CAREER POINT UNIVERSITY

APPLICATION OF DIGITAL SYSTEM IN MEDICAL

SUBMITTED BYANUGYAA SHRIVASTAVA

K12986

Mobile Devices and Apps for Health Care Professionals

INTRODUCTIONThe use of mobile devices by health care professionals (HCPs) has transformed many aspects of clinical practice. Mobile devices have become commonplace in health care settings, leading to rapid growth in the development of medical software applications (apps) for these platforms. Numerous apps are now available to assist HCPs with many important tasks, such as: information and time management; health record maintenance and access; communications and consulting; reference and information gathering; patient management and monitoring; clinical decision-making; and medical education and training.

USE OF MOBILE DEVICES BY HEALTH CARE PROFESSIONALS

Types and Prevalence of Devices Used

The introduction of mobile computing devices (personal digital assistants [PDAs], followed by smartphones and tablet computers) has greatly impacted many fields, including medicine. Health care professionals now use smartphone or tablet computers for functions they used to need a pager, cellphone, and PDA to accomplish. Smartphones and tablets combine both computing and communication features in a single device that can be held in a hand or stored in a pocket, allowing easy access and use at the point of care. In addition to voice and text, new mobile device models offer more advanced features, such as web searching, global positioning systems (GPS), high-quality cameras, and sound recorders. With these features, as well as powerful processers and operating systems, large memories, and high-resolution screens, mobile devices have essentially become handheld computers.

The first mobile device that incorporated both communication and computing features was the Blackberry, which was introduced in 2002. After the Blackberry was brought to market, other handheld mobile devices were introduced. Perhaps most notably, in January 2007, Apple launched the first-generation iPhone. Subsequently, smartphones that run the Google Android operating system were introduced in October 2008. Because of the intuitive touch-screen user interfaces and advanced features and capabilities that the iPhone and Android smartphones offer, ownership of mobile devices has increased rapidly. In April 2010, Apple introduced a new innovation, the iPad tablet computer, which because of ease of use, portability, and a comparatively large screen was yet another transformative computing tool. The iPad ignited the tablet computer market. Tablets that run the Google Android operating system (Samsung Galaxy

and others) were launched later that year, making the use of these mobile devices even more widespread.

Without a doubt, medicine is one of the disciplines that has been profoundly affected by the availability of mobile devices. This is evident in many surveys of HCPs that reveal a high ownership rate of these tools, which HCPs use in both clinical practice and education. Smartphones and tablets have even replaced desktop systems as the preferred computing devices for HCPs who need fast access to information at the point of care.

The June 2012 Manhattan Research/Physician Channel Adoption Study found that doctors’ ownership and use of mobile devices is pervasive, with 87% using a smartphone or tablet device in their workplace, compared to 99% who use a computer. Surveys have shown that around 80% of physicians use an iPhone, while most of the remainder opt for Android smartphones. An estimated 66% of doctors own a tablet computer, which 54% use in their practices. Interestingly, the popularity of mobile devices does not correspond with age, since 80% of physicians ages 55 and older own a smartphone. Similar results reflecting the pervasive use of mobile devices by HCPs were reported in a survey of medical school faculty, residents, and students. The results of this study found that 85%, 90%, and 85% of respondents, respectively, use mobile devices in a wide variety of clinical settings ranging from classrooms to hospitals.

Need for Mobile Devices at the Point of CareOne major motivation driving the widespread adoption of mobile devices by HCPs has been the need for better communication and information resources at the point of care. Ideally, HCPs require access to many types of resources in a clinical setting, including:

Communication capabilities—voice calling, video conferencing, text, and e-mail Hospital information systems (HISs)—electronic health records (EHRs), electronic

medical records (EMRs), clinical decision support systems (CDSSs), picture archiving and communication systems (PACSs), and laboratory information systems (LISs)

Informational resources—textbooks, guidelines, medical literature, drug references Clinical software applications—disease diagnosis aids, medical calculators

Prior to the development of mobile devices, these resources were mainly provided by stationary computers, which do not support the need for mobility in health care settings. In an attempt to address this need, some health care environments set up portable, wireless mobile information stations such as Computers on Wheels (COWs) or Workstations on Wheels (WOWs). With the availability of mobile devices, however, clinicians now have access to a wellspring of information at their fingertips, through their smartphones and tablets.

