$$ - An Introduction To The iPhone For Clinicians

Introduction

In the last 12 months there have been significant developments in the portable electronic device (PED) space. Whereas this sector was previously limited to laptops, there is now a variety of devices to suit a particular context, as seen by the increasing popularity of netbooks and ultra portable devices.

Coupled with convergence, we are now seeing devices that bundle Internet connectivity with portable communication capabilities, enabling extra Information Management and Information and Communication Technology (IM/ICT) portability.

Perhaps the most popular of these devices is the Apple iPhone. This phone is a portable, hand-held communication device enabling telephony, information management, Internet browsing, data synchronisation, and many other features.

Connectivity is possible over legacy mobile phone networks, 3G (HSPDA) mobile phone networks, or Wi-Fi. The iPhone’s screen, with its 320x480 pixel resolution, delivers significant clarity. Interaction with the device is by touch screen, and depending on the application in use, the screen can be viewed in landscape via simply rotating the device 90 degrees in either direction.

The iPhone’s web browser is called Safari. This browser is configured to open up a new web page for each new site being browsed, with an intuitive interface allowing the user to switch between open windows.

A basic set of applications is pre-loaded onto the iPhone with a vast array of applications downloadable from the Apple App Store. These applications vary in cost from free or a few dollars, up to $40 or $50. Due to the iPhone’s portability and connectivity options, it lends itself to use in medical applications.

Medical informatics

A number of medical applications for the iPhone can enhance patient interactions in multiple consulting contexts. You only need to a search on medical applications for the iPhone to see the growing number of applications constantly being developed. These can be accessed via the App Store under the “Medical” category. There are also a significant number of patient‑centric applications available, with most of these categorised under the “Health and Fitness” category. As with all Apple-sanctioned iPhone applications, access to these programs can either be via the iPhone itself, or by using the App Store interface built into the iTunes desktop application.

Using an application like Epocrates, which can be loaded for free, you instantly have a medication referencing program. Aside from the fact that it is USA centric, it is still a useful tool for medication enquiries including dosing and complications. It allows you to make your own notes and run comparisons with nominated medications, and also offers a free clinical service to download summaries of relevant journal articles.

Anatomical assistance is available from programs like Netter, which is an American anatomical atlas. Through high grade illustrations, anatomical concepts can be viewed with easy rotation and focus via the touch screen. Structures are highlighted by the touch of a finger and are extremely useful in both updating knowledge and as a consulting aid in clinical consultations.

The iPhone includes a GPS receiver that allows the current location of the user to be displayed on a Google map complete with either satellite of Google Street View imagery. Route mapping can also be achieved with the iPhone, though at present there is no voice activated directions functionality included. The iPhone’s GPS functionality is a useful tool that would be of benefit to those GPs still doing house calls.

Connectivity

With the ever growing need for instant access to data, the iPhone, with its preloaded Cisco IPsec VPN client, enables secure remote access. Coupled with an RDP (Terminal Services) application, a clinician has the ability to access medical files wherever there is Internet connectivity, either via 3G or Wi‑Fi.

At present this connection can be quite slow, but with increasing 3G capacity and the eventual deployment of 4G or LTE technology capable of delivering bandwidths of up to 100MB/s, we will see significantly enhanced performance and functionality.

Documents and Email

The iPhone allows email to be accessed in a variety of ways. IMAP connectivity and preloaded SSL encryption email can facilitate access on the fly. With a variety of settings messages received and sent can be loaded locally or stored via your applications server so that you have defacto synchronisation.

Most documents attached to emails can be viewed on the phone, but the options for storing and editing these attachments is limited.

A number of web services designed for receiving incoming PDF documents have launched companion iPhone applications. One such program is called MBox, which converts faxed documents to email, allows users to view these documents on the iPhone as PDF documents. This enables access to correspondence while away from the physical office and underpins the beginnings of the virtual medical practice. This will be further enhanced with the arrival of iPhone applications for accessing investigation results as well as secure clinical correspondence.

Shortcomings

Despite the large leap forward made by Apple with the release of the iPhone, the device has a number of short comings:

  • Bluetooth connectivity is only basic and does not allow synchronisation to other Bluetooth enabled devices.
  • The iPhone version of the Safari browser currently lacks Java and Adobe Flash support. In addition, a number of video formats are currently not accessible.
  • Battery capacity is limited, and heavy use of Wi-Fi or 3G networks can deplete the battery quite quickly.
  • Currently there are issues with dropped calls, a problem that was meant to be addressed by a software update. However even though this has been improved it can still be a problem and will need to be addressed by Apple and the mobile phone carriers.

Conclusion

The iPhone has reorientated the IT industry as to which device will be the primary electronic connectivity port, and other manufactures are now bringing out smart phones in direct response to some of the key features delivered by the iPhone.

The enhanced connectivity provided by the iPhone and similar devices will require medical practitioners to assess their communication strategies as well as challenge standards for accessing both medical literature and their own patient records.

There are few Australian-centric clinical applications designed specifically for the iPhone at present. However Apple’s iPhone and similar devices will increasingly provide greater portability and accessibility options for clinicians through ever increasing numbers of medical education resources, clinical support applications and connectivity tools.

Posted in Australian eHealth

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