What side of the iOS vs. Android debate are you on when it comes to healthcare mobility?
Chris Sullivan, Global Healthcare Practice Leader, Zebra Technologies, provides an overview of the benefits and drawbacks of each platform and how developers can make the best decisions about which mobile operating system (OS) is the right choice for the solutions you develop, now and in the future.
Can you share the positives and negatives, in general, about iOS and Android?
Sullivan: iOS is a stable and secure, developer-friendly platform that is used in both consumer and enterprise environments. Compared to other operating systems, iOS is extremely predictable and delivers fewer bugs and complications, making it easier for developers to code. With iOS, businesses are not only committing to an OS but a defined set of hardware platforms (iPhone, iPad, and iPod Touch).
In contrast, there are several hundred Android manufacturers, producing more than 24,000 different devices, sold under 1,000+ brands, and available in more than 200 countries. iOS does not offer as much flexibility as other platforms, which can make it difficult for developers who might need it to meet unique use cases. Android offers a more robust experience that allows developers to go much deeper and offer more customization options.
A recent Gartner security study puts Android higher in nine categories compared to one for iOS, and the two are rated as comparable in 20. The security advantage that iOS enjoyed over early Android releases has closed. Android’s flexibility enables vendors like Zebra to make significant add-on enhancements like Mobility DNA that are not possible on a closed OS.
In addition, iOS was originally designed for consumers making integration difficult for organizations wanting to use it at the enterprise level. Providing iOS device support for enterprises has always been secondary to consumers. Our customers and partners have expressed that using iOS to communicate and collaborate with non-iOS devices (IoT devices, location beacons and other technology ecosystems beyond iOS) has often led to a poor experience. Businesses require systems that offer device compatibility with non-Android and non-iOS devices to make it easier to connect several devices at once, which is critical for large enterprises utilizing multiple platforms.
What do these features mean for healthcare specifically?
Sullivan: iOS in healthcare has had great physician adoption right out of the gate based on personal usage and ensuring comfort and confidence with the interface. The initial control of that device is also easier due to iOS’s closed environment, meaning fewer security concerns. The iOS experience works well for basic functionalities such as voice communication between physicians and text messaging. While most physicians may prefer iOS, they’re typically less than 10 percent of the workforce. So, when healthcare facilities are purchasing iOS for their entire staff, this can cause complications, lead to unexpected hidden costs and an inability to fulfill all of their healthcare use case requirements.
As the healthcare digital environment becomes more advanced, iOS point of care mobility implementations can increasingly become more challenging to use and may result in the inability for a hospital to cost-effectively implement some of the available data capture, clinical decision support, and workflow efficiency use-cases. With a more sophisticated environment, hospitals selecting iOS run the risk of making large, initial investments that can’t scale and grow with their evolving needs and require a separate investment in Android to manage advanced use cases.
From a healthcare perspective, Android device manufacturers can produce devices that tolerate chemical disinfectant wipe-downs and/or be manufactured in anti-microbial materials to prevent the spread of infection. Since iOS was initially created with the consumer in mind, it wasn’t built to withstand harsh healthcare environments and use cases, such as daily disinfecting. Facilities using iOS in these instances quickly learn that the device life expectancy tends to be shorter.
Being able to manage the device centrally, whether it’s iOS or Android, is also crucial for version control changes to happen. With iOS this isn’t an option in the same way that it is for Android, and as such, can make it difficult for healthcare facility IT departments managing these large fleets/ecosystems of devices.
If a developer had to pick one platform for a healthcare app, which should they choose?
Sullivan: The answer depends on the developer and what they are trying to do. There are distinct benefits to developers using each platform, but the use case should drive the decision-making process. iOS is strong for physician-only apps or things like home health monitoring and home wearables. For customized use cases that require interoperability with other devices, Android is the better choice for the movement of data from an IV pump to a patient monitoring vital signs tool (or even security camera) where you’re trying to merge different data sets. iOS may not be able to monitor and analyze the data collected on a mobile healthcare app in the same efficient and cost-effective way that Android can.
Android is also the best platform when it comes to OS updates. For developers creating a healthcare app, this is critical in avoiding last-minute software changes. iOS’ coding surprises can leave a developer scrambling and are never ideal when creating a new healthcare app or ensuring the long-term success of one. At the end of the day, if you know your business objectives and the use cases, then that will drive you to the right decision.
Is the better strategy not to choose but to develop the app for both?
Sullivan: In many instances, the best strategy will be to apply a cost-effective methodology to develop for both OSes. Best practice cost management examples could include limiting the diversity and scope of the software application and developing third-party interoperability partnerships to achieve solution deliverables that may be outside core company capabilities.
Beyond looking at the market today, do you see it taking a specific direction in favor of one or the other platforms in the future?
Sullivan: iOS seems to be the platform that drives the most initial attention and popularity from both consumers and large organizations, but it only has 40 percent adoption in the enterprise space. Meanwhile, Android tends to receive less initial attention but has been adopted by the other 60 percent. iOS might be flashy and eye-catching to the public, but Android has been recognized as a cost-effective platform that’s built for long-term use and will help companies reduce their total cost of ownership. As healthcare digital maturity accelerates in the future, Android is likely to be the platform of the future due to inherent enterprise environment advantages and its seamless ability to securely bring e power and convergence at the point of care, which will drive better patient care workflows.
For those organizations focused on green initiatives, consumer-grade lifecycles are not eco-friendly. Smartphones have a two-fold impact on the environment. The direct impact comes from disposing of devices. The less obvious impact is the significant amount of energy used to mine and process rare earth metals used in smartphone production. iOS-based devices typically have short lifecycles of only 2-3 years. Conversely, Zebra’s Android-based mobile devices are designed to be supported with security updates and hardware service for up to 10 years.
What else do developers need to know about developing for the healthcare mobility market?
Sullivan: The healthcare industry is the fastest-growing vertical for technology adoption, but ironically also happens to be the market that tends to lag the most. For developers, this is a huge consideration. Nurses and healthcare providers that work with patients day in and day out tend to make up the bulk of the staff at healthcare facilities. Being aware of this and understanding their audience can go a long way in helping developers choose the best platform to work on for their specific needs. For providers and organizations making purchasing decisions, they also really need to think about which OS is best for their security needs and from a liability standpoint. If most staff using these platforms are nurses and providers working with patients, they want the best device that will help minimize disease and the spread of infection that could lead to potential legal issues down the road for an organization. 
