iPad

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
D

deleted4401

Has anyone bought/used an iPad for clinical use in a radiation oncology clinic? I think where I'm working the physicians/physicists will be getting 3G iPads and I'm just wondering how it can be integrated - i.e. checking films/OBIs, contouring, dictation/transcription services?

S

Members don't see this ad.
 
From the little I've seen it seems like they iPad could definitely be adapted to checking films, or reviewing EMR's... Contouring may be a stretch but not impossible. The physicians I've seen really prefer to dictate into their handheld recorder as well.

As a note, I don't have a ton of experience in Radiation Oncology but have spent a fair amount of time around the iPad. I think that there is a definite place for the iPad in radiation oncology but it will take some creative "app" designers to adapt the UI to the more sophisticated tasks in radiation oncology. (IE, contouring...)
 
I am excited to get one, not for contouring and dictating, but as a tool to go paperless in hanging on to key papers. I am sure we all store electronic copies of important articles already, but I also tend to hang on to paper copies b/c I have highlighted them and scribbled notes on them, etc.

The iPad has apps such as iAnnotate which enable you to save edited versions of PDF files. You can highlight, make notes, etc, not unlike other tablets out there - but c'mon it's the iPad so it would be cool to have!

The sucky thing about the iPad is the way the current OS is setup, you can only save stuff (including PDF files) into iTunes. You can't create a nice folder on the desktop to organize files. Also, there is no USB port, and transferring data onto the iPad is quite a chore and tedious if you are moving over large amounts of data (who wants to email themselves hundreds of articles and save them one by one into iTunes?). I am confident Apple will deal with these issues. Seems like they intentionally create stupid problems like that with the first generation of all their devices so that they can quickly release a second, awesomer generation (which could have been the first). Anyway, I'm holding out for now, but do see some amazing potential in our field in several ways. Toys like this will make our jobs much easier IMO.
 
Members don't see this ad :)
Has anyone bought/used an iPad for clinical use in a radiation oncology clinic? I think where I'm working the physicians/physicists will be getting 3G iPads and I'm just wondering how it can be integrated - i.e. checking films/OBIs, contouring, dictation/transcription services?

S

I know of at least one program that bought them for the faculty to use. I think the plan was to bring them into clinic and use them with EMR, although the EMR app is read-only at this point. Certainly having fast access to check the chart would be nice.

Hard to imagine they have enough processing power or bandwidth for contouring.

The iphone NCCN app (which does not load at all on my iphone) could benefit from a larger screen, but I can just call that up on my laptop.

I envision having AJCC staging, an imaging atlas, a handbook or two, and shared drive access to documents from an ipad as a nice first step, and I will probably buy one in the next generation.

Oh, and Netflix. Definitely Netflix.
 
Slightly different topic, but...

Any medicine related iphone/ipad app you find useful?

My suggestions:

medcodes: icd 9 codes
ctcae v4.0: self explanatory
Epocrates: everyone knows epocrates
Medscape: drug listings like epocrates. News update is pretty nice too.
webMD mobile: I really like the physician search feature (which can be imported to your contact list... great for practicing docs)
nejm this week: NEJM for free!
NCCN guidelines: slow to load (unless you upload them as favorite) and hyperlinks need to be activated, but good to have NCCN on you all the time.
 
Not directly medical but useful are Dropbox and the readers Stanza, iCHM, and eDJVUreader.

Medical radio (ReachMD) and AHRQ ePSS are great free apps, but I don't use them much any more. UMMS Medical Info loads quickly and has great breadth but no depth.
 
Reading papers maybe... Definitely NOT for approving films.
A couple months ago a RadOnc in Florida was convicted of Medicare fraud. He claimed he checked the films which he billed for on his PDA. AT&T ratted him out - no data transfer took place :)
 
I dug a little bit, and it seems that you could connect if you are using Citrix software for medical records, using an iPad app, and this would allow you to also connect with Mosaiq (if you are an Elekta site). It appears that one would be able to plan/view daily imaging from it, but would have to see it in action. Sounds intriguing.

I have never found a medical app worth using for a handheld. I could imagine that epocrates or pocket medicine might be good if you are an internist/hospitalist/PCP.

For ICD codes, like for everything else, wiki has a pretty good solution. Just type the disease, and when it goes to the wiki page, in the right hand corner is the ICD-9/10 codes.

-S
 
A couple months ago a RadOnc in Florida was convicted of Medicare fraud. He claimed he checked the films which he billed for on his PDA. AT&T ratted him out - no data transfer took place :)

Yup

http://www.techhotspot.co.cc/melbou...tle-fraud-case-brought-by-atlanta-based-finch

Because MIMA was not in compliance with physician supervision requirements, the federal complaint alleged that Dr. Scarbrough created a system using hand-held devices thatcreated the illusion of real-time physician supervision of IGRT, even though the defendants never intended to supervise the administration of this complex radiation therapy as required by Medicare.

Sullivan and Simpson worked with a forensic computer expert to unmask what the government called MIMAs sham practices. MIMA emailed images of patients to its doctors hand-held devices,but with our expert we identified for the government the types of data showing whether the doctors actually viewed these images, said Sullivan. As the Justice Department concluded, the AT&T data records clearly showed that the MIMA doctors made little use of these devices to review patients images.
 
The sucky thing about the iPad is the way the current OS is setup, you can only save stuff (including PDF files) into iTunes. You can't create a nice folder on the desktop to organize files. Also, there is no USB port, and transferring data onto the iPad is quite a chore and tedious if you are moving over large amounts of data (who wants to email themselves hundreds of articles and save them one by one into iTunes?)..


Best way around this is through Dropbox, a cloud drive so you can save your files locally on your harddrive and it's acessible anywhere. They have an iphone app, but the PDF reader is mediocre. GoodReader is another awesome app you can use in conjunction w/ Dropbox with a much more robust pdf reader. You can also just use your iphone as a wifi connected drive through GoodReader.
 
our physics and IT people have been walking around with ipads for the past few weeks. we are using citrix to run mosaiq on the ipads, and of course our electronic medical records system. you should in theory be able to do everything in mosaiq on the ipads. not sure how it is working yet, but the rumor is that all our attendings will be getting one soon. maybe it will trickle down to us one day...
 
Goodreader now features USB tranferring too.
 
Members don't see this ad :)
hey guys,

saw this post from awhile back, wondering if any of you who said you'd be getting it in your department had any updated feedback or anecdotes of how you're using it? I put a post with mini-poll up on sermo if any of you are members

https://app.sermo.com/posts/posts/66893

at this past ASTRO, Varian was demoing a beta of their new Aria software (like mosaiq from elekta) and they had an ipad app (also in beta) which seemed pretty impressive. any thoughts?
 
"The sucky thing about the iPad is the way the current OS is setup, you can only save stuff (including PDF files) into iTunes. You can't create a nice folder on the desktop to organize files. Also, there is no USB port, and transferring data onto the iPad is quite a chore and tedious if you are moving over large amounts of data (who wants to email themselves hundreds of articles and save them one by one into iTunes?."

Papers, by Mekentosj.com is the best thing since sliced bread and has an iphone and ipad version already rolled out and de-bugged. It's a pdf library with an interface similar to itunes. You can import papers into your library from your hard drive or via pubmed, etc. You can also share papers directly with anyone on the same wireless network. I rotated at a hospital that had a fully-functioning EMR (EPIC with both charting and imaging) on the ipad as well as papers for every resident. My attending pulled up the relevant literature on his ipad and just pinged it to everyone when he wanted to make a point on rounds, including students with iphones (me). Pretty nifty.
 
Last edited by a moderator:
"The sucky thing about the iPad is the way the current OS is setup, you can only save stuff (including PDF files) into iTunes."

The need for itunes has been one of my biggest gripes about the ipod/iphone/ipad etc. (along with the noticeable absence of expandable storage like SD or microSD).
 
Our program actually bought all of the residents ipads to use in the clinic and at home. Some of us use it more than others.

- I use iAnnotate and the Aji server to link to the folder on my computer that has my all my papers in pdf. This way I can access any paper at any time. It also keeps my folder organization/catagories. There are other apps that can do this as well.

- We can remote desktop to our computer and look up Mosaiq. This is helpful if you want to put in a script or review images in tumor board but the interface is not ideal.

- We have a citrix app so we can look up the hospital medical records. It does not support mosaiq at this time.

- It is nice to be able to look up wikkibooks radonc as well as my papers or put in an order while in tumor board or a meeting without having to lug a laptop around.

- There are not many good oncology/radiation oncology apps out there yet but give it some time...
 
We've been using the iPad in my clinic for about 4 months. As others have pointed out, we use Citrix to reach a remote desktop, then we have full access to Mosaiq and ExacTrac for real time image guidance verification. I just checked one before I typed this sentence!

Mosaiq also functions as our EMR, and allows editing/approval of dictations, etc. We have also templated a weekly check section, so all weekly notes can be done right in the room. Working with Mosaiq on the iPad platform is a bit clunky, but more of that is due to Mosaiq's limitations as an efficient EMR platform. I understand they are working to address some the inherent flaws for their January update. Our IT guys are actually kicking around some ideas w/ Impac about developing a more intuitive system/app FOR the iPad. If I hear anything on that front, I'll pass it along.

As far as contouring, I'd say not yet. Any large bandwidth collection of files will have to be remotely accessed for the time being, at least until they come out with the 10 TB iPad. I'd venture to guess that contouring would be painfully slow and difficult right now, but there have already been some pretty elegant tablet-based solutions released (Nucletron's Oncentra comes to mind), so it wouldn't be a stretch to see it for the iPad in the near future.
 
So if you're reading papers on it, taking notes etc, what apps are you using? iAnnotate seems like a good one to keep papers that you want to take notes on, papers app for storing and organizing. Are people using styluses (?styli) to write or just the good ol' finger?
 
I usually just use my finger. When consenting a patient on the iPad we use the pogo stylus (it is not ideal but the best we have found). Goodreader is another good app for keeping articles but I prefer iAnnotate. Velocity is a contouring/registration software that we have and they are reportedly working on an iPad app (not ready in the near future).
 
Quick question re: mosaiq:

In terms of creating templates with mosaiq, is there any way to automatically population the vitals, nurse entered patient medications, etc into an H&P template?

I know that you can do that with Epic and that was really helpful.
 
Quick question re: mosaiq:

In terms of creating templates with mosaiq, is there any way to automatically population the vitals, nurse entered patient medications, etc into an H&P template?

I know that you can do that with Epic and that was really helpful.

Per our transcriptionist, it's perhaps technically possible, but the proper formatting isn't there, thus creating more headaches than just dictating it. I'm told this is another area they're working on for the much-anticipated software update.

If anyone knows different, please tell me how you do it!
 
are you guys using it in your interactions with patients at all?

for instance, reviewing their plan with them at their first OTV after starting treatment, showing them anatomy or natural disease spread (as rationale for treating locoregional nodal stations)?

what cases (sleeves, covers, etc) do you find the most form factor friendly for use in the office? any suggestions?
 
Today is a timely period to revive this thread. I just got a new iPad. Any suggestions on apps you find helpful in clinic or work overall?
 
Goodreader as a PDF reader/ editor for almost any document. Keeps all the papers and texts I could ever want in one place. It's really the only program I'd recommend buying.

Kindle for ebooks, it's a great universal platform, and can read whatever you buy anywhere!

drawMD is a free app that is primarily surgical now, though they are working on a radiation oncology centric app, which will be awesome!
Otherwise, just enjoy it, it's a fun toy!
 
Thanks! I've got a list, I'll include those as well. I will be using this in clinic, so I'll let you know more after a bit of trial and error.
 
Are there any good contouring atlases or just simple MRI/CT anatomy apps that people are using on ipad/android tablets? I have been using the Netter ipad app and it is nice for remembering all the basic anatomy I forgot, but it would be really nice to have something that was not just a cartoon.
 
I'm a big fan of PDF Expert. Better interface than GoodReader. Synchronizes using a variety of methods including Google Drive, SFTP, box.net, Dropbox, SkyDrive and WebDAV. Allows all the normal fancy features with PDFS (highlighting, annotating, etc). Highly recommended.

Other random suggestion but not as rad onc related: Elements. Simple text editor that syncs flawlessly with Dropbox. Works really well for managing lots of information and has quick text search. Plays well with nvALT (OS X) or ResophNotes (Windows).
 
Top