Mobile Apps Can Enhance And Customize Office Operations
Retina specialists can download a handful of medical apps for easy reference, office management, patient education, and more.
LISA B. SAMALONIS
Growing numbers of retina specialists are using apps — on their smartphones, tablets, or other portable devices — in their practices, and app use in medicine is growing faster than in the general population as physicians continue to embrace the technology in a variety of ways to help care for their patients and manage their practices.
With the explosion of handheld device technology over the last several years, use of mobile apps has surged. In 2011, the mobile medical applications market reached $150 million and is predicted to grow 25% annually for the next 5 years, according to Kalorama Information.
According to the report, the medical app market is growing at a faster rate than the standard app market, due to the growing number of health-care professionals using these apps for everyday business.
WHAT’S DRIVING THE GROWTH
The right app can make a difference. Several medical and eye-care apps stand out in the crowded app stores for their usefulness for easy reference, office management, coding help, patient education, and convenience. As more retina specialists make the switch to electronic medical records, app use is increasing.
The worldwide popularity of the iPad has fueled the demand for ophthalmic applications that doctors can use in their practices, according to Robert Watson, president of Patient Education Concepts, Inc. (Houston, TX), the company that makes the Sight Selector app.
“Since we have over 1,000 3-D images within our app, doctors can just pull the iPad out, go to the subject they wish to discuss, and click on the appropriate 3-D image and start talking and drawing with their fingers or styluses,” he explains (Figure 1).
A short animated video with professional narration can make a subject easier to understand and saves the doctor time interacting with each patient. “This makes the doctors happy, enhances the patient experience, and leads to increased revenues from both a time management and an increased conversion to premium services perspective,” Mr. Watson says.
The Sight Selector’s interactive program helps patients “test drive” their vision by showing them realistic simulations of how they might see after their procedure, explains Mr. Watson. Retinal topics in the app include flashes, floaters, diabetic retinopathy, AMD, and retinal detachment.
COURTESY: PATIENT EDUCATION CONCEPTS, INC.
Figure 1. Sight Selector iPad Edition provides both 3=D images and narrated videos to educate patients on topics such as open-angle glaucoma, narrow-angle glaucoma, flashes, floaters, diabetic retinopathy, macular degeneration, and retinal detachment.
“The Sight Selector App was based on the same principle behind the IOL and LVC Counselor, but we have now expanded the content to include general ophthalmic, cosmetic, and optical topics,” explains Mr. Watson.
The newest version is Sight Selector Subscription, which costs $299 a year and can be used on up to five iPads. It includes all 84 topics, plus any new topics as they become available. It also has a print feature that allows users to print a PDF of each topic to hand out to patients.
Doctors can also use iPads or iPhones or tablets or smart-phones to connect with the office when they are traveling, using an app such as the RDC (remote desktop connection), which securely connects remotely to the office computer system.
Instead of walking back to the office for a book, the doctor can look up an item while in the exam room or walking from one room to the next.
The JUMP intuitive Windows remote desktop app (Phase Five Systems, LLC, Dubai, United Arab Emirates) allows users to access patient records as if they are in the office when they are at home, at a meeting, or elsewhere.
Users set up a password and firewall to meet HIPAA requirements. RDC has high-end 128-bit encryption. Data does not get transferred over the line because the user is only viewing what is on the terminal.
Consultant Jeff Grant, of HCMA, Inc., a practice management and health IT consultancy in Shell, WY, notes that he shares some useful apps with other ophthalmologists to help with remote connectivity, as well as ICD-10, and medical information. “ICD 10 Lite (iPremium Apps, Sharja, United Arab Emirates) is a great app for coding help, and the best remote desktop protocol app I’ve found is PocketCloud (Dell, Round Rock, TX),” he says.
Retina specialists are turning to convenient medical apps for some of their reference needs. Retina specialist Eddie Kadrmas, MD, in Plymouth, MA, loaded Epocrates (AthenaHealth, Watertown, MA) on his iPhone and refers to it often.
As a sub-specialist, Dr. Kadrmas says he references Epocrates many times a day to look up the interactions and side effects of his patients’ systemic medications.
Figure 2. Eye Handbook also provides easy eye care reference and diagnostics.
With the app, clinicians can look up dosing, research certain diseases and treatment options, view the photographic identification of pills reference, and use the tools and calculators to consult formulas, normal ranges for lab tests, and CPT codes.
Other popular ophthalmic apps include:
• Skyscape, a free app from Skyscape.com, Inc. (Marlborough, MA), which provides drug information, dosing calculators, and selected formulary information;
• Archimedes (Skyscape), a medical calculator with interactive tools organized by specialty;
• MedAlert (Skyscape), which provides updates on clinical trials, clinical news, and drug alerts; and
• Medscape (WebMD, New York, NY), which provides prescribing and safety information for drugs and supplements.
Retina specialists can also keep a few ophthalmology specific apps on their devices for convenient referencing and diagnostics. The convenience of having the app on a handheld device can increase efficiency in the offices and save the physician time.
For example, instead of walking back to the office for a book, the doctor can look up an item on an app while in the exam room or walking from one exam room to the next.
Popular apps include the Eye Handbook (Figure 2), the smartphone treatment reference and diagnostic tool for eye care professionals, from doctors at the University of Missouri-Kansas City and Cloud 9 Development. This app is helpful for its coding capabilities, list of eye medications, and a photo atlas. It also has testing features, such as an included Amsler Grid.