The results of the 2012 Manhattan Research/Physician Channel Adoption Study also identified the purposes for which HCPs rely on mobile devices. Searching was the most popular activity among HCPs, with 98% using their desktops/laptops to search, 63% using their tablets, and 56% using their smartphones. Focusing on smartphone use for doctors alone, searching is again the most common activity, occupying 48% of phone time, with professional apps consuming an additional 38%. Physicians were also found to spend an average of three hours per week

watching web videos for professional purposes on desktops/laptops (67%), tablets (29%), and smartphones (13%); the most frequently viewed content (55%) was continuing medical education (CME) activities. A frequent reliance on mobile devices was also reported in the survey of medical school HCPs and students, with 85% reporting the use of a mobile device at least once daily for clinical purposes, often for information and time management or communication relating to education and patient care.

Development of digital dashboard system for medical practice: maximizing efficiency of

medical information retrieval and communication

It is reported that digital dashboard systems in hospitals provide a user interface (UI) that can centrally manage and retrieve various information related to patients in a single screen, support the decision-making of medical professionals on a real time basis by integrating the scattered medical information systems and core work flows, enhance the competence and decision-making ability of medical professionals, and reduce the probability of misdiagnosis. However, the digital dashboard systems of hospitals reported to date have some limitations when medical professionals use them to generally treat inpatients, because those were limitedly used for the work process of certain departments or developed to improve specific disease-related indicators. Seoul National University Bundang Hospital developed a new concept of EMR system to overcome such limitations. The system allows medical professionals to easily access all information on inpatients and effectively retrieve important information from any part of the hospital by displaying inpatient information in the form of digital dashboard. In this study, we would like to introduce the structure, development methodology and the usage of our new concept.

Electronic Medical RecordAn EMR contains the standard medical and clinical data gathered in one provider’s office. Electronic health records (EHRs) go beyond the data collected in the provider’s office and include a more comprehensive patient history.

For example, EHRs are designed to contain and share information from all providers involved in a patient’s care. EHR data can be created, managed, and consulted by authorized providers and staff from across more than one health care organization.

Unlike EMRs, EHRs also allow a patient’s health record to move with them—to other health care providers, specialists, hospitals, nursing homes, and even across states. For more information about electronic medical records and the differences between EMR vs EHR, please visit the Health IT Buzz Blog.

An electronic medical record (EMR) is a digital version of a paper chart that contains all of a patient’s medical history from one practice. An EMR is mostly used by providers for diagnosis and treatment.

Benefits of Electronic Medical RecordsAn EMR is more beneficial than paper records because it allows providers to:

Track data over time

Identify patients who are due for preventive visits and screenings

Monitor how patients measure up to certain parameters, such as vaccinations and blood pressure readings

Improve overall quality of care in a practice

The information stored in EMRs is not easily shared with providers outside of a practice. A patient’s record might even have to be printed out and delivered by mail to specialists and other members of the care team.

Digital mammographyDigital mammography, also called full-field digital mammography (FFDM), is a mammography system in which the x-ray film is replaced by electronics that convert x-rays into mammographic pictures of the breast. These systems are similar to those found in digital cameras and their efficiency enables better pictures with a lower radiation dose. These images of the breast are transferred to a computer for review by the radiologist and for long term storage. The patient’s experience during a digital mammogram is similar to having a conventional film mammogram.

Mammography is a specific type of breast imaging that uses low-dose x-rays to detect cancer early – before women experience symptoms – when it is most treatable.

Tell your doctor about any breast symptoms or problems, prior surgeries, hormone use, whether you have a family or personal history of breast cancer, and if there’s a possibility you are pregnant. If possible, obtain copies of your prior mammograms and make them available to your radiologist on the day of your exam. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown. Don’t wear deodorant, talcum powder or lotion

under your arms or on your breasts as these may appear on the mammogram and interfere with correct diagnosis.

