the time he saves not having to chase down records.

"Patients often have a lot of questions, and I am able to answer them immediately with the latest data in real time," Nathanson said. "I can sit there at the bedside and I can go over what's going on."

When it comes to treating surgical patients, being able to pull up diagrams and x-rays at their bedside has been a real game changer for B.I. Deaconess Dr. Henry Feldman.

"The number of times I've had patients say to me 'That's the first time I've understood my disease' -- I mean, it happens all the time to me. To me, that's validation as a doctor," he said.

Some also see doctors' embrace of the iPad as validation for Apple ( AAPL) as a new leader in the health-care enterprise market, while competitors like Research in Motion ( RIMM) are just beginning to roll out their tablets.

Analysts at Chilmark Research estimate 22 percent of doctors in the U.S. were using iPads by the end of 2010. In February, four out of five doctors surveyed by health marketing company Aptilon said they planned to buy an iPad this year.

The strength of doctors' iPad adoption has caught the health care IT industry by surprise.

"It's created quite a disruption for the health care IT vendors," Chilmark health-care IT analyst John Moore said. "It's very challenging as to how to prioritize this."

It comes at a time when the industry has been focused on rolling out updated electronic health record systems that will help hospitals and doctors meet deadlines for achieving federal health care technology standards known as "meaningful use."

Yet, in many ways, that's what may be helping to drive the intensity of doctor demand for the iPad.

The Perfect Storm

The government authorized up to $30 billion in reimbursements for qualifying health care IT systems as part of the 2009 stimulus act, in an effort to speed up adoption of electronic health records, known as EHRs.

The criteria for meaningful use in 2011 include capturing patient information in EHRs and inputting more of doctors' treatment orders and prescriptions electronically. The goal is to improve care by reducing errors and duplication, ultimately bringing down costs.

For the doctors who will have to input much of that data, a lightweight, portable tablet that can be used at a patient's bedside fits the bill.

"I would call this a perfect storm for medicine," said Dr. John Halamka, chief information officer at B.I. Deaconess. "You have alignment of funding; a cultural change where doctors want to use devices to improve quality; you also have new devices and new software that is much easier to use."

Halamka and his team develop all of the healthcare IT systems used at their hospital in house. They're now working on developing secure apps for their doctors that will work on iPad, Android, Blackberry and any other platforms physicians may want to use.

For most commercial health care IT players the priority now is the iPad, because that's what's generating the most demand.

GE Healthcare is even offering a free iPad 3G to doctors who sign on for its Centricity Advance EHR software platform before March 31, as it prepares to roll out a dedicated iPad app for the system in the second quarter.

"All of them without exception are building an iPad application," said Chilmark's John Moore, "because customers are demanding them."

Can RIM Catch Up?

The iPad's first mover advantage in health care will present a major challenge for Research in Motion ( RIMM), which announced that its new Playbook tablet will be available April 19th, more than a month after Apple launched its new iPad2.

RIM has lost the handheld app war to iPhone and Android, but analysts say the BlackBerry maker has hedged its bets when it comes to positioning the PlayBook for the health care market.

"Suffice it to say, iPad will still dominate a year from now," MobihealthNews editor Brian Dolan said. "Two years from now -- who knows?"

In a report this month called "The Coming Medical Tablet War," MobihealthNews analysts note that in its early demos of the tablet, RIM often showed off health care apps.

The PlayBook runs on a brand new operating system based on software by QNX -- a firm with a history of providing support for medical devices which RIM acquired a year ago.

Security features could also help tip the balance for BlackBerry with hospital technology officials, according to Dolan.

"A lot of health care facilities have BlackBerry enterprise servers installed, which means they have the security installed," he said.

But PlayBook will also be able to run more widely-available Android apps, and Chilmark's John Moore thinks that could pose a source of worry because of problems with malware on the open-sourced Android market.

With Apple's strict App Store policies, "there's a higher level of comfort with CIOs if they're bringing in an Apple-based device, that at least the apps are vetted to a certain degree," Moore said.

But some app makers have to answer to a higher authority: federal regulators.

Regulating Tablet Apps?

One of the biggest questions hanging over the adoption of tablets for health care is what the FDA will do about apps used in patient care as well as using features like the camera on the iPad2 for diagnostic purposes.

"If it takes a picture, is that a medical device? Is that a diagnostic tool?" asks Chilmark's John Moore. "We still don't have a really clear definitive picture on that."

"This is a point of discussion in Washington," says B.I. Deaconess CIO John Halamka, "If error is introduced because of a software mistake, how do we make sure that is reported? What oversight exists?"

So far, the FDA has cleared a handful of apps for the iPhone and iPad, including Airstrip Technologies' remote patient cardiology monitoring system and MIM software's Mobile MIM radiology mobile app.

It's important for the FDA to set safeguards, but with doctors just beginning to explore new possibilities with tablets, regulators need to find a balance, Halamka said.

"Allow innovation. Don't stifle it," he said.

-- Written by Bertha Coombs of CNBC

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