So, you thought the iRex iLiad carried a bit of heft around the price tag, eh? Well check out this rugged $3,995 MedTab ET-100 (http://www.emanotec.com/medtab.htm) E Ink tablet from Emano Tec. Full specs:


powered by WinCE 5.0 with an Intel XScale 624 MHz CPU
weight: 9.5 oz. (270g)
dimensions: 5.5"x7.5"x 0.5" (140x190x12mm)
screen: 8.1" (205.7mm) 1024x768, E Ink, 16 grey scales, touch-enabled
connectivity: WiFi 802.11 b/g, bluetooth (optional)
battery: Li-ion 1800mAh (runtime: 6 hours on one charge, 12 hours with optional larger battery)

The MedTab is obviously is not designed for you to consume your favorite Michael Crichton novels on it; rather, it's made for the technology-inclined hospital staff who needs to access information from anywhere in a clinic. And the good news: should you plan to buy more than 50 devices, you'll get a 50% discount ($2,000/unit).

(high-res photo attached)

Thanks to realityloop (http://www.mobileread.com/forums/showthread.php?threadid=9965) and Brian Gilbert who sent in the news.

It ain't *that* wonderful, not enough to be worth a $3,995 price tag. Hell, not even for a $1,000 price tag.

But then, the doctors and hospitals will write it off their business taxes. ;-)

Derek

Too expansive!
Its panel is just 8.1, 1024*768, 16 grey scales as same as that one of iLiad.

If $3.995 will be accepted by any kind of customer, the $699 iLiad has already succeeded!

I think the problem of iLiad and this one is "price", not their "spec".

This is aimed at institutions, hospitals. I work for a major cancer research hospital which has been trying for a long time to electronicize their medical records (part of the problem is that some of the docs can't agree on what forms they ought to use). If they could get the plan together, something like this would be worth it's weight for actual implementation hardware -- assuming that it does what it says it does. From that perspective, the high price is actually reassuring, believe it or not. If they're charging $4k apiece for them, it says they'll stand behind them big time, and it suggests they'll have the resources to do so. Which in turn, means it's more likely that it will actually do what it's supposed to do.

Yeah, it's way too much for a reader, but it's about right for a high-end medical instrument, which is what this is claiming to be. It might or might not read e-books too, but that's not what it's meant to do, just like my new Pentium Duo isn't really intended solely to allow me to play minesweeper (but don't tell my wife that!). :grin2:

I think it's well worth the price. $1000 for the unit + $1000 for the costumized software for the special purpose is not too much, if it really does what it supposed to do and you get support and consultation.
Medical equipments are not cheap usually.

What I feel sorry about is that it has only 8 " screen.
It would have been great to see a hardware with 10" display.

True (I'm hoping for an A4, myself), but somebody has to make a 10" display first! :nice:

I'm also unsure how much docs, as a group, care if such a device will fit in their lab coat pockets (as this one will). :shrug:

Let's consider feature sets and prices, shall we? First, here's what MedTab has to say about its hardware.

********

The MedTab includes the following rich feature set:

Portable – 12 Ounces, measuring 5.5” X 7.5” X 0. 5” which comfortably fits a lab coat pocket

High Resolution Display – 1024x768 pixels using a proprietary E-Ink high contrast, low power “digital paper” display.

Rugged – capable of withstanding 30g impact

Touch Screen (including pen for notations)

Intel 624MHz Processor

WinCE OS

Bluetooth for audio or data transfer

Fingerprint scanner

Audio In/Out

802.11/g WIFI

Cisco’s OEM security Client– supporting state of the art wireless security

EmanoTec has extensively modified WinCE to support this radically new and different display technology. This makes porting an existing application to MedTab as simple as installing it on a standard PDA.

Most EMR systems require a thin client which is either a standard web browser or a custom client. Many of the newer EMR systems use standard web browsers as their client. MedTab provides Microsoft Internet Explorer (IE) which has been modified to be an OS shell and presents itself in kiosk mode. Thus, the device is secure from user tampering and the entire screen is available to the backend system. MedTab uses WinCE as its OS which most vendors support if they have a custom client. The most common customer client is Citrix which supports WinCE.

********

Going down the list:

The 8" display, in and of itself, costs a manufacturer around $150 in OEM quantities and the display controller board will add another $20-$30 and touch-screen will add another $10-$15 (I know, I've had plenty of reason to check while working on the concept of a custom ereader for NAEB.), while the rest of the features of the SBC (single board computer) - which provides the power to the actual computing process - runs about $50 in OEM quantity. And except for the 'ruggedized' case and the fingerprint scanner, every single 'feature' listed above in the list is *STANDARD* on most of the SBCs! So except for those two items in the list, we can ignore any claims of 'special engineering and design'. As well as the idea that these now-ignored features somehow added to the cost of the device.

Okay, what about the ruggedization? Have you ever dropped your Dell Axim X51V? (Which has exactly the feature set found here - again, minus the fingerprint scanning.) I have. From about five feet, outside its case, onto a tile floor. Guess what? It still *WORKED*! Thing is, as there are no spinning hard drives to get destroyed when the read/write arm ploughes into the surface of the drive, most of what's in these devices are pretty rugged and securely attached already. If the connection to the battery or if the screen itself doesn't crack and shatter, the device probably won't stop working.

That brings up fingerprint scanning. It's so *complex* - not - that at least *THREE* different laptops are offered with it built in. For no significant increase in price. Let us be real here. Adding in the hardware to scan a fingerprint for security purposes adds about another $30 to the cost.

That leaves all the rest of the hardware, which will add about $30-$40 to the cost. End total cost per unit hardware is almost certainly about $300, not the $1,000 someone else opined. And all of the major stuff has been developed by MedTab's suppliers - at most, they designed the case, although many manufacturers will even do that for you!

Now on to the software.

First and foremost, WinCE - which is most properly called by the name given by Microsoft for this generation - Microsoft Windows Mobile 5.0! Guess what! The primary manufacturer (read *ONLY* volume manufacturer) of e-ink displays has *ALREADY* designed a full and custom interface between its display/controller and WinMobile5! It, PVI, *GIVES* it away to their customers!

And as for porting applications to MedTab's device, well, has *ANYONE* tried developing for WinMobile??? Easy? Not really as you're pretty much limited to Visual Studio, Mono, and Delphi, which, while they *can* develop WinMobile apps, really are designed for making full-blown Windoze apps. But that's a darn sight easier than porting an app made for Windoze to WinMobile! And porting from a Linux app to WinMobile is enough to cause haxxors to cry! But once it is done - once - the process of inserting new features is simple.

Now we get to the extensively modified IE shell. Hunh? Since when? And making the IE shell the WinMobile shell is a nifty trick, but it's been so well documented that the haxxor's blind, deaf and dum grandmother could do it after only 15 minute of programming lessons on her first computer.

So that dispenses the myth of software costs.

Nope, this unit is priced such because they know doctors want to have big tax-writeoffs and dont' want to be bothered with maintaining a programmer in-house.

Derek

I wouldn't want to be the one to be signing that hand-receipt! Ouch, don't leave it in your car (or on your desk, for that matter!) :uhoh2:

A succinct rundown, there Derek. :nice:

About the only thing I see on the hardware that you seem to have missed is that e-ink screens (and particularly 8" ones) haven't proven terribly drop resistant so far (we've had a number of iLiadites who can attest to that). I'm guessing they must have done some work to the end of shoring it up to get it to withstand a 30G impact, under any conditions.

Also, I'm wondering if the $150 you mentioned for the panel may be for the 6" panel? If so, the 8" would be more expensive, naturally (since it's almost 1.5X the surface area, if I remember correctly).

Still, you're right, the hardware cost doesn't account for most of the price. We really don't know what all the software does, or what applications it includes, so estimating its development cost is almost pure guesswork. :sad:

Still, I think I agree that I wouldn't expect for it and the hardware together to approach the ~$4k for the whole unit, but I have less trouble believing that they might make up 2/3 of it, which would be about right for a 50% markup. :shrug:

You're right that docs don't like to keep programmers, but hospitals often do (I am one such :)), and it's going to be mostly big outfits that they're aiming at, a somewhat limited market (which might explain some of the price too). From where I'm sitting, I can tell you that the idea of a fully Electronic Medical Record (EMR) is a really big cookie that larger hospitals are chasing, and from what I can see, it's apparently really hard to do (but that may depend some on how temperamental your medical personnel are).

When it comes right down to it, this thing is basically a really high-end, battery efficient, special screen UMPC optimized for a medical environment -- $4k isn't much of a price tag in that market, more so with the volume discounts their site mentioned.

It's not a reading device, but a toaster isn't a clothes iron either, but it's still good at what it's meant to do -- this device may very well be the same, we just don't know.

All that being said, I think I'll see if I can't bring this device to the attention of our EMR folks. Who knows? Maybe I might actually see one at some point. Eventually. :grin:

Yeahbut...

The 6" screen - in OEM quantities - runs between $97 and $106. And yes, that $150-$160 per 8" screen *is* the quoted OEM cost from the manufacturers in similar quantities. Ruggedized may well add to the cost, but probably not enough to raise the 'costs' by $200-$700 per unit.

And we're forgetting one *MINOR*, *NIGGLING* detail. Screen refresh rate. The average e-ink screen has a refresh rate that can be, at best, called abominable when compared to a typical LCD screen. Unless they're expected to put up with still images of data monitoring charts, the doctors are going to become real irritated with the device when attempting to study an EEG, or EKG. And while the device would certainly be able to display a snapshot from a CAT scan, the fact that it's limited to 4-level grayscale would make it less than useful. Even just bringing up a patient's records will not be as transparent to the end-user than what a typical LCD will do.

And don't forget that reducing the 'moving' part of the display to a 128x160 pixel sector won't get rid of the need to refresh the entire screen. IIRC, the best refresh rate for e-ink is 1/4 second, with most applications/modes needing 1/2 or 1 second. My Dell Axim refreshes in 1/60th of a second, and does so 60 times per second, all the time.

Yep. this device is vastly overpriced for what it's going to offer. They could have *easily* offered the same thing for under $1,000, and still made a profit - in single unit quantities!

Derek

They're specifying (http://www.emanotec.com/images/MedTab-specs.pdf) (PDF warning) 16 level grayscale, and a refresh rate of .4 to 1.1 seconds, with a stroke delay of 20 ms per segment for writing, in other words 8.1 diagonal inches of Gen 2 e-ink, so the cost scale may be slightly different that what you've seen. Of course, I have no idea if you've seen any details on Gen 1 vs. Gen 2, so there you go. :nice:

Add to that half a dozen possible input methods, and 8 different listed apps, about half of which I believe are fairly unique to the medical arena, as well as HIPAA compliance -- this isn't just WinMobile/IE repackaged.

And for all that we still haven't really begun to get into all the details in the specs. :shrug:

Really, I'm not sure how much it matters what they charge, if the target customers will pay the asking price, then well and good, if not, then they'll have to deal with that. For the rest of us, it's not what we're after in the first place (so the device itself isn't really relevant to us), but it has the side effect of increasing the overall e-ink demand, which should hurry cost/price declines on the stuff, which is a good thing. :nice:

I wouldn't want to be the one to be signing that hand-receipt! Ouch, don't leave it in your car (or on your desk, for that matter!) :uhoh2:
With all patient info on board!!!

Security's a must...

@ Derek.
Come on, Derek ...
We all know that when you add word "Medical" to *any* piece of equipement, you automatically get price that is magnitude higher that the same stuff sold under other label.
The same goes for words "wedding", "baby" and a few other magical words. But "Medical" is the leader of the pack.

@ Derek.
Come on, Derek ...
We all know that when you add word "Medical" to *any* piece of equipement, you automatically get price that is magnitude higher that the same stuff sold under other label.
The same goes for words "wedding", "baby" and a few other magical words. But "Medical" is the leader of the pack.

Gee... And there I'd have said that "MilSpec Ruggedized" was the leader of the pack, at least when it comes to electronics. :rolleyes5

Xenophon

Yeah...

I'd have to give you the nod over Kacir if we consider per-item price inflation. However, if we look at it from the view of total number of potential customers who are willing to pay the inflated prices because of the wordage, 'medical' wins hands-down. So it's a tie.

:D

Derek

Gee... And there I'd have said that "MilSpec Ruggedized" was the leader of the pack, at least when it comes to electronics. :rolleyes5

Xenophon

I was astonished at some of the prices. Very underpowered PCs were selling for $5K as simple protocol converters. In the environment I came from I had to justify a 6% return on investment - same as putting the cash in the bank. At this p[lace - and many medical equipment places - they were lookng at a 900% ROI minimum to put out a new product. One of the high idiocies was a java front end to a datatbase that they thought they could sell for $500K each. A freeware version was already out there.....

We have forgotten the largest single element of cost in any medical device sold in the US, insurance. I would expect insurance to run about $1,200 per unit sold or lent on trial. That is assuming that they have a good track record with past devices.

Add to that selling expenses since with the long lead times involved with medical devices these can be quite high. FDA review and certification costs need to be factored into each unit plus there's always the allowence for maintenance service and repair of units under warrenty. Don't forget G&A expenses and profit.

These are costs that we seldom see as we focus on the hardware and software aspects of the devices alone.

Others have mentioned the vertical market eFlyBook based on the iRex iLiaid by Airinc. It sells for ~$1,500 and packages all of the forms and maps a pilot needs in one jandy portable device. This replaces a large overstuffed briefcase of maps that need to be updated frequently and they alone cost about $4,000 a year. It also replaces the journal/flight book pilots carry and maintain about their flying. From a cost perspective, the eFlyBook is a bargain. From what I know about medical devices, I suspect that the MedTab ET-100 is also a bargain.

From where I'm sitting, I can tell you that the idea of a fully Electronic Medical Record (EMR) is a really big cookie that larger hospitals are chasing, and from what I can see, it's apparently really hard to do (but that may depend some on how temperamental your medical personnel are).

The temperamental staff is the biggest problem with electronic charting. I was hired by a rather large clinic to develop a strategy for moving to electronic charting.

I began by reviewing the forms they use most often, how they use them, etc. The first thing I noticed was they used a requisition form for lab work on which the doctor would use an ink stamp to put lines in the top right on which to write the patient name, number, etc.

Since it was an internal form, and the ink stamp space was horribly congested to the point one could NEVER read what it said when it was faxed someplace -- I created an almost identical copy of the form, but added a VERY clear and large box at the top in which to put this information (with the fields all labeled, and for simplicity sake in the same order as the stamp).

I replaced their paper form with a paper form. I was just trying to simplify things and make them more efficient BEFORE I threw the computer into the equation.

What happened? Despite our best efforts -- we kept getting lab work forms back from the Doctors with the information crammed into the top corner where the stamp used to be (their stamps were taken away when the form was "corrected"). The clearly labeled easy to write in section for this information that took almost 1/4 of the form --- blank.

This went on for months -- management finally decided to give stamps back and the Doctors went back to them. "But that's how we do it."

So, to get back on topic. If the company hopes to ever sell any of these devices, they need to provide EXTENSIVE support to any hospital that purchases them. They need to be highly customized to how each different practice charts, or the staff will never adopt them and will fight every chance they get. Hence the reason for the high cost (overlooking the just because they can point).

If the company can get the markups it looks like they are on each device, they can afford to give support and training.

Do you think they could just include a LART with each unit purchased? Or do they need to supply LART operators too?

Our 'temperamental person' problems lie mainly in their inability to agree on a single form to use -- they each have to have a custom one ... that they developed themselves, naturally.

Funny you should mention stamps. The group I work for asked me to implement a feature to replace rubber stamps for marking a particular type of document as having been approved, which I did, replicating the stamp's content exactly. About a year later they asked me to do exactly the same thing, because they'd forgotten that I'd already done it, dug up their grotty old stamps from wherever they'd been buried, and started using them again. Oh, and incidentally were complaining about the undesirable effects that resulted from their incorrect use of the feature I'd built to replace the stamps, in the first place. :deal:

Whatayagonnado?

For those who don't already know, a LART is an 'L-User Attitude Readjustment Tool,' AKA Clue Bat, Clue Brick, Clue-by-Four, and several others. :nice: