4. Day of Surgery
Mobile MIM & OsiriX HD
In anticipation of an upcoming procedure, the surgeon often runs through the steps in her head. For procedures and specialties, which are dependent on cross sectional imaging, being able to review the CT or MRI is a very effective way to mentally prepare for surgery. Two robust iPad radiology viewing apps offer this ability without requiring a PC or radiology workstation, providing the surgeon has access to the “DICOM” imaging data, as is usually the case if the patient has brought a CD ROM from the imaging facility.
Mobile MIM allows DICOM data to be uploaded directly from a CD ROM to their secure cloud based service, after which the images can be viewed on an iPhone or iPad. This is a very convenient service that even allows studies to be easily shared among physicians. However, there are charges associated with uploading and viewing studies.
OsiriX HD requires a WiFi connection to OsiriX , a remarkable free & open-source Macintosh desktop DICOM reader application. It can also interface with a hospital DICOM server, if access is granted.
Safe Surgery
Before making incision, every surgeon should observe a pause to confirm with the OR team that the correct procedure is being performed on the correct side on the correct patient. The safety benefits of the pre-surgical checklist have been amply documented and are now part of a worldwide initiative by the World Health Organization to reduce surgical errors. The WHO checklist has now conveniently been placed in an app which prompts the user to verify each of the components of the checklist have been completed:
- Sign In (Before induction of anesthesia) With at least nurse and anesthetist
- Time Out (Before skin incision) With nurse, anesthetist and surgeon.
- Sign Out (Before patient leaves operating room) With nurse, anesthetist and surgeon.
5. After Surgery
Surgical Logbook
Every surgeon needs to keep a log of his or her surgeries. For residents, this is required by the ACGME for program accreditation. Even beyond that, surgeons may have to document cases to apply for hospital privileges not to mention to follow their patients’ outcomes and conduct research. For those surgeons looking for simple, lightweight logging software, a few mobile applications are available.
Surgical Logbook, as per its description, provides:
- Customizable and simplified menus to allow practical logbook entry
- Description recall feature allows previously entered fields to be saved for future use
- Add operative or identifier photos to logbook entries
- Backup individual entries or the complete logbook via email in spreadsheet format.
- Logbook statistics filtered by procedure, surgeon or operative role
- Security Password feature to aid in keeping data confidential
Surgichart
The idea behind SurgiChart seems to be broader than replicating a paper logbook. It is intended to serve as a communication platform between the surgeon, office, implant representative, referring doctor and patient family. In addition to the iPhone and iPad app, there is also a web interface. The idea is to provide a common location where information about an upcoming case as well as intraoperative images and surgical findings can be loaded. The referring physician can get an immediate email at the conclusion of the procedure while images can be shared with family. According to the description, version 1.0 is intended only for spine surgery with other surgical specialties “coming soon.”
Conclusion
The flexibility and ubiquity of smartphones has made them a natural platform for app developers targeting surgeons – among the most mobile of physicians. In just two to three years, a panoply of options has already become available to serve the surgeon. But while this period of growth has been rapid, it will no doubt just be preparation for applications yet to be imagined.
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