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I currently work for a pretty large hospital and have been dabbling in iPhone development for a couple years. The CEO is wanting to get together a group to see what mobile technology we could create. I was contacted to be the main developer.

I wanted to gather some ideas of what kind of mobile apps people have seen deployed in hospitals. Not necessarily medical apps that you can get on the app store, but rather apps built specifically for a hospital.

Any ideas?

If this is not the appropriate forum for a question like this, can someone point me to a forum where it would be appropriate?

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I don't have actual suggestions but pay special attention to possible security / privacy related issues in that field. – Inca Jul 31 '11 at 16:52
@Inca: <quote> the HIPAA (in USA) only apply to "covered entities" and their "business associates." To understand whether software falls under the HIPAA rules, a developer must answer two questions: (1) Who will be using the application, and (2) What information will be on the application? </quote> mobihealthnews.com/11261/… – rwong Jul 31 '11 at 17:24
@Joey Green: Since the proposal for Healthcare IT is not yet in beta stage, this is probably the best place. – blubb Jul 31 '11 at 18:23
I am advocating the Android in our hospital. Android is good start, if the devs team is familiar with Java – Rocket Surgeon Aug 29 '11 at 13:41

8 Answers

I just got back from a visit from my GP - she had a netbook or something like it, and what appeared to be an application that had:

  • her appointments

  • my medical records

  • an ability to get the ball rolling on blood tests

Throughout the appointment, I noticed she was able to take notes and navigate through it. Since it was a netbook, it had a keyboard, but she also had an electronic pen interface that let her use the pen like a mouse for clicking through information.

It was networked into the office's main network, since she was able to get me to the front desk and immediately print out the paperwork needed for blood tests.

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Joey, there are tons of needs within the hospitals. We recently develop here (Colombia) a Clinical Enterprise System with:

  • Registry and enrollment (fingerprint enrollment) of patients.
  • Medical history tracking and interop (to third parties like insurance' companies).
  • Diagnosis helper (expert system).
  • Prognosis assistant (web for users to check at home).

And other nice things can't discuss 'cause sign an NDA. But I think that could give you an idea. Our main client is an iPad app (iPhone also supported but with less graphic detail, due to resolution). And almost all can be done (except fingerprint enrollment due to hardware limitations).

The thing with medical and health system is that there are tons of interesting projects but a very big deal: data privacy, so development is not easy, but fun.

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How do you deal with the lack of user security on an iPad? Our docs want iPad apps, but the lack of user profile makes it difficult to audit who sees what on the iPad. We're concerned about data confidentiality... – Jennifer S Aug 18 '11 at 13:35
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We are basically authenticating against Hospital's LDAP getting a token, ciphering and decoding as needed. We use some private API's to do that. But since the app is deployed on house, doesn't violate any restriction such as AppStore ones. – Randolf R-F Aug 18 '11 at 16:48

There are lots of good, specific ideas here. Consider as you brainstorm the high-level catagories into which the potential applications fall.

points for analysis:

  1. duplicate exactly the functionality of an existing desktop app--or sub-section of an app
  2. summarize or aggregate data from multiple sources
  3. input or output? (also, general reference vs. specific records)
  4. unique-to-mobile (i.e. taking movies or pictures, esp. with GPS/geo-location info and date/time stamps integrated)
  5. for the staff or the patient? (as a patient, I love to see diagrams of procedures before they happen to me)

There are probably others. Sifting through these might help one idea rise to the top.

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You've made some good points. I'd just like to comment a bit on the 4th one - GPS tagged photos work very badly in closed spaces (not saying that they work all that good in open spaces, but oh boy, do they miss the target in buildings ...) ... (btw, definitely something that should be improved on, but unfortunatelly he cannot do much about it). – Rook Aug 29 '11 at 2:57

Read this review of an iPad app, on TechCrunch, for ideas.

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See if you can implement an iPhone tricorder to scan people for injuries.

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2  
additional hardware required. Inclusion of such devices into the app makes both subject to double regulation: FDA (being medical diagnostic devices) and HIPAA (privacy). – rwong Jul 31 '11 at 18:31

There is a detailed scheduling system behind the use of certain equipment like MRI and PET scanners. Making it possible to schedule appointments while on the go would be useful. At the hospital I formerly worked at we had considered this but there weren't enough available, qualified developers to make it happen.

Having a mobile-friendly way for an employer to access documents(with a concern for medical privacy, obviously) would also be great.

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The US Food and Drug Administration recently pointed out that medical mobile apps might need to be certified as medical devices. The same article where I read that said that FDA certification for medical devices these days typically costs thirty million dollars. That pretty much puts garage developers and most hospitals out of the game.

I once worked for KnowMed Systems, later iKnowMed. They have since been bought out by some other company, so I don't know what name they have nowadays. We wrote an electronic medical records app in Smalltalk that saved its data to a Gemstone object-oriented database running on Windows NT4. The doctors all used laptops running Windows 95.

A similar electronic medical records app that used mobile devices instead of laptops would be much more convenient to the doctors. No need to haul a heavy laptop around.

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It gets worse. When working in a hospital environment the hardware (so the phone or tablet) will have to be able to withstand sterilisation procedures (basically, cooking it in an autoclave) and being regularly wiped/washed with disinfectant. AFAIK no current smartphone or tablet can withstand such punishment. For use in office spaces (so no patient contact) that's of course not a factor, but neither would be the certification cost most likely. – jwenting Aug 29 '11 at 9:36
jwenting, Android works on x86 PCs that can also run windows or other Linux distributions. Maybe there is a hardened tablet that normally runs Windows, in which the operating system can be replaced by Android. One might find such a tablet by looking through the ads at Circuit Cellar, a trade magazine for embedded developers. – Don Quixote Aug 29 '11 at 9:56

While some of the above ideas are good, I suggest that you try to analyze process cycles and identify which processes requires a mobile device. To do this you need to perform some front end analysis with different staff categories. A set of simple brain storming session together with known issues to IT could be a good start.

Creating a duplicate application like scheduling may add little value. Keep in mind that several of the hospital process are associated with legal terms and workflow requirements.

In short, solve an existing problem and don't create software just because you know the technology. You know the say "...if you got a hammer...)

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