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Healthcare Apps in Hospitals and Clinics June 2012

Discover some of the ways healthcare apps from the App Store are transforming the healthcare industry. Clinical reference apps turn your iPad into a mobile library and make it easy to earn CME credits. EMR apps can improve workflow and provide access to patient records. View DICOM images away from a workstation, and stay current on radiology advancements with medical imaging apps. Remote monitoring apps keep you updated on patients’ vitals. And innovative personal productivity apps let you make mobile presentations, access your files, and more. Use this guide to learn the many ways healthcare apps on iPad can change the way you work. 1 Overview 2 Clinical Reference Hundreds of apps are available to enhance point-of-care interactions. Make each visit with your patients more meaningful, educational, and productive. 3 Access Your EMR Securely access clinical data from your hospital electronic medical records (EMR) on iPad. Manage patient records and lists, view schedules, and dictate notes on the go. 5 Medical Imaging Apps Discover apps that connect to your PACS server and bring DICOM viewing functionality to your iPad. 7 Monitor Patients Remotely Remote patient monitoring gives you instant access to waveform data right from the patient’s bedside monitors. 9 Personal Productivity Learn how powerful business and productivity apps can help you manage all your professional responsibilities.

iPad in Hospitals and Clinics

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Overview

Transforming healthcare. Healthcare apps from the App Store are changing the way medical professionals work. Doctors can securely access electronic health records for faster decision-making and improved care. Nurses and physicians can use apps at the bedside for better patient interaction and education. And there are apps to make it easy for medical professionals to maintain competence and learn about new and developing areas in medicine. Healthcare apps made for iPad are designed to take advantage of all the breakthrough technology built into iPad. The amazing battery life on iPad provides up to 10 hours of nonstop productivity—enough to last an entire shift, with time to spare.1 The power-efficient A5 chip and innovative features of iOS keep iPad on the job as long as you need it. The Retina display on the new iPad features a 2048-by-1536 resolution, 44 percent greater color saturation, and an astounding 3.1 million pixels. This allows for crisp viewing of text and medical images. And the new iPad supports fast cellular networks, including 4G LTE networks in the U.S. and Canada,2 so you’re always connected to the tasks that need your immediate attention.3 The modalityBODY app for iPad enables physicians to explain complex structures of the anatomy for better patient education.

iPad comes with two cameras—one on the front and one on the back—so you can communicate with hospital staff via FaceTime video calling.4 The intuitive Multi-Touch user interface, incredible display, and instant-on access make iPad the perfect tool for running healthcare apps. Whether you’re at the hospital, in the exam room, in surgery, in transit, or on call, healthcare apps on iPad deliver the time-critical information you need to support your clinical, administrative, and professional needs.

iPad in Hospitals and Clinics

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Clinical Reference

Your mobile medical library. Instead of carrying bulky printed reports and bulletins, or paging through multiple volumes of hardcover journals, use your thin, lightweight iPad as a mobile library. The App Store features a wide range of medical reference apps that transform traditional books into digital media.

The Merck Manual – Professional Edition Look up patient symptoms, diseases, and clinical approaches with this trusted resource. Access content offline for anytime access. Use Heart Pro III as a reference and patient education tool to help explain heart problems and illustrate proposed treatments.

NEJM iPad Edition New England Journal of Medicine enhances your reading experience with rich audio, video, and other multimedia features in an integrated, easy-to-navigate format. JACC iPad Edition Access JACC articles and related content on cardiology news. Review relevant guidelines, slide sets, clinical trial summaries, interviews, and images.

“The iPad has allowed physicians and care providers to fall back into the natural workflow of patient care. The ability to interact with complex healthcare data and display this information in an intuitive way gives our physicians a distinct advantage in the Canadian healthcare system.” – Dale Potter, Senior Vice President and Chief Information Officer

The Ottawa Hospital, Ottawa, Ontario

modalityBODY: Interactive Anatomy and Medical Imaging for iPad Create interactive anatomy image libraries for reference, training, and patient education. Build custom collections or purchase content from leading publishers.

Earn continuing medical education (CME) credits on the go. Need CME credits to maintain your license? Apps for iPad like MedPage Today Mobile let you earn free CME credits from over 30 specialty areas and keep track of your scores and progress. • MedPage Today Mobile: Get groundbreaking medical news, audio and video reports, and free CME/CE post-tests. • Medscape: Get complete medication information with this reference app. Includes a drug interaction checker and treatment guides for diseases and conditions. • The Oncologist HD App: Stay current on cancer treatments and technologies with the latest news, research, and integrated CME courses. With iPad, it’s easy to keep up with your license requirements and take advantage of downtime between patient appointments or after work.

iPad in Hospitals and Clinics

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Access Your EMR

Improve workflow and access patient records from anywhere. iPad gives physicians the ability to securely access and manage clinical records. Carry iPad on your rounds to check clinic schedules, hospital patient lists, medical histories, injury reports, allergies, and notes on the spot. There’s no more sorting through masses of paperwork for the right information, and no need to leave the patient’s side to access a computer, order a treatment, or check on a medication. With iPad and EMR apps, you can accomplish these tasks immediately, wherever you are.

Epic Canto focuses on a physician’s review workflows. Quickly access patient information in the clinic, in the hospital, or on call.

Waiting for that critical lab result? Receive instant updates and check on lab orders right from your iPad. Many EMR providers have incorporated Push Notification into their apps to notify physicians when lab orders are ready. iPad and EMR apps make it easy to find answers, provide timely patient advice, and keep patient records current. Instantly check medication dosages and side effects, see the status of prescription orders, and add notes to health records, even when you’re away from work.

Securely access patient records. With apps from Epic, Cerner, Allscripts, and other EMR providers, clinical users can securely view and interact with clinic schedules, hospital patient lists, health summaries, test results, and notes. These apps include features that take full advantage of the intuitive iPad interface and Multi-Touch technology to optimize your clinical experience.

“For a busy clinician like me, finding and reviewing patient information on an iPad saves valuable time. iPad instant-on and battery life are stunning, and this has completely changed the way I do my rounds.” – Milisa K. Rizer, M.D., Clinical Director, EMR, Information Technology

Ohio State University Medical Center, Columbus, OH

Epic Canto Access clinical information from your hospital’s Epic Electronic Health Record. Preview patient conditions during rounds, review workflows, and get in-depth reports. Cerner Physician Express Quickly access Cerner EMR to review clinical information and submit orders directly to the EMR for a seamless, integrated experience. Allscripts Wand Connect with Allscripts Enterprise EHR to get real-time patient summary information, prescribe drugs electronically, and verify lab results.

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Turn to FaceTime for a second opinion. FaceTime lets you quickly bring in a second opinion on a case—even if the colleague you’re consulting with is miles away.4 Each FaceTime session is encrypted end to end with unique session keys. Use FaceTime on the new iPad or iPad 2 to discuss a case with a nurse or physician in another location. Use the second camera to show a patient wound or rash and get additional input. FaceTime on the new iPad or iPad 2 opens up the possibility of telemedicine, allowing physicians and patients to hold video consultations.

Transmit prescriptions instantly and accurately. Many handwritten paper prescription orders are illegible or are missing information. A recent pediatric unit study revealed that drug prescription and administration error rates decrease significantly with computerized prescriptions.* E-prescribing makes errors and illegibility a thing of the past. For hospitals that haven’t migrated completely to electronic health records, numerous apps can help with the transition to e-prescribing. Apps like Micromedex Drug Information and PEPID for iPad provide comprehensive information such as drug interactions and adverse effects, on thousands of generic and over-the-counter drugs, which you can even view offline.

Micromedex Drug Information Instantly access drug information such as dosage, therapeutic class, generic names, precautions, and contraindications.

“I use iPad clinically for keeping up to date with my patients in the hospital. I no longer need to find a desktop computer or lug around a laptop.  The information is with me on my iPad. In addition, I can review lab findings at the bedside with a patient and/or family.” – Mark J. Fleschler, M.D., F.A.C.P.

Texas Health Resources, Arlington, TX

PEPID for iPad Get comprehensive tools, including dosing calculators, a drug interaction checker, and a database that includes 7500 drugs and more than 800 illustrations.

When you’re ready to write a prescription, use an app like Allscripts ePrescribe to order and transmit prescriptions directly from your iPad to the appropriate pharmacy.

Allscripts ePrescribe Automatically integrate with the Allscripts ePrescribe desktop version. Prescribe multiple medications or prescribe from patient history.

iPad also makes prescription pickups and refills simpler for your patients. The Walgreens app uses GPS positioning to show the nearest store and even lets patients use the iPad camera to order refills in seconds.

Walgreens for iPad Get prescriptions refilled quickly and conveniently. Just scan the barcode on your prescription bottle using the iPad camera to instantly order refills.

Whether you need to review medical records, update your notes, consult with colleagues, check drug information, or order prescriptions, iPad makes it easier to give your patients the answers, resources, and point-of-care attention they require— even when you’re away from the clinic. *Source: U.S. National Library of Medicine. National Institute of Health. PMID: 12840964.

iPad in Hospitals and Clinics

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Medical Imaging Apps

Mobile radiology is now a reality. Diagnostic medical imaging has undergone nothing short of a revolution. Dramatic breakthroughs in higher-resolution CT, MRI, ultrasound, and interventional technologies have enabled healthcare providers to deliver more informed diagnoses, pursue more effective treatments, collaborate more easily with colleagues, and communicate more clearly with patients. But along with these advances have come some challenges. The healthcare industry’s reliance on imaging may have intensified, but so has the pressure on hospital systems to accomplish more with fewer resources. Apps available for iPad enable wireless transmission from your hospital PACS system to radiologists and other clinicians that need access to medical images. iPad is not intended to replace an imaging workstation, but it does remove the technology barrier of accessing a complicated DICOM workstation for a nonradiologist. There’s no need to view patients’ images on a workstation or a bulky PC. With medical imaging apps on iPad, you can accomplish these tasks immediately wherever you are. Waiting for that critical scan to complete? Receive updates and check on imaging studies right from your iPad by leveraging Apple Push Notification, and instantly inform radiologists and other clinicians when studies are ready for review.

Securely view DICOM images. “To be able to view 2D and 3D volumes using the Siemens syngo.via WebViewer app on an iPad while I’m away from a workstation saves a lot of time. And to be able to show my patients their scans is invaluable.” – Dr. Elliot Fishman, Professor of Radiology, Surgery, and Oncology; Director, Diagnostic Imaging and Body CT

Johns Hopkins Hospital, Baltimore, MD

Imagine you’re at lunch, commuting on a train, at another site, on vacation—really anywhere—and you need to review an urgent case. You can use a variety of apps on iPad to view images from a PACS server anywhere you have a Wi-Fi signal or access to a mobile network.3 Imaging apps on iPad can simplify workflows and save time. For example, a technologist might run a scan and check to see if it meets the radiologist’s requirements while the patient is still being scanned. Even if you’re away from your desk, imaging apps on iPad allow you to view the study and advise the technologist on the spot—saving an additional round of scans for you, the technologist, and the patient. Apps like Mobile MIM provide secure, wireless access to medical images. Radiologists, radiation oncologists, and other clinicians can use Mobile MIM on iPad to read CT, PET, MRI, SPECT, ultrasound, X-Ray, and radiation therapy plans. The Siemens syngo.via WebViewer app makes 3D volume rendering on iPad a reality, enabling surgeons to interactively view 3D volumetric imaging data.

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You can choose from a number of iPad imaging apps available in the App Store.

“I use iPad in the operating room to view the complex anatomy of the patient’s organs as 3D models. The Multi-Touch functionality is unaffected by the latex surgical gloves or by the sterile bag which completely covers the iPad, thus meeting all infection control protocols.” – Maki Sugimoto M.D., PhD, Surgeon & Associate Professor of Gastroenterology

Kobe University Graduate School of Medicine, Japan

Mobile MIM View encrypted MRI, SPECT, PET, and CT images transmitted via MIMcloud or a MIM workstation when you don’t have access to a DICOM system. Siemens syngo®.via WebViewer Get secure access to patients’ 2D and 3D DICOM images on iPad. Requires the syngo.via solution from Siemens AG, Healthcare.* Centricity Radiology Mobile Access Improve efficiency with remote access to data from GE Centricity PACS. Review reports or 2D, 3D, and MIP/MPR images in patient rooms, the ICU, OR, or ED. Aquarius Mobile View advanced 3D visualization imaging based on the client/server architecture of Aquarius iNtuition system.* eFilm Mobile HD Connect to any PACS with this companion app to eFilm Workstation. Examine images in detail with tools such as window level, stack, zoom, and pan.* OsiriX HD Transfer images from DICOM-compatible software through standard DICOM protocols with this interactive visualization app for display and analysis of medical images.*

Stay current with radiology educational and reference apps. Radiology residents and physicians can polish their skills by reviewing interesting cases and advances in medical imaging. Educational apps for medical imaging help you test your skills to come up with a diagnosis, and they keep you current on continuing medical education requirements.

CARDIO3® Comprehensive Atlas of Echocardiography [HD] Find detailed answers with this reference and learning tool for cardiologists, cardiac surgeons, internists, and sonographers evaluating echocardiograms. CTisus iQuiz: The HD Edition Study new cases and clinical histories each month with images and multiplechoice questions. Review by area of interest, such as colon, kidney, or pancreas. Radiopaedia Vol 6: Head and Neck Radiology Teaching File HD Expand radiology knowledge with this free resource written by and for the radiology community. Use teaching files for board exam preparation and more.

* This app is not intended for diagnostic use.

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Monitor Patients Remotely

Monitor your patients anywhere. With patient monitoring apps on iPad, physicians now have immediate access to detailed data wherever they are, giving them expanded resources to help treat patients and make crucial healthcare decisions when time is of the essence. Cardiovascular disease (CVD) is responsible for 17 percent of national health expenditures. Between 2010 and 2030, total direct medical costs of CVD are projected to triple from $273 billion to $818 billion. Over the same time period, real indirect costs (due to lost productivity) for CVD are expected to increase by 61 percent, to $276 billion.* Improvements of even half of one percent in cardiovascular disease diagnosis and timely treatment would have a huge impact on national spending for CVD, and would save nearly $1.4 billion annually.

AirStrip – Patient Monitoring pulls information from hundreds of different types of patient monitors and ECG machines, as well as a variety of other clinical information coming from your facility’s EMR to your iPad.

Each year, about 1.2 million people in the United States have heart attacks. Primary coronary intervention (PCI) for acute myocardial infarction should be performed as quickly as possible, with a door-to-balloon time of less than 90 minutes. Paramedics typically obtain a 12-lead electrocardiogram (ECG) in the ambulance for patients with symptoms compatible with myocardial infarction. When they’re in doubt about the diagnosis, they consult the Critical Care Unit (CCU) cardiologist by sending a fax of the EKG. If ST-elevation myocardial infarction (STEMI) is confirmed by the physician, the CCU informs the catheterization laboratory staff that a STEMI patient will be arriving. Using an iPad app that displays clear 12-lead ECG information instead of waiting for a blurry paper fax allows CCU physicians to make faster, more accurate decisions on cardiac treatment. Thanks to these remote monitoring apps on iPad, the paradigm of primary coronary intervention for STEMI patients has changed forever. Apps like AirStrip – Cardiology and the LIFENET System give emergency departments and cardiology teams a clear view of ECGs on the spot. These apps are especially valuable when transporting patients with acute myocardial infarction or STEMI. With apps such as AirStrip – Cardiology, AirStrip – Patient Monitoring, and AirStrip OB, caregivers can view critical clinical data on iPad—including second-by-second patient monitoring information—to keep a constant watch on at-risk patients, from initial emergency response all the way through treatment in the hospital.

* Source: Heidenreich PA, Trogdon JG, Khavjou OA, Butler J, Dracup K, Ezekowitz MD, Finkelstein EA, Hong Y, Johnston SC, Khera A, Lloyd-Jones DM, Nelson SA, Nichol G, Orenstein D, Wilson PWF, Woo YJ; on behalf of the American Heart Association Advocacy Coordinating Committee, Stroke Council, Council on Cardiovascular Radiology and Intervention, Council on Clinical Cardiology, Council on Epidemiology and Prevention, Council on Arteriosclerosis, Thrombosis and Vascular Biology, Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation, Council on Cardiovascular Nursing, Council on the Kidney in Cardiovascular Disease, Council on Cardiovascular Surgery and Anesthesia, and Interdisciplinary Council on Quality of Care and Outcomes Research. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation. 2011;123.

iPad in Hospitals and Clinics

“AirStrip – Cardiology for the iPad is more advanced than anything else like it available today, and pushes the path toward a day when all clinical hospital information will be available on mobile devices.” – Darren Dworkin, CIO

Cedars-Sinai Medical Center, Los Angeles, CA

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When a patient is in the hospital, caregivers can use AirStrip – Cardiology on iPad to connect with the GE Healthcare MUSE Cardiology Information System. This enables a continuous flow of ECG data and interactive historical data access, helping mobile clinicians make more informed care decisions. Unlike traditional remote diagnostics images sent over fax or as a PDF, zooming in on waveforms in AirStrip – Cardiology on iPad doesn’t degrade visual clarity. Clinicians can view 10-second increments of current data and compare it with historical tests that were conducted up to one year earlier. Using AirStrip – Cardiology on iPad for early evaluation and triage of STEMI patients can shorten door-to-balloon time, reduce infarct size, limit ejection fraction reduction, decrease length of stay, and reduce overall hospital costs.

AirStrip – Cardiology Analyze ECG data remotely, with four times as much data as previously available. Use the interactive tools to help you review and compare ECGs on iPad.

The AirStrip – Patient Monitoring app for iPad connects you with your patients anywhere you have a cellular3 or Wi-Fi connection. No matter where you are, this remote monitoring app can greatly reduce and even eliminate delays in the clinical assessment and treatment of patients. As a clinician, you can log in securely to your facility straight from the app and view live, streaming patient data on iPad from virtually anywhere. AirStrip – Patient Monitoring pulls information from hundreds of different types of patient monitors and ECG machines, as well a variety of other clinical information from your facility’s EMR.

AirStrip – Patient Monitoring Check on your patients and review their vitals, cardiac waveforms, labs, medications, intakes and outputs, and allergies—all within seconds of when they were recorded.

Obstetrics and perinatal care have long been associated with a high level of risk and liability. Poor communication between physicians and nurses regarding the fetal strip is a significant patient safety issue. AirStrip OB solves the communication problem by providing virtual real-time, remote fetal strip access to the physician via iPhone or iPad.

“Remote monitoring with AirStrip OB allows us to further protect our tiniest—and one of our most vulnerable—patient populations and their moms.” – John Allbert, M.D., OBGYN

Presbyterian Hospital, Charlotte, NC

AirStrip OB Securely log in to your hospital’s labor and delivery unit and see real-time nursing notes, vital signs, labor status, and maternal and fetal strips.

iPad apps for remote patient monitoring include waveform views and other critical data from EMRs, bedside monitors, and devices; medication and pharmacy information; and other important clinical details. With apps like AirStrip – Patient Monitoring and AirStrip OB, physicians and nurses always have secure, native access to essential patient data, regardless of their physical location.

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Personal Productivity

Showcase your presentation. Whether you’re participating in the next Grand Rounds or sharing information with a small group of colleagues, iPad makes it easy to give stellar presentations.

For larger audiences, simply connect your iPad to an external display, projector, or HDTV using the Apple Digital AV Adapter or Apple VGA Adapter (sold separately). With Keynote, you can view speaker notes and control the Keynote presentation with your iPad, while your audience sees your slides on the large screen.

Keynote for iPad is a powerful, affordable app that lets you quickly design and edit world-class presentations by simply touching and tapping. Photos, charts, tables, and themes are only a tap away. With the Keynote app you can create and deliver professional-looking presentations right on your iPad—even if the file was originally created in Microsoft PowerPoint on a PC.

Keynote Open, edit, and present Keynote and PowerPoint presentations on iPad. Use templates, transitions, and graphics to create stunning presentations.

Access any document. In addition to supporting your clinical duties, iPad allows you to work with Microsoft Office files anywhere. View and update Word and Excel documents using the Pages and Numbers apps, respectively. And view virtually any email attachment from your inