A few weeks ago, I was the team physician on the sidelines of a high school football game when I received a call from another resident asking for advice interpreting an x-ray. Rather than rely on their description of the x-ray or a less than ideal smartphone picture of a computer screen, I hung up the call, used my remote connection app on my smartphone and remotely connected to the hospital server where I could view the actual x-rays in my hand from the sidelines. Without leaving the game, or even the field, I called the resident back and we made a plan based on my review of the actual x-ray images and lab results.
In the not too distant past, orthopaedic surgeons being consulted while on home-call were completely dependent on the primary physician for information regarding the patient. That included the important evaluation of the patient’s imaging studies by a physician that may not have significant experience reading or interpreting orthopaedic conditions. Similarly, the orthopaedic surgeon would have to ask for any test results or special studies.
Several years ago, I remember listening to consulting physicians attempt to describe a fracture that was sometimes not an entirely accurate representation of what I found when I arrived in the hospital. In many surgical specialties, imaging is critical to decision making; improved accessibility can allow us to activate OR teams, request further imaging necessary for decision making, or begin surgical planning sooner. Particularly in specialties where imaging is critical to decision making, mobile access to imaging studies can help streamline and accelerate patient care.
There’s a proliferation of platforms that offer that functionality. Merge Healthcare and Mach7 are two enterprise imaging vendors that feature mobile access as part of their strengths. These types of platforms have to be contracted by your hospital or facility where imaging is performed. In general, the selection and implementation of these types of tools rests with radiology, whose needs may be slightly different than those of surgeons.
Personally, I have experience using Microsoft Remote Desktop RD client. Others may be familiar with Citrix’s XenDesk or VMWare as virtual desktops through which they can access their clinical systems. These apps allow for the remote connection to an alternative server – such as a hospital network – from a mobile device. Basically, this strategy is effectively like jumping on a hospital computer, which allows for the remote evaluation of a patient’s medical records or imaging studies when the physician is not located in the hospital. The downside here is that often these platforms are not designed well for use on mobile devices.
I can be covering a high school football game and, when I receive a consult page, I can pull up the x-rays or MRI on my mobile device. That way, I have a significant understanding of the patient’s injury before talking to the consulting physician. That capability greatly facilitates and expedites the care of the patient particularly for orthopedic problems.
It’s important to realize that these apps do not replace the important physician-to-physician communication; rather they enhance that information exchange. Nonetheless, secure platforms that allow surgeons to access imaging studies via mobile devices can help expedite care. Physicians that are not familiar with these mobile technologies should talk with their hospital technology department about remote server access or even dedicated mobile access platforms for reviewing imaging studies.
The ways that surgeons utilize these types of tools are very different than others in the hospital and even vary within surgical specialties. Those use cases should be at the forefront as more and more hospitals adopt these systems. It’s important that surgeons collaborate with their IT teams to ensure that our use cases are considered so that the needs guide the decisions made by IT managers.