Mobile Medicine Mary J. MarklandUND SE Clinical Campus Librarian February 21, 2012
Areas to Cover• Overview• Professional Medical• Patient Medical• Useful for life and business• Fun
Tablets, Readers, Smartphones
New Sony Tablet
Winners of MID Design Competition
What do you need to do?• Connect to the internet – All the time?• Make phone calls?!• Read books – Inside or outside• Access work documents/web sites• Keep track of life stuff• Paying for coffee at Starbucks with NFC (near field communication)
• Screen size• Connectivity – Data plans are expensive• Input by keyboard or tapping• Camera• Battery life• Do you need to carry it with you?
Nice Guide at Yale Medical Libraryhttp://www.med.yale.edu/library/services/computing/pdahardware.html
Comparing E-Readers and Tabletshttp://paidcontent.org/table/comparing-e-readers-and-tablets-november-2011
CNET updates tablet test results January 2012http://reviews.cnet.com/8301-19736_7-20080768- 251/cnet-updates-tablet-test-results
Don’t Forget about HIPAA• Will you be accessing patient records?
Hospitals are lagging behind • Reception • Speed of personal day-to- day technology has outpaced hospital budget planning processes. • Most hospital systems are mouse and keyboard driven • Are they a distraction from patient care (Facebook and email)? • Distracted doctors/medical staff in the OR?
FDA Regulations• The FDA is going to regulate any apps or devices that display or use patient data• Problems with junky EHR programs and some asthma apps that claimed to CURE asthma.
“Stealth campaign to get the iPad into the hands of doctors.” Robert McMillan Wired 12/5/11• Company rarely promotes corporate use of devices• Created Medical Apps Store within iTunes• But don’t want to mess with FDA so can’t promote it as a medical device• VA looking for bids - 100,000 devices across 152 hospitals
University of Chicago • CIO, Eric Yablonke • “This is not ‘nice to have stuff’ anymore, this is life saving stuff.”http://medchiefs.bsd.uchicago.edu/iPad.html
What about your patients?• ≈ 11 percent of all adult cell phone users downloaded an app that helps them manage their health.• Consumer health apps for the iOS platform will likely number more than 13,000 by the summer of 2012• Share of US adults who own tablet computers nearly doubled from 10% to 19% between mid-December and early January 2012• Same surge in growth also applied to e-book readers, which also jumped from 10% to 19% over the same time period Pew Internet & American Life Project http://pewinternet.org/
Site vs. App• App is a piece of software that you download onto your device. It may or may not need an Internet connection to work.• A site is a website that is optimized for use on a smaller screen like a phone. Usually it’s a very simple design. You need an Internet connection for these to work.
Android vs AppleAndroid Apple• Maybe not as much scrutiny • Applications are scrutinized on the apps. There is the more closely possibility of viruses and malware. • Claim all apps are locked so they can’t affect other stuff• Many different versions of the operating system on the on the device. Less chance market depending on your of viruses??? device. • Easier to figure out what• It’s hard to figure out what version of iOS you have apps work with what version of the OS
DynaMed• Download via SkyScape• Need a serial number• Skyscape also comes with – Archimedes calculator – Outline of Clinical Medicine (OCM)• Downloads completely so works without Internet connection• The mobile version lags the online version by several weeks.
MDConsult• Special Website• Create a personal account at main site• Caveat: If you go to the mobile site, it sets a cookie and might make it impossible for you to go to the regular MDConsult screen (where you could go to FirstConsult) UNLESS you go in and delete the cookie.
Other Medical Apps
Other Great Lists• Susan Fowler, Washington University – http://beckerguides.wustl.edu/mobileresources• Duke University Medical Library – http://guides.mclibrary.duke.edu/mobile• Johns Hopkins Welch Medical Library – http://www.welch.jhu.edu/internet/mobile_resources.cfm• Best Medical iPhone Apps – http://blog.softwareadvice.com/articles/medical/the-best- medical-iphone-apps-for-doctors-and-med-students-1100709/
Drugs• ePocrates• Micromedex• Lexicomp
PubMed Options• PubMed Mobile (NLM)• PubMed for Handhelds (NLM)• PubMed on Tap $2.99• PubSearch Plus $1.99 – Works with EZProxy to get at library subscriptions• PubSavvy $1.99• Orkov
Other Reading Apps• Instapaper – Save webpages to read offline• Kindle• Overdrive – Download library books• Stanza• NetNewsWire – RSS Feed Reader – Can send web pages to Instapaper
GPS in Medicine• TED talk – Bill Davenhall – “Your Health Depends on Where You Live” – “Geomedicine”• Locate user and map it against publically available data for disease prevalence, chemical pollution.• Where do you expose yourself to risks?• Where you’ve lived may determine your health
NYC Condom Locator• New York Public Health Dept
Tracking• Can you self-manage your health better if you can track data, aggregate it and see trends?• Project HealthDesign from UW and Robert Wood Johnson Foundation – “Forging a new vision of personal health records by exploring practical ways to capture and integrate patient-recorded observations of daily living into clinical care – http://www.projecthealthdesign.org/
Wireless Body Area Networks
Sensors• No more stethoscopes?• Bye-bye Holter Monitor – Replaced by a patch that you send in by mail• Realtime EKGs• Vital Signs• Contractions• Sleep• Fetal Heart Rate• Handheld Ultrasounds
• From Corventis• “Smart Bandaid”
• Diagnose poor balance when walking• Future – vibration device to alert user • BMI • Weight • Balance Score • Audio output • WiFi
Jawbone UP - $99• Measures activity, sleep and nutrition and tells it all to an app• The battery lasts 10 days and works in the shower• Has silent alarm that goes off periodically when the band senses a little too much down time.
