Jarrod Shapiro, DPM
Practice Perfect Editor
Assistant Professor,
Dept. of Podiatric Medicine,
Surgery & Biomechanics
College of Podiatric Medicine
Western University of
Health Sciences,
St, Pomona, CA

Tablets: The New Stethoscope

The one constant in life is change, and this is especially true with medical technology. We are constantly bombarded with the next new technology, whether it's a surgical instrument, imaging method, or drug we can't live without.

Another new technology that is becoming the next great thing is the tablet PC: iPad, Galaxy tablet, or a variety of others.

27% of primary care physicians and specialists have a tablet. 67% of doctors use a smartphone

This is old news to many. In fact, a recent survey of more than 5400 physicians showed 27% of primary care physicians and specialists have a tablet while 67% of doctors use a smartphone (1). This huge adoption by physicians reflects the growing use of these new technologies in the general population, especially by professions. I wonder: is the tablet PC/smartphone become the new stethoscope?

Tonight's Premier Lecture is
Nutrition and Neuropathy
by Allen Jacobs, DPM, FACFAS

I was a fan of the Star Trek series, specifically the Next Generation. We can argue all day about the relative strengths and weakness of the original Star Trek vs Next Generation — who's the better captain, Picard or Kirk (I vote for Picard) – but in a quite prescient way, these shows predicted the smartphone and the tablet PC, specifically as applied to medicine. Picture the nameless injured Enterprise crew member who went down to the planet for an away mission with Piccard and Riker (it's always the unknown crew mate who gets injured). They return to the ship and Dr. Crusher pulls out a tricorder — only now picture a smartphone — to scan the injuries. Our new technology is becoming ever better at interacting with the world around it, which will make this technology increasingly useful for us in medicine. For example, the “lab on a chip” research currently underway will soon allow us to instantly determine intimate patient information at the touch of a finger.

Bones and Dr. Crusher on Star Trek were depicted using touchscreen

Picture again Captain Picard walking into his office, picking up the ubiquitous PADD (Personal Access Display Device). Yes, that's actually what the makers of Star Trek called it. It is the iPad; it even uses touchscreen technology — as do many of the interfaces of the Enterprise. I don't know if Steven Jobs thought of this image when creating the iPad, but Apple clearly made science fiction into science fact – to our benefit.

I recently bought an iPad with the intentions to use it primarily for work. Of course, it has non-work benefits like viewing Netflix movies. I spend a good deal of time interacting in some way with computers, whether it's the EMR system, digital radiology, email, presentations, writing, or any of a number of other tasks. I also do quite a lot of teaching in both the classroom and clinical realms. As such, I wanted a mobile, easy, high quality interface that would work well with my current technology. This is, of course, exactly what I got. Several of these goals are easily satisfied by my tablet, while I'm still learning to figure out some of the more medical-specific programs.

Some of the programs I'm currently able to use include the following:

A program to access PDF files – combining this with my online Dropbox journal article library makes reading current research easy.
ePocrates – drug prescribing information including data about specific drugs, pill images, etc.
Video conferencing
Camera
Calendar
EMR – we currently use an online EMR system called Health Fusions. I don’t like this system except for its easy availability and my ability to access patient health information anywhere.
Coding Assistant information
Word processing
Create presentations

What I CAN'T do yet but would like to:

Direct access to my practice's digital imaging system.
Show a professional patient consent video for procedures. I'd love to see an application that lets me do this.
Remotely look at my patients. It would be great from a practice management and medicolegal standpoint to be able to look at a postop foot via telemedicine and determine if their edema is concerning or just a nervous patient. This is currently possible using Apple's Face Time app between Apple product owners.
Dictate my notes into my iPad using a high quality rapid recognition program. Dragon is just not there yet.

Will the iPAD iPad actually replace the stethoscope? Maybe not quite yet. But it’s only a matter of time. I’m looking forward to what the next few years will bring. Welcome to the world of science FACTION.

What apps are helpful to your practice? Write in and educate us...