Figure 3. The Wills Eye Manual is now an app available through Skyscape.
COURTESY: LIPPINCOTT WILLIAMS & WILKINS.
Similarly, the Wills Eye Manual (Figure 3; available through Skyscape) provides specific ocular information. Dr. Kadrmas uses this app as an easy reference (especially after hours) for things that are outside his subspecialty of retina.
Additionally, he has downloaded an internal medicine app from Skyscape, which comprehensively covers the body and a wide range of diseases. “It is a good cross-reference resource to check things when talking to the patient,” he explains.
Figure 4. A custom Doctor App is a unique way for patients to reach the practice.
COURTESY: CLOUD 9 DEVELOPMENT
Andrew N. Antoszyk, MD, in practice with Charlotte Eye, Ear, Nose and Throat Associates, in Charlotte, NC, notes he also uses Epocrates for easy reference. In addition, he uses Mobile PDR (PDR Network, Montvale, NJ) and Eye Handbook. “These apps can help pinpoint drug interaction issues, medication errors and/or improve compliance,” he says.
CROWD SOURCING AND PRIVACY
A recently released app, called Figure 1 (Toronto, Canada), is a crowd-sourced medical library app for healthcare professionals. It is available for free through Apple’s iTunes App Store. Joshua Landry, MD, internal medicine and critical care specialist and co-founder of the app, notes he developed it because he wanted a safe way to share clinical images with colleagues while protecting patients’ privacy.
Customized apps are another trend gaining traction in medicine. Retina specialists can now create an app personalized to their practice.
Figure 1 uses images that have had identifying details removed, and the app supplies a number of in-app tools that users may remove. It also has an automated face-blocking function that lets a user block facial features that might identify a patient. Because the images do not have any identifying features and are not linked to patient information, they do not run afoul of HIPAA, Dr. Landy says.
Dr. Landy says the app is still useful for physicians who chose to not post pictures. For example, users can access the images that others are posting to learn from them, use them as a reference for their own practice, or comment on them so that others can learn from their insight and experience.
CUSTOMIZED JUST FOR YOU
Customized apps are another trend gaining traction in medicine. Retina specialists (and other doctors) can now create an app personalized for their practice through the Doctor App by Cloud 9 Development.
One of the major benefits of this approach, according to retinal physician and app co-developer Vinay Shah, MD, is that it gives patients the impression surgeons and their practices are on the cutting edge of technology. “It is a very easy and unique way for patients to reach the practice,” he explains. “Patients can tell their friends that their doctor has an app.”
Besides increasing the practice’s visibility, personalized apps in medicine can be used for scheduling and cancelling appointments, patient medication reminders, pre- and postoperative instructions, directions, one-click calling, practice and ophthalmic news, and patient education. “The doctor can have personalized patient education brochures or videos on the app,” Dr. Shah says, noting that he no longer gives patients paper brochures.
Practices can update the app at any time and also load relevant custom or prepared patient education media for a particular patient population to view. “This cuts down on chair time, it allows the patient to be more educated, and the patient can ask more educated questions when they are at the practice,” he says.
Doctor App version 2.0 upgrade features more detailed analytics package, multilanguage support, additional customization options, YouTube link to upload videos, and medication and appointment reminders that patients can set themselves.
“For the physician, the most important new feature is the analytics package, which provides detail about which devices the app is being downloaded to, and which pages are receiving the most ‘hits’ from patients. This helps the practice to know which information is most needed/valued by patients,” Dr. Shah explains.
The app is available for free for the Android platform, and it has a monthly fee of $44.99 a month. For Apple users, the app costs $499, with a monthly $44.99 fee. Other fees may apply with the Apple version.
With the continuing implementation of electronic health records and “meaningful use,” as well as the addition of younger “digital-native” physicians who are entering medicine and are tech-savvy, the future role of mobile apps is predicted to increase.
Peter J. Polack, MD, who practice in Ocala, FL, and is the author of the book Navigating the EMR Jungle: 10 Steps to Ensure a Proper EMR Rollout (eMedikon, Ocala, FL) says EMR will lead to the use of even more custom apps that will be able to integrate with a standard EMR platform.
“The key apps in the future are going to be the ones that have one specific purpose and can give you the information that you need specifically, quickly, and simply and not have apps that try to do too much at the same time,” Dr. Polack says.
Dr. Polack recently launched a Web-based app called ProtoQue Phone Triage Manager, which routes calls based on their level of urgency. He and his colleagues created the app because they could not find the right commercially available solution for phone triage. So they decided to make one, he says, noting his 10-physician, five-office practice receives up to 1,000 calls of varying urgency on some days.
“There are a whole host of apps out there for medicine and health care, each trying to solve a specific problem,” Dr. Polack explains. “We came up with a solution seven years ago for the problem of patients slipping through the cracks because of poor phone call management processes. This was developed in-house for our own use. But after several colleagues expressed interest in using it as well, we teamed with a software development company to develop an enterprise-scalable version.”
A BRIGHT FUTURE
This app, he says, can help physician and practices avoid malpractice claims related to improper phone triage. “We are now rolling out trials in different specialties besides ophthalmology and have had interest from other industries including manufacturing companies,” he adds.
Dr. Polack foresees consolidation and more standardization of EHR companies and systems in the future as companies work to stay on top of the phases of meaningful use. With it will come a more extensive custom app marketplace that will provide innovative business solutions. RP