DICOMIntroductionDigital Imaging and Communications in Medicine (DICOM) is a standard for handling, storing, printing, and transmitting information in medical imaging. It includes a file format definition and a network communications protocol. The communication protocol is an application protocol that uses TCP/IP to communicate between systems. DICOM files can be exchanged between two entities that are capable of receiving image and patient data in DICOM format. The National Electrical Manufacturers Association (NEMA) holds the copyright to this standard. It was developed by the DICOM Standards Committee, whose members are also partly members of NEMA.

DICOM enables the integration of medical imaging devices – like scanners, servers, workstations, printers, network hardware, and picture archiving and communication systems (PACS) – from multiple manufacturers. The different devices come with DICOM Conformance Statements which clearly state which DICOM classes they support. DICOM has been widely adopted by hospitals and is making inroads in smaller applications like dentists' and doctors' offices.

DICOM is known as NEMA standard PS3, and as ISO standard 12052:2006 "Health informatics -- Digital imaging and communication in medicine (DICOM) including workflow and data management".

ApplicationsDICOM is used worldwide to store, exchange, and transmit medical images. DICOM has been central to the development of modern radiological imaging: DICOM incorporates standards for imaging modalities such as radiography, ultra sonography, computed tomography (CT), magnetic resonance imaging (MRI), and radiation therapy. DICOM includes protocols for image exchange (e.g., via portable media such as DVDs), image compression, 3-D visualization, image presentation, and results reporting.

The core application of the DICOM standard is to capture, store and distribute medical images. The standard also provides services related to imaging such as managing imaging procedure worklists, printing images on film or digital media like DVDs, reporting procedure status like completion of an imaging acquisition, confirming successful archiving of images, encrypting datasets, removing patient identifying information from datasets, organizing layouts of images for review, saving image manipulations and annotations, calibrating image displays, encoding

ECGs, encoding CAD results, encoding structured measurement data, and storing acquisition protocols.

Types of EquipmentThe DICOM Information Object Definitions encode the data produced by a wide variety of imaging device types, including:

CT Computed Tomography) MRI (Magnetic Resonance Imaging) Ultrasound X-Ray Fluoroscopy Angiography Mammography Breast Tomosynthesis PET (Positron Emission Tomography) SPECT (Single Photon Emission Computed Tomography) Endoscopy Microscopy Whole Slide Imaging OCT (Optical Coherence Tomography)

DICOM is also implemented by devices associated with images or imaging workflow including:

PACS (Picture Archiving and Communication Systems) Image Viewers and Display Stations CAD Computer Aided Detection/Diagnosis Systems) 3D Visualization Systems Clinical Analysis Applications Image Printers Film Scanners Media Burners (that export DICOM files onto CDs, DVDs, etc) Media Importers (that import DICOM files from CDs, DVDs, USBs, etc) RIS (Radiology Information Systems) VNA (Vendor Neutral Archives) EMR Electronic Medical Record Systems) Radiology Reporting Systems

Fields of MedicineMany fields of medicine have a dedicated Working Group within DICOM, and DICOM is applicable to any field of medicine in which imaging is prevalent, including:

Radiology

Cardiology Oncology Radiotherapy Neurology Orthopedics Obstetrics Gynecology Ophthalmology Dentistry Maxillofacial Surgery Dermatology Pathology Clinical Trials Veterinary Medicine

CONTENT1. Mobile Devices and Apps for Health Care Professionals

2. Use of mobile devices by health care professionals

3. Development of digital dashboard system for medical practice: maximizing efficiency of medical information retrieval and communication

4. Electronic Medical Record

5. Digital mammography

6. DICOM

7. REFERENCE

REFERENCE• https://en.wikipedia.org/wiki/Applications_of_artificial_intelligence

• https://www.researchgate.net/publication/222181617_Applications_of_digital_photogrammetry_to_medical_investigations

• http://www.cse.wustl.edu/~jain/cse574-08/ftp/medical/

• https://en.wikipedia.org/wiki/DICOM

• http://www.or-technology.com/point-of-care/Einsatzgebiete/Desaster-management-field-hospitalt-digital-mobile-X-ray.html