Asthmapolis • GPS enabled inhaler tracks usage • Sends text if forget to take your medicine
• 1.2 million sold
FitBit• Automatically tracks your fitness and sleep via tracker in your pocket, on your waistband, shirt, bra or wrist• Walk within 15 ft of base station and your data is automatically uploaded
Zeo Personal Sleep Coach • ZQ Score – Calculates total amount of time you slept (Total Z) then adds and subtracts points based on the amount of restorative sleep (Deep and REM) and disruptive sleep (time and duration spent awake) that you get throughout the night.
Accelerometors• PocketCPR – Tells anyone how to do CPR – Measures rate and depth of chest compressions
Medical Applications• Surgery – 3D displays, anatomical structures identified• Radiology• Diagnosis• Education
Augmented Reality• Add a layer of information to the real world• Uses camera• Sometimes needs GPS and compass on phone
AirStrip – Cardiology (iPhone) –Free• AirStripOB obstetrician app was the first iPhone medical app to receive FDA clearance.
Skeletal System Pro II – (NOVA Series)(iPhone/iPad) – $5.99/$14.99• visually show detailed areas of the bone system• the ability to rotate, cut and get superior/inferior views all with the simple stroke of the finger.”
EyeDecideMD (iPhone/iPad) –Free• View the eye in 360 degrees. Rotate, expand, shrink, annotate, and move the eye in any direction on the screen!• View Cross Section, expand or full.• See eye anatomy layer by layer from the outer skin to bone to eyeball.• Turn annotations on or off, and view more information
Mobile MIM (iPhone/iPad) –Free• Registration, fusion, and/or display for diagnosis of medical images from only the following modalities: SPECT, PET, CT, and MRI.• Mobile MIM provides wireless and portable access to medical images.• FDA officially granted the mobile radiology application a 510(k) clearance, the first diagnostic radiology app to receive it, in February 2011
VueMe (iPhone/iPad) – Free• Patient-centered counterpart to MobileMIM.
Anatomy 3D: Organs (iPad) –$6.99• 3D models, video, audio lectures, quizzes and text• Detailed information on the brain, heart, stomach, spleen, pancreas, small intestines, reproductive organs, large intestines, kidneys, liver, skin and lungs.• Learn about cells, tissues and organ systems.• Diagrams of the organ anatomy, histology and location,
Gene Z Systems• Solar Powered• Genetic analysis microRNAs in blood samples• Detect cancer??
Malaria Microscopy• Send malaria microscopy images for remote diagnosis
Penultimate• Extremely cool app that lets you draw on your iPad• Integrates with Dropbox so you can share the files between computers• Can also email• Can import photos• $0.99
Lenny the Carb Counting Lion
Into the Future• Eric Topol’s Top Ten Targets for Wireless
Apple’s Picks for 2011 Top Medical Apps
Fitness Apps• iMuscle (iPhone/iPad) – $1.99/$4.99 – Use it to identify a body part or individual muscle by zooming into a 3-Dimensional human body with the musculature exposed. Then access all the exercises associated with the development / rehabilitation of that muscle.• Gorilla Workout : Athletic Fitness Training on a Budget (iPad) – $1.99
More Fitness Apps• Nike Training Club (iPhone) – Free• P90X (iPhone) – $4.99• FitnessClass (iPad) – Free
Lots of Diet Apps• Calorie Counter: diet & activities (iPad) – Free• The Eatery (iPhone) – Free – Snap photos of your food to become aware of your habits.• Fooducate (iPhone) – Free – Automatically scan a product barcode, search for products, or browse by categories. See product’s highlights (both good & bad), compare products, select healthier alternatives.
Pregnancy (Sprout) (iPad) –$3.99• Helpful information about you and your baby, Stunning color images and 3D models, Weight tracker, kick counter, contraction timer, and Personal MyBaby and Doctor Says sections.”
Keeping Up• iMedical Apps – http://www.imedicalapps.com/• mHealth Update – http://www.mhealthupdate.com/• mLearnopedia – http://mlearnopedia.com/• Mobihealthnews – http://mobihealthnews.com/• InfoWorld Mobile Technology Channel – http://www.infoworld.com/d/mobile-technology• Software Advice – The Medical Blog – http://blog.softwareadvice.com/articles/medical/
Other Useful Apps• Email• Calendar• Address Book/Contacts• Evernote• Dropbox – transfer files between devices• Travel
UND Email Setuphttp://und.edu/dept/bpos/ipad/ipad.html
Calendar• Repeating appointments• Color coding• Sharing calendars• Download & Sync multiple calendars – I have Outlook (work) and Google (personal) – Can share Google calendars with anyone• Customize reminders/alerts
Evernote• Keep track of emails, notes, web pages, lists, draft documents, audio files across multiple devices, creates tagged notebooks
Dropbox • Share files between devices – laptops, phones, tablets , desktops, etc • Windows, Mac, Linux, Mobile
Travel• Trip Tracker• Sleepmaker• Yelp• TripAdvisor• Zagat• Public Transportation – Metro Tracker – DC• Translate• CardStar
QR Codes• Quick Response Code• 2-D Bar Code• Take a picture with a phone and use app to find out more info about product• Price comparisons, E- tickets, Facebook?• Can generate your own codes
Wikitude• Scans your surroundings and adds information about what’s going on around you• Uses camera• Use it in the car too
Google Goggles• Text – Translation• Landmarks• Book cover – Where to buy• Artwork – Websites• Logos• Wine