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Is the iPad® about to change emergency medicine?

  
  
  
  
  
As noted recently in Emergency Physicians Monthly, the iPad is causing a growing number of emergency physicians to think about ways to use the device in the emergency room.

Hype aside, just as the iPhone® changed mobile phones and the iPod® revolutionized the music industry, it's likely that the iPad will change the way work is conducted in the emergency department.

How? Because of the pace, the interruptions, and the need for information, the tried and true pen and paper method of operation denies emergency physicians easy access to patient data and decision support. Some EDs are using electronic information systems, with doctors sometimes more focused on the computer screen than on the patient. Still other EDs use scribes.

However in the not-too-distant-future, the iPad could potentially change everything, allowing emergency physicians and staff to use iPads to tap on elements of the history of the patient - all very quickly at the bedside. These tablets would also enable physicians to go over images and lab results with patients, and review diagnoses and instructions.

It will all come down to the buzzword of 2010 "apps". At present there are no fully integrated and comprehensive ED information system apps on the iPad. For now, an emergency department could use existent apps for patient education, interfacing with  PACS, or discharge instruction templates.

But once ED-specific apps are made available - and they will - it's likely that emergency physicians and nurse practioners could have a tracking board to monitor patients' bed status or vitals, voice transcription software that can export transcriptions to charts, and many more. Some experts are predicting that a vendor will eventually release an app that does it all, seamlessly interfacing with the enterprise, offering charting, computerized order entry, bed tracking, results review, and admission and discharge pathways.

So even though the iPad is currently in its infancy, stay tuned. Before you know it, the technology will likely liberate physicians and have them chuckling about the "old days" of desktop ED information systems and paper charts.  

Any thoughts on the topic?  Please share!


Comments

I've been an apple fan since the company came out with the Apple personal computer (late 70s). My brother stood in line for an iPad the day they came out, but I took the 'wait and see' attitude knowing that a better version would be out in the near future... that was until my wife one day looked over after one of those slick iPad commercials and said 'how come you don't have one of those? Needless to say I didn't hesitate to take advantage of that green light (one of my partners happened to be down in San Francisco and he dropped in the Apple store to pick one up for me!). 
 
The minute our local IT guys found out I had an iPad we went on a mad search for iPad medical functionality. I watch a nice YouTube video from a Visalia Hosp that was using Citrix Zenapps to deliver their current desktops on the iPad. The guy pulled up their current EMR with a few finger taps, then he brought up a live view of their ICU monitor, then the clincher.... PACS. Wow. I immediately forwarded this to my Meditech vetting group and all the administrators I could find on my email global address list. It spread like wildfire and by the next day I downloaded the Remote desktop app to bring up our ED tracking program and PACS in our ED! 
 
I walked over to bed 10 and showed the patient his broken ankle zooming with a two finger gesture and a universal 'ooooohhhh cool' from the nurses and family. I was able to bring up bed 1's lab trends to discuss his worsening renal issues and also show him how nicely his CXR's had changed. A picture is worth so much more. 
 
So by purchasing the iPad and just having it in the dept has sparked great 'what if' conversations from nurses, techs, unit clerks, and attendings. There is no doubt that we have some challenges to make the iPad the appliance as common as our stethoscope (I haven't dropped it from greater than 1 ft yet), but I look forward to exploring the possibilities.  
Posted @ Thursday, May 27, 2010 5:11 PM by Bert Duvoisin
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