ECR 2014 - RC305 - Mobile IT in radiology

In radiology, display usages is usually in portrait and sometimes in landscape orientation. The introduction of tablets has introduced the ability to mix the use of portrait and landscape use of a display. The tablet also provides many more features such as speech recognition that are normally provided by the PACS workstation. Tablets allow portability of images outside radiology, facilitates interaction wiith clinicians, facilitates interaction with patients.

In this session a good overview was given by J. Fernandez-Bayo about the technological developments showing a close to diagostic trend in the capabilities of tablets. After this, O. Ratib presented on the software side of tablets and the possible applications in Radiology. Good applications are already shown and validated although clinical question at a time. The big breakthrough now is the use in surgery where iPads are brought into the OR to have access to the images of a patient. Currently the images are downloaded to the iPad but the trend is towards cloud computing with on-line acces to data and high end visualization and post-processing.

In a final presentation, E. Randschaert presented on teleradiology. In a very interesting presentation he showed that mobile devices are not yet to be used for routine primary diagnosis, but they are moving in that way. The developments already allow a wide spread implementation and the tables are already used by  many physicians for different applications ranging from image viewing to teaching. 

ECR 2014 - session SS105 - Trends in reporting, image management and mobile computing

10 presentations on different topics were covered in this scientific session:

CAD

Evaluation of a Siemens software tool called FastSpine to perform analysis of the spine with automatic labeling and curved reconstruction. They showed a high percentage of correct automatic labeling of 93.5%. FastSpine took about a minute to perform on average with manual correction where needed. The CAD provided time saving in more complex cases and had a comparable performance.

Two presentations focused on RECIST implementation. One looked at the implementation of dedicated tools for RECIST analysis and showed a clear saving in reading time while maintaing reproducibility. A Japanese group presented a cloud-based Lesion Management Solution that is used to track patients in lung cancer screening workup.

MOBILE DEVICES

This session showed again that mobile devices are of great interest and interesting applications are identified and implemented. Four of the presentations covered this topic.

A by dr von Falk showed that an iPad could be used for diagosis of CT data although screen size and security are still hampering the implementation. Another issue with mobile devices is the diiffering reading environments that cannot be controlled and thus could influence the reading quality. Mobile devices should probably be implemented as additional possibility and not for primary use. 

The dkfz demonstrated the use of an iPad for offline analysis of radiology information at a distant location to be used during autopsy. 

A group from Pisa also evaluated the iPad on CT images and showed the iPad to be faster for evaluation with even higher sensitivity and specificity for the iPad.

An important point to keep in mind with all the evidence for using iPads in radiology is that it is all focused on a limited, well defined, clinical question and mostly limits to CT.

Another group from Germany introduced the iPad in anatomical courses. The developed AnatomyMap a dedicated software tool for interactive exploration of volume rendered data running on a remote server using a web based interface.

QUALITY CONTROL

A group from switzerland showed that after transfer from free text to structured reporting they needed quaity control of those structured reports. They analysed about 250 reports on over 30 criteria. They showed that one third was excellent, one third good and one third non-optimal. The two worst performing radiologists were those not (properly) using the structured reporting. 

USABILITY

A Dutch group presented their work on interface customization. Most PACS systems have an adaptable interface, but the radiologist do not optimally use this capability. The showed that using adaptive support suggestions based on usage could help to improve radiology workflow and workstation usage. 

RSNA 2013 - RC526 - Cool technologies for radiologists

Tablet applications. 

- Pocket

Collecting bookmarks to websites into your pocket for later acces on any device.

- PDF readers

Examples are GoodReader, iAnnotate PDF, expert PDF. They allow reading and annotation of different files. However, they all are paid apps.

- Educational tools

Audience response apps are Poll everywhere (over 40 respondents requires a monthly payment), Poll runner ($10 per year), socrative (free and easy to use but a bit simple compared to others)

Baiboard collaborative whiteboard allowing multiple users that can join a board.

- technology tools

Editorially.com is a website to cooperate on writing a paper. It includes a full version tracking. This is a free tool.

Udutu online course authoring tool. Pre designed course templates can be used to design and share courses. Sharing either by webpage or by building a zip.

Udemy has a simpler GUI with less style which is also free to use.

Dropbox alternatives that can be used are Spideroak. Drawback is that it does not provide sharing. However, the data security level is higher than when using dropbox.

Interesting InfoGraphic about the future of mobile Healthcare (mHealth) from mHealthNews

RSNA 2012 - Poster stating the top 5 apps for radiological images on the iPad

According to a poster presented at RSNA, the top five apps to get onto your IPad for reviewing radiological images are:
1- Mobile MIM
2- ResolutionMD mobile
3- eFIlm mobile HD
4- OsirixHD
5- iClarity
Of these ResolutionMD Mobile and Mobile MIM have obtained FDA approval. All these viewers have basic viewing functionality and safe connection protocols.
The authors conclude that 'far from substituting radiologists workstations, the iPad can be a good and useful portable device for visualizing radiological images'

RSNA 2012 - IT should be embraced by radiology

As stated by the cover story of today's RSNA daily bulletin, IT is required to become a value innovator in radiology. In future radiology, IT influence should not be restricted to RIS and PACS, but extend to embracing new developments in mobile computing, social networking and virtual collaboration.

RSNA 2012 - Radiology Informatics Series: Mobile Computing Devices

This early morning a whole session on Mobile Computing Devices. Apperent from the attention mobile devices get both from the industry and the RSNA itself, this is a very important topic that will greatly influence the future of radiology.


Mobile lessons from other failures are:

1. Make sure your app works very well

2. Native apps win hands-on over web-apps


Both healthcare professionals and patients will be demanding the use of mobile devices. Although ipads and iphones are used prominently in industry and hospitals, the consumer market is dominated by Android because of the much larger market share in smartphones of Android.

To keep up to pace, healthcare institutions should pay attention to mHealth and start developing apps for both their employees and customers.

VSIN31-03 • Comparative Efficacy of Intra-operative Interfaces for Interventional Radiologists: The Microsoft Kinect Device, Hillcrest Labs Loop Pointer and the Apple iPad

Cherng Chao et al


Intra opative image review is challenging and standard setups using keyboard and mouse are not optimal. This group compared the used of Microsoft Kinect, hillcrest labs loopp pointer, apple iPad for image interaction all using mimcloud software. Time, measurement and easy of use was determined for a prototypical task measuring a liver lesion. The Kinect software used a button approach to switch tasks. 29 radiologists participated in this study. The iPad was the fastest in performing the task while the Kinect was the slowest. However, sterility requirements hampers the use of the loop and the iPad. All three devices were believed to be usefull in the future. Windowing and measuring proved to be the most challenging tasks. Users with video game experience and experience with a particular interaction method showed a better performance.


Main shortcoming of this study was that the users using the Loop and iPad did not use gloves.

VSIN31-04 • Modular Design of a Mobile Web-app Clinical Decision Support and Communication Tool for Radiologists and Ordering Clinicians in a Multi-Facility Academic Medical Center

Loyrirk Temiyakarn , MD et al


This group used iwebkit 5 to build a modular webapp that provided all kind of information beneficial to different healthcare providers such as guidelines, phone lists, protocols, etc.

VSIN31-05 • Enhancing Utilization of Mobile Imaging: Assessing Variation in Diagnostic Accuracy of iPad with the Nature of Radiological Findings on Chest Radiographs

Supriya Gupta et al


30 cases following tube placement at ICU were evaluated on iPad and (after one week) on a PACS workstation. The conclusion is that the iPad still has to be evaluated for image quality and to determine that it can be used for a certain task. Image quality heavily depends on the app. DICOM calibration of iPad screens is becoming a critical issue and methods have to be developed specifically for tablets.

Use of Mobile Devices in Healthcare institutions

Amcom Software surveyed nearly 300 healthcare organizations to better understand how healthcare facilities are addressing questions about the use of mobile devices and to see how far along hospitals are in devising their strategies. This white paper report titles "The Role of Mobility Strategies in Healthcare" examines the top three topics and discusses solution ideas.

Emerging mHealth: Paths for growth

PWC published a report entitled "Emerging mHealth: Pahts for growth" that shares the results of a global research study about the opportunities and challenges of mobile health from the perspective of patients, payers and providers. The pdf of the report can be found here. The presentation on the report can be found on slideshare here. 

Report: Docs are adopting tablets more than you think

Physicians’ device and digital media adoption are evolving much faster than anticipated, especially when it comes to tablets, according to a May report from healthcare market research firm Manhattan Research.
Report: Docs are adopting tablets more than you think

iPad as good in interpretation of pulmonary embolism as PACS workstation

The iPad is gaining ground in medical imaging. In a recent (online) publication in the journal Emergency Radiology entitled "The iPad as a mobile device for CT display and interpretation: diagnostic accuracy for identification of pulmonary embolism", the authors demonstrated the use of iPad interpretation of CT scans in patients suspected with Pulmonary Embolism. They conclude that:

CT interpretation on an iPad enabled accurate identification of pulmonary embolism, equivalent to display on the PACS. This mobile device has the potential to expand radiologists’ availability for consultation and expedite emergency patient management.

Publication: Design and Implementation of I2Vote

Below the abstract and a link to the full text of a recently published article by our group concerning I2Vote.

Design and implementation of I2Vote--an interactive image-based voting system using windows mobile devices. Int J Med Inform. 2011 Aug;80(8):562-9.

Abstract

PURPOSE:

To develop, implement and test a novel audience response system (ARS) that allows image based interaction for radiology education.

METHODS:

The ARS developed in this project is based on standard Personal Digital Assistants (PDAs) (HP iPAQ 114 classic handheld) running Microsoft® Windows Mobile® 6 Classic with a large 3.5 in. TFT touch screen (320×240 pixel resolution), high luminance and integrated IEEE 802.11b/g wireless. For software development Visual Studio 2008 professional (Microsoft) was used and all components were written in C#. Two test sessions were conducted to test the software technically followed by two real classroom tests in a radiology class for medical students on thoracic radiology.

RESULTS:

The novel ARS, called I2Vote, was successfully implemented and provided an easy to use, stable setup. The acceptance of both students and teachers was very high and the interaction with the students improved because of the anonymous interaction possibility.

CONCLUSION:

An easy to use handheld based ARS that enables interactive, image-based, teaching is achieved. The system effectively adds an extra dimension to the use of an ARS.

 

Study: iPads boost residents' efficiency

Providing personal mobile computers to medical residents increases their efficiency, reduces delays in patient care and enhances continuity of care, according to a research letter in the March 12 issue of the Archives of Internal Medicine. Read more about this in the HealthImaging coverage: Study: iPads boost residents' efficiency

Are free Apps a security hazard for patient privacy?

"You might want to think twice the next time you download a free app to your smartphone. That app could be riddled with malware able to steal information stored on your phone, according to IEEE Fellow Jeffrey Voas. It pays to be extra cautious now, Voas says, because mobile hacking is on the rise, with free apps possibly the most popular tool for gaining access." 

This is the first sentence of a news item at the IEEE 'the Institute' website. If this is actually true the increased use of apps in the medical arena could potentially lead to a privacy risk for patients. An increasing amount of apps are (freely) available that allow to record patient information and data to facilitate the work of the physician and have the information available on their mobile device. However, as shown in the research mentioned above, this could potentially lead to access to that data by others than the physician. The researchers only scanned Android apps,  where the risk may be higher than with Apple because of the fact that every app going into the Apple appstore is checked. In 280000 Android apps scanned they found some kind of malware in about 1 percent of the apps. The actual percentage could be higher because not all malware can be easily detected.

Pocket Physio app launched for knee surgery patients

UK Specialist Hospitals (UKSH), an independent healthcare provider to the NHS, has launched a physiotherapy app – Pocket Physio – for patients undergoing major hip and knee surgery. It is available in the AppStore.

Pocket Physio is the first physiotherapy app designed by an orthopaedic provider specifically to help improve patients’ recoveries.

UKSH has also made it freely available in the UK to anyone interested in finding out more about the physiotherapy involved in hip and knee surgery.

Hosital IT Europe

Registration of heartbeat and location of elderly people

A Dutch development involves the use of smartphones and a heart beat sensor to register the heartbeat of elderly people. Partner or children of the subject will automatically get a notification when there is a problem with the subject and can see on their phone what the problem is, where the subject is located and what the shortest route to the subject is from the current position. A great development that could be a good solution for cardiac patients. The youtube movie below gives a short introduction in Dutch, the website is also only in Dutch.

There's an App for That... And the FDA Is Figuring Out How to Regulate It

This past September, the FDA held a public workshop to discuss its proposed approach to the oversight of mobile medical applications. The workshop allowed attendees to provide input regarding the agency’s draft guidance statement before it issues a final statement. Representatives from several physician specialties took part.

There's an App for That... And the FDA Is Figuring Out How to Regulate It

Medical offices will spend thousands on iPads and other tablets

Seems that the mobile technology is finally really getting accepted. At least according to this research review I found at DOTmed.com.

They state that many medical and dental offices plan to spend thousands of dollars buying tablet computers like the iPad in 2012, as the technology continues to shake up health care.

The finding comes from a new survey on technology-purchasing trends of small and medium-sized businesses (SMBs). The survey, The NPD Group's third quarter SMB Technology Report, also found that three-quarters of the practices polled said they're in the market to buy.

Read more by following this link:

DOTmed.com - Survey: Medical offices will spend thousands on iPads, other tablets, next year

Nuance launches mobile voice development challenge

Nuance launches mobile voice development challenge