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Montag, 4. April 2011

Apple in Medicine

The Latest on iPads, Apps, and the FDA
Featured in aycan's April 2011 issue of "News and Views"

Since its inception in 1976, Apple technology has revolutionized many industries including graphic arts and printing, music, and mobile connectivity. Today, Apple technology, along with third party solutions, is transforming the medical industry.

The impact of Apple in medicine began with use of its development tools. As an example, in 2004, Apple’s well-conceived integrated development tools led to the most successful Open Source project in medicine to date, OsiriX. Developed by a team from the University of Geneva, under the lead of Professor Dr. Osman Ratib and Dr. Antoine Rosset, both trained Radiologists, OsiriX is an image-processing application dedicated to DICOM images.

After the Open Source was introduced, commercial entities began to offer various value-adds including plug-ins for radiology applications such as hanging protocols, AAA measurement tools, lung-nodule detection algorithms, and an ejection fraction tool. Medical certification, such as FDA and CE Mark, also became available for OsiriX and many of its applications. Other value-adds from commercial suppliers include support, training, and integration services. Open Source and commercial versions of OsiriX are now running on more than 60,000 Apple desktops/laptops and continue to grow in acceptance and use. Outside of its intrinsic value as a tool, OsiriX has allowed the medical community unprecedented access to a high-end DICOM viewer.

While software created with Apple’s development tools has impacted radiology and a limited number of other medical communities, it wasn’t until the introduction of the iPad in 2010 that the entire medical community was affected by Apple technology. From administration, to clinical work, to surgery, the iPad is increasingly being used in all areas of medicine due to its extreme portability, superb image quality, large screen size, and the multitude of medical apps being developed to run on it.

The first FDA approved medical app came in February 2011 with Mobile MIM from MIM Software. Approved for review and medical diagnoses of MRI, CT and PET scans, this breakthrough paved the way for future apps to be approved. And not long after, the FDA did just that with approval of Mobisante’s MobiUS for smartphone-based ultrasounds. Other hot apps currently being reviewed are for preliminary interpretation of brain CT scans, and for evaluating for the presence or absence of tuberculosis. The app-development trend is expected to continue as demand from the medical community continues to increase for solutions that increase productivity and drive down costs. 

In addition to apps, the portability of the iPad is changing how medical professionals work. For example, the University of Chicago issued over 100 iPads to residents in their medical center. According to a report from NBC, the iPad is allowing residents instant access to patients’ electronic medical records, and they in turn are able to share charts and medical images with patients at their bedsides. This allows patients to participate more in their own care and allows residents the ability to provide minute-to-minute care. This workflow improvement has also allowed residents to spend more time with their patients and less time filling out paper work—in some cases paperwork has reportedly been cut in half. 

The portability of the iPad is also contributing to growth in Teleradiology, the practice of remote review, interpretation, and diagnosis of radiological images. The iPad allows radiologists to work more easily from remote locations, which is particularly important for patients in rural areas where specialists are not available. As more apps and mobile versions of PACS systems emerge for the iPad, Teleradiology will continue to grow and become more effective.

Release of the iPad 2 (March 2011) brings even more potential for its use in medicine given its improved processor and operating system, lighter weight, and smaller size. All these advancements improve ease of mobility and performance.

In addition to Apple development tools and iPads, there are other Apple products and apps that have use in medicine. And keeping pace with all this potential is the FDA. Due to increased marketing, interest, and use, the FDA is paying closer attention to Apple products and apps for the medical community. In particular, they have expressed much concern about mobile technologies being used for diagnostic purposes. With Apple medical solutions now solidly on the FDA’s radar, it will be even more challenging for mobile-technology application providers to obtain FDA clearance and approvals.

As Apple technology continues to evolve, and companies continue to develop and obtain FDA approval of medical apps, we anticipate the Apple in Medicine List to grow along with greater productivity for its users and better care for patients. 

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