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A sampling of the latest handheld devices and mobile applications built with physicians in mind
Personal digital assistants are old hat to many physicians. But a new generation of mobile technology that integrates handheld devices with software and services honed for the medical mind-set now targets physicians more directly. One reason for the change is because doctors are more actively involved in product development. Manufacturers consult with them on design elements, and in some cases, the physicians become entrepreneurs and develop products for their peers. Offerings range from hosted messaging systems to portable PCs. The result is products and services built to accommodate physicians’ need for speed and mobility.
For most new technologies, response time and convenience are central concerns. A physician could spend time driving to a hospital to view a patient’s cerebral angiogram, for example, or view the image on a mobile device from wherever he or she happens to be. In stroke cases, a decision to administer clot-busting tissue plasminogen activator drugs must be made within three hours of the onset of symptoms — a decision physicians could make more quickly if they have the diagnostic test results at their fingertips. Here is a sampling of new products in the evolving field of mobile medical technology.
Take one tablet
Physicians have been using tablet PCs for a few years now, but Motion Computing has created a device specifically for the medical market. The company’s Motion C5 is a point-of-care device that can help with tasks such as clinical documentation and medicine administration. The tablet PC, which was designed with input from clinicians, includes an integrated camera and an optional bar code reader. “We’ve spent a lot of time listening and observing and asking questions,” said Joel French, vice president of Motion Computing and general manager of the company’s Healthcare Business Group.
Physician feedback led to a number of design features. For example, the Motion C5 uses a pen as the main input device rather than a keyboard. Clinicians are more comfortable working with the pens, French said, adding that keyboards can harbor pathogens. An elastomer overmolding protects the tablet and helps it withstand the effects of germicidal cleansers used to disinfect it, French said. Dr. Brian McCardel, an orthopedic surgeon in Lansing, Mich., cited the ability to clean the surface of the device in a few seconds as a positive feature of the Motion C5. He also praised the product’s bar code reader.
“Many of the medication administration systems now are tied to bar codes,” he said. Physicians can use the portable device at patients’ bedsides to show them medical images in the course of discussing treatment options, McCardel said. “It’s been a helpful educational tool,” he added. The Motion C5’s size appeals to clinicians who often work on their feet, McCardel said. The 10-inch-by-10-inch tablet weighs about 3 pounds. At press time, Motion Computing had manufactured a number of preproduction units but had yet to begin shipping the device for commercial sale.
Even so, French said interest is so high that every unit manufactured has 400 would-be buyers. One of the early users is the medical center at the University of California, San Francisco, which has conducted a usage study of the Motion C5. Motion Computing and Intel are working with hospitals enrolled in Motion Computing’s Clinician Usability Study Program to evaluate the device’s effectiveness and usability.
to smart phones
Global Care Quest’s Integrated Clinical Information System (ICIS) Mobile takes advantage of the current generation of handheld devices to deliver remote access to picture archiving and communications systems, electronic medical records, and vital signs.
The application can run on any wireless PC, handheld device or smart phone. Dr. Neil Martin, founder of Global Care Quest and chief of the Neurosurgery Division at the David Geffen School of Medicine at the University of California, Los Angeles, said the company started with a Palm OS application but found that Microsoft Windows Mobile offered more power for displaying graphics and made it easier to interface with server databases.
Martin said smart phones are becoming the handheld device of choice for mobile users. “The PDAs are fading — almost disappearing to a certain degree,” he said.
Although serving the same purpose as PDAs, smart phones offer connectivity via cell phone networks in addition to wireless computing networks.
Their size is another plus. “More and more, it’s second nature for everybody to carry their phones,” Martin said. “No one is going to carry any other computer platform all the time.”
He said the ideal smart phone for a mobile medical application has a 2.5-inch to 3-inch screen with the highest resolution possible. The phone should also have generous onboard memory and storage, a fast processor, connectivity to high-speed data networks such as Evolution-Data Optimized and High-Speed Downlink Packet Access, wireless capability, and a small keyboard.
In his view, the top devices at the moment are the Sprint PPC-6700, Verizon XV6700, the Palm Treo 750 and the AT&T 8525 Pocket PC.
Regardless of the device physicians choose, faster response time is the main medical value of mobile access to medical images. The technology “shaves minutes off the decision cycle and dramatically enhances the ability to provide treatment,” Martin said.
chart Rx for recording doctor’s notes
XtremeMac’s MicroMemo lets physicians turn their Apple iPods into audio recording tools. The MicroMemo plugs into the bottom of an iPod nano and includes a flexible boom microphone. An XtremeMac representative said physicians use the device for dictation. “A lot of people already have an iPod and don’t want to spend a hundred bucks for a digital recorder,” he said. “The MicroMemo is an indispensable tool for taking notes, recording conversations with patients, even rehearsing and recording talks and speeches,” said Christopher Springmann, executive producer and host of the Life Love and Health radio program, which airs on XM Satellite Radio. Springmann has reviewed the product. MicroMemo appears in at least one medically oriented product. Thinklabs Medical offers it as part of the recording package for its ds32a digital stethoscope, which also comes with a 2G iPod nano.
The MicroMemo offers low- and high-quality recording options. The 2G iPod nano has a recording capacity of 12 hours in low-quality mode and three hours in high-quality mode. The 8G iPod nano records 51 hours in low-quality and 12 hours in high-quality mode. MicroMemo also works with video-capable iPods. The 60G iPod’s recording capacity is 384 minutes at low quality and 98 minutes at high, the company said. When recording with MicroMemo, the microphone is set away from the iPod’s hard drive so it won’t pick up noise from the unit, the XtremeMac representative said.
The microphone is detachable, so users can substitute any microphone with a 3.5mm plug. Springmann said he often attaches a Sennheiser MD-46 microphone when recording with MicroMemo, although he added that the product’s stock microphone is also quite good.
HIPAA-compliant paging
LongCall Technologies offers a hosted, secure e-mail service that supports wireless access via Research in Motion’s BlackBerry devices. The service, built around Microsoft Exchange, makes e-mail available on handheld devices. Messages sent using the LongCall system comply with the Health Insurance Portability and Accountability Act, the company said. LongCall’s standard subscription package costs less than $375 a year. “We offer a secure network for physicians to communicate with each other and their offices,” said Dr. Ed Fein, chief executive officer of LongCall and chief medical informatics officer at St. Peter’s University Hospital in New Jersey. He said about 200 professionals are on the network. “With the use of ‘push e-mail,’ we allow the wireless devices to get the messages as they are sent, without the time lag,” Fein added. “This allows physicians to use their smart phone/BlackBerry wireless devices instead of pagers.”
The BlackBerry is the device LongCall most often recommends to physicians, according to the company’s Web site. LongCall is a BlackBerry alliance member, but the company also supports devices that run Palm OS and Microsoft Windows Mobile. Jeff McDowell, vice president of global alliances at Research in Motion, said pushing data to physicians is a new trend in handheld computing. “I think in the past there may have been a focus on data capture and pushing the data back up to corporate information management systems,” he said. “Now we see that the information can be pushed back down to the physician and updated automatically.” For example, McDowell said, automatic alerts can help physicians communicate and make decisions with other hospital and medical staff. Radiologists can now use a laptop or tablet PC to access Nuance Communications’ online speech-recognition tool for dictating reports.
With the company’s Dictaphone PowerScribe Workstation for Radiology, radiologists open a Web browser to connect to a Web server that lists the reports needing dictation. The product includes a microphone that plugs into a USB port. Bob Fleming, Dictaphone product manager at Nuance, said health care providers who have outsourced the interpretation of radiology exams are among the biggest users of the remote tool. The service is especially useful for teleradiology firms that have teams of radiologists working around the clock. “You can have the service provider log in to the PowerScribe system and interpret and document cases,” Fleming said. Kurt Finke, chief biomedical engineer at the Veterans Affairs Department’s Midwest Health Care Network, said the Minneapolis VA Medical Center deployed PowerScribe a few years ago.Since then, eight VA hospitals have installed the system.
Finke said PowerScribe’s speech-recognition capability has compressed the amount of time it takes for a referring physician to receive a radiology report. That’s because it is no longer necessary for a medical transcriptionist to listen to and type a dictated report. With PowerScribe, when a radiologist has finished dictating his or her notes, the resulting electronic report is automatically sent to the medical facility’s information system, where authorized physicians can view it.
Submitted Date: Jul 17, 2007
Source: Government Health IT
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