In February, the FDA issued a first-of-its-kind clearance for a mobile app for medical imaging, granting radiologists the regulatory go-ahead to interpret CR, MRI, and nuclear-imaging studies remotely on iPhones and iPads if a diagnostic monitor is unavailable. The approval signifies that the growing trend of mobile medicine has finally reached the radiology department; though the FDA stressed that tablets and smartphones were not to be used as replacements for traditional imaging workstations, “The approval validates that this type of technology is viable for imaging,” according to Chris Massoll, director of product management for Virtual Radiologic (vRad), Minneapolis, Minnesota.
In fact, the signs that medicine is evolving to become more mobile have been increasing in recent years. Research indicates that medical residents are increasingly reliant on mobile apps; one website, iMedicalApps.com, features reviews and rankings of the many health-care–related apps available for the iPhone and Android platforms.
“There are a lot of apps targeted at providers—including diagnostic-viewing apps, electronic medical record apps that are designed to provide some patient-level information at the point of care, apps for monitoring and viewing vital signs, and education apps,” Massoll says. “One of the largest industry segments buying the iPad is health care. It may not be officially stamped as ready to go from a regulatory standpoint, but there’s interest from end users. The demand is there.”
Drivers of MobilityMassoll sees several factors driving the mobility of health care. Prime among them is rapid adoption among medical residents and younger clinicians. “Physicians coming out of medical school want the information they need in their hands,” he says. That information will, of course, include radiology reports and key images. “I predict that the delivery of results to referring physicians via mobile devices will become pervasive,” he says. “Before long, they’ll expect access to full-blown DICOM images; real-time sharing of audio/video clinical information will be next.”
The pressure to supply this information to mobile devices is also coming from the consumer side, Massoll notes. Soon, patients will want to see their test results delivered (as quickly as possible) to their own smartphones and tablets. “It’s going to enable patients to take better control over—and have a more meaningful dialogue about—their health care,” he predicts. “Pushing images and reports to the physician and patient, right in the room, will allow real-time consultation with the radiologist. That speaks volumes for the patient.”
Perhaps most important, however, is the fact that health care is under continual pressure to do more with less—and mobile apps are an advancement that, properly leveraged, could permit more efficient care in a rapid timeframe. “The endgame is to provide better care to patients, at a lower cost,” Massoll says. “For all health care providers, the most important piece of this is the delivery of relevant information to the point of care.”
Changes on the WayWith providers poised to become increasingly reliant on mobile apps, “Vendors will be forced to create new tools and services that they may not have historically considered, leading to new ways to deliver care,” Massoll predicts. At this year’s meeting of the Health Information and Management Systems Society in Orlando, Florida, the message for health IT administrators, Massoll says, “was that you can’t just keep your head buried: Your physicians are going to be doing this either way, and you have to find a way to control it.”
With more and more mobile apps in use, Massoll notes, health-care organizations will be increasingly reliant on cloud-based platforms. “The main driver for the adoption of cloud-based technologies may well be mobile computing,” he says. “These technologies increasingly depend on some kind of centralized business logic that has to reside somewhere, and a lot of that will be likely to move to the cloud. This represents a fundamental change in the way health-care institution are acquiring technology. The model has historically been one of significant capital outlays. With the cloud model, you just pay for what you consume.”
For radiology, health care’s new trajectory will mean more than just mobile interpretation, Massoll says. “The second piece of the workflow is the dictation and creation of radiology reports,” he says. “Dictation apps will eventually be married with interpretation apps to create a truly useful tool.”
This has implications for radiologist–patient interaction, he notes. “If you look at the things radiologists spend time on that are not patient oriented, it’s often nonclinical work,” he says. “Giving them these tools, wherever they are, would open the door for them to interact more with patients.”
Toward this end, vRad has developed several mobile apps for radiology, including an app (available in the iTunes store) that delivers reports and key nondiagnostic images to referring physicians as soon as the report is signed, along with providing cloud-based access via Internet.
“We’re trying to lead the creation and adoption of mobile apps in radiology,” Massoll says. “We want to bridge the communication gap and bring the radiologist closer to the delivery of care.” Next, the company plans to enable referring physicians to access the entire DICOM dataset using mobile devices.
“The number of mobile apps available for health care today is significantly higher than even a year ago,” Massoll concludes. “With widespread adoption, the concept of mobile computing has the opportunity to turn health care upside down in the coming years.”
