Details of highly successful U Chicago hospital iPad program revealed
[cross-posted from iMedicalApps.com]
Recently, physicians at the University of Chicago published a research letter in the Archives of Internal Medicine detailing their experience with the routine use of iPads by internal medicine residents during their regular duties.
What they documented was that use of the mobile device was objectively associated with faster order entry after patient admission and the subjective assessment that it saves up to one hour per day for each resident.
We had previously reported on the Univ Chicago iPad experiment here and here.
In our recent article reporting on the research paper we agreed that rate of order entry is a reasonable proxy for increased workflow efficiency but also noticed the study raised many interesting questions. Bhakti Patel, MD is the first author of the study was kind enough to talk to iMedicalApps about the research and to share some of the interesting findings that did not make it into published article.
Some of the questions that I asked of Dr. Patel, currently a critical care-pulmonology fellow at the University of Chicago, were:
- when & why did you decide to study the use of iPads?
- how did you choose the study setting?
- what were some of the hurdles in initiating the trial?
- how did you decide what security & infection control measures to use ?
- how were the devices managed?
- what do you plan on doing next?
Read below to learn more about this groundbreaking study on the use of mobile devices by hospital based physicians.
(more…)
Veterans Administration hospitals CIO says VA must become “iPad friendly”
[cross-posted from iMedicalApps.com]
In a nod to the reality of rapid physician adoption of tablets and smartphones, the CIO of the VA system recently stated that the VA must find a way to accommodate iPads at a conference on federal information technology.
According to Baker, the fact is that 100,000 residents rotate through the VA each year and “they’re all carrying mobile devices”. In order for them to do their jobs, they want to be able to access resources on the internet.
In an article published at nextgov.com, CIO Roger Baker said
I’ve told my folks I don’t want to say ‘no’ to those devices anymore…I want to know how I say yes
The key, according to Baker, is security. While the iPad can be secured, proper protocols need to be developed. Otherwise, the device can be likened to a “huge unencrypted USB stick with no pin”. In order to facilitate development of security protocols, a pilot program has been launched giving out iPads to select employees in situations where security is looser.
In an easy to understand analogy, he proposed
If it won’t go on a device where you’re willing to put all your banking information, your pins, your passwords, [then] don’t put veterans’ information on it.
As we have published on this site before, there are ways to secure your iOS device adequately for medical use (“How to secure your iPhone or iPad for medical use“). The issues are not always technological, often it is a question of policies and habits of the users. A positive contribution by a large scale institution like the VA can only help to instill good habits and a better understanding of security in future doctors.
Mobile MIM liberates doctors to view CT & MRI scans on iPads and is FDA approved
[cross-posted from iMedicalApps.com]
One of the most attractive uses for an iPad in the clinical setting is the potential to view radiologic imaging at the point of care. But, while the graphics capabilities of even the first iPhone were enough to be able to adequately display multi-slice imaging, there were two critical pieces missing to make the iPad a viable mobile radiology workstation: FDA approval and a simple way to store and transfer images to the iPad.
MIM Software, a radiology software company, seems to have neatly solved both these problems by pairing their viewer, Mobile MIM, with MIMCloud, their cloud based radiology (DICOM) viewing and sharing web application and by obtaining the first ever FDA clearance for mobile imaging software in February 2011. The story of their FDA approval process will be highlighted in an interview with Mark Cain, CTO of MIM Software tomorrow.
MIM Mobile is a free download from the App store and runs on both iPhone and iPad. As the video portion of this review will demonstrate, the app is very well engineered with amazingly fluid navigation. even with images containing hundreds of slices. It also performs mutli-planar reconstructions out of the box, meaning that the same body part can be visualized in three planes simultaneously. These are invaluable tools for evaluating imaging abnormalities and for planning surgery. When you realize that they were executed on a device with limited physical memory and no virtual memory , they are even more remarkable. This might be why MIM was on stage with Steve Jobs at the unveiling of the iPhone software development kit in 2008 and why MIM Viewer was one of the few non-Apple apps highlighted in the recent iPad 2 commercial, as we recently noted .
iPrescribe turns your iPhone into a prescription pad [App Review]
[Cross-posted from iMedicalApps.com]
Billed as the “the first and only standalone electronic prescription application for smart phones”, iPrescribe allows for easy electronic prescription using an iPhone app.
To use it, the doctor only has to enter the patient’s name, date of birth, drug and dosage. Favorite prescriptions can be stored. If the patient’s zip code is entered, the app will even suggest nearby pharmacies. The magic is that once you touch “send”, all that is left is for patient to pick it up the pills at the drug store. No more holding on the phone or fumbling for a script pad. It is an enticing proposition for many doctors.
iPrescribe was just recently released to the App store and uses the SureScripts national e-prescribing network to process the electronic prescriptions. By utilizing this network, iPrescribe thus has access to pharmacies in just about every community the US. Only qualified medical professionals with valid NPI and DEA numbers are allowed to use it. In addition to the $19.99 download fee, there is a $9.99 monthly subscription fee, following a free 30 day trial. Doctors who already have e-prescribing included as part of their electronic health records (EHRs) may not have need for a separate app.
I found the app easy to use with a clean, well-thought out interface. The web interface, where you could also add and edit patients, is less polished. The main drawback of using app is the most obvious one, namely that the any prescriptions entered will have to be recorded separately into patients’ charts, although the web interface does allow for export of prescription histories.
The past, present, and future of medical apps
[The article below is simultaneously published by iMedicalApps.com and the Journal of Surgical Radiology (http://www.SurgRad.com), a widely read, peer reviewed journal]
In just a few short years, smartphones with advanced operating systems have sparked a bright new era of mobile medical applications. Although the Blackberry smartphone had been the device of choice for physicians for most of the previous decade, the arrival of Apple’s iPhone in 2007 revolutionized mobile phones. The highly anticipated release of the iPhone software development kit (SDK) a year later immediately launched a wave of mobile software development and, almost immediately, interest in medical software.
As if to underscore this interest, a physician was on stage with Apple CEO Steve Jobs in 2009 demonstrating an early version of Air-Strip, an iPhone application that provided real-time monitoring of fetal heart rate tracings. This was nothing less than a thrilling peak at a possible future where physicians remained connected to their patients’ data, freed from the physical constraints of having to be at the hospital or office.
In the last two and half years, a new world of mobile medical applications has flourished. Currently, there are over 6,000 apps classified as health related across the various app stores, although only 30% are directed to clinicians. Still, with the numbers of physicians using smartphones climbing from an already high 72% to a projected 82% by 2012, the market for clinician oriented apps will only continue to increase.
Here at iMedicalApps we review and comment on mobile medical technology and apps from the perspective of physicians. In this column, we are going to explore the world of mobile apps and ask where medical professionals will be going to look for the medical apps of the future.
App Stores
After the iPhone in 2007, the next major revolution in mobile computing was the iTunes App Store, introduced a year later along with the iPhone SDK. (more…)
Apps for management of diabetes could be vehicles for reducing health care expenses in future [mHealth]
[Cross posted from iMedicalApps.com]
The cost of managing chronic diseases is the largest portion of health care expenditures in developed countries. For example, the prevalence of adult acquired diabetes has been rising in the United States, in concert with increasing rates obesity. The CDC has termed it an “epidemic”, especially in light of the massive costs incurred by the health care system due to diabetes.
The deleterious health effects of many chronic conditions can be diminished by behavior modifications. While few would underestimate the difficulty of having patients lose weight or exercise more, good management of blood sugar in diabetes is both objectively measurable and strongly correlated with reduced end-organ damage.
This is among the reasons why Research2Guidance has recently nominated diabetes as the condition most likely to be most targeted by mobile medical software and devices (mHealth). This finding is part of their recently published Global Mobile Health Market Report 2010-2015. This is the same report that also predicted that, in the future, medical apps are likely to be distributed by physicians and health care institutions.
This time Research2Guidance is highlighting the portion of the survey where they looked into where mobile devices have the most potential to affect health outcomes. While other chronic conditions such as hypertension and obesity have larger populations, the market researchers felt diabetes had the largest market potential due to the huge cost saving potential, the demographic & geographic overlap between smartphone users and diabetics and the real potential to improve sugar management using mobile devices. As per Research2Guidance,
To manage patients diabetes in “real time” and “on-the-go” situations, shared information within the healthcare industry and especially between medical professionals whilst “on-the-go” is essential.
Practice Fusion to launch EMR App Store, launching next evolution of EHRs: Interview with Matthew Douglass, VP Product Development
[Cross-posted from iMedicalApps.com]
Practice Fusion is a free, web-based electronic health record that has seen a rapid rate of adoption over the last two years and, as we reported recently, is currently the largest commercial EHR installation after Kaiser and the Veterans Affairs.
But like all “overnight successes”, the rise of Practice Fusion is not accidental and not without laborious engineering. In fact, important design decisions at its inception have been instrumental in its growth, allowing for rapid iteration of features without incurring heavy development and deployment costs. Matthew Douglass, currently the VP of Product Development, has been through almost the entire history of the company. He was the second person to join the company and continues to lead the engineering process.
In this interview we learn some of the fascinating story of Practice Fusion’s rise, its plans to expand its API (application programming interface) and launch an app store.
We envision that doctors could prescribe an app much like they prescribe a medicine now. – Matthew Douglass
Interview with Founding Member of Health 2.0 Accelerator, Erick Von Schweber, CEO of SURVEYOR Health
We recently wrote about the Health 2.0 Accelerator (H2A), describing at as “laying the foundation for interconnected medical apps of the future”.In this interview, we talk to Erick Von Scheber, one of the founding members of the Accelerator. He is also co-founder of SURVEYOR Health, a service that analyzes patients’ medications and makes sophisticated predictions of the likelihood of drug interactions and their potential symptoms.
For those who are not familiar with the the Health 2.0 Accelerator, it is one of a few organizations dedicating to shaping the future world of interconnected healthcare “apps”. The non-profit and vendor neutral nature of H2A gas attracted a broad spectrum of industry participation. The strategy of the H2A is to provide a “ight-weight open framework”, not comprehensive standards. As with the best of multi-lateral organizations, the members are all individually motivated to be part of a solution that could potentially be beneficial for their businesses. What has emerged over time is that H2A may end up serving providers and EHRs as much as consumers.
Continue Reading January 24, 2011 at 12:04 pm Leave a comment
The Accelerator Apps Network is laying the foundation for interconnected medical apps of the future [Health 2.0]
[cross-posted from iMedicalApps]
At this past October’s Health 2.0 meeting in San Francisco, many great new ideas about the future of health care were presented with a special emphasis on technology. For a great overview check out the keynotes by Jeff Goldsmith & Tim O’Reilly. The conference, organized by Matthew Holt & Indu Subaiya started in 2007 and bills itself as the “the leading showcase of cutting-edge technologies in health care”. Those not lucky enough to attend the conferences can follow along on the Health 2.0 blog.
Besides exploring the overarching themes of the future of health care in general and health IT in particular, many innovative companies, young and old, gave on-stage demos at the conference. One demonstration in particular stood out for me. This was the demo by the Accelerator Apps Network which showed the future of interconnected companies and applications seamlessly exchanging patient information. The Health 2.0 Accelerator Apps Network is a non-profit industry consortium launched by the Health 2.0 company.
We have discussed before the untapped potential of medical apps that exist as isolated data islands. Here was a vision where applications, small and large, collaborate across the internet to create a powerful mesh of services that simultaneously serve patients and doctors. From the description:
The Health 2.0 Accelerator Apps Network is a growing ecosystem of web applications and services that work together – collaborating 2, 3, 4 and more at a time, serving as platforms for other apps and as interoperable bridges between apps – all to connect and support patients, caregivers and providers
Future Uses for the iPad in the Operating Room: a Game Changer ?
[cross-posted from iMedicalApps.com]
As we discussed in the first of this two part series, mobile devices are already entering the world of the surgeon. Currently, it is mostly downloadable apps that promise to help surgeons with the informational portions of their tasks, such as tracking the cases they have done, e.g. Surgichart or helping in the consent process, e.g. Surgery Risk
While apps that are dedicated to the technical aspects of surgery, such as the excellent AO Surgery Reference, are becoming available, in the future we will see the iPad (or its brethren) actually in the operating room. Why ? Because the iPad has many characteristics that make it a great an advanced surgical instrument.
First is its small size. Every modern operating room has stacks of electronic equipment hanging from the ceiling or in large cabinets for patient monitoring and controlling in-field devices. Since the iPad already supports a bevy of standard wireless communication protocols, many of these large boxes’ functions could likely be off-loaded to an iPad with clever engineering. One immediate advantage would be that the iPad could be brought directly into the operative field in a small sterile bag where the touch interface makes it possible to change settings even using gloved hands. This means that the surgeon or assistant could manipulate the controls rather than asking the room staff to make every little change. The long battery life means that an iPad can make it through even a long surgical day without needing a recharge (at least not before the surgeons do !)
Even more intriguing are the possibilities for user interfaces that incorporate the built-in sensors in the iPad, specifically the accelerometer and gyroscope. These sensors have made the iPod Touch a massive success in the mobile gaming world by allowing players to interact with games by turning and twisting their devices. Could they also lead to new types of assistive surgical instruments ? Read below as we explore these ideas.
(more…)
November 10, 2011 at 5:14 pm Leave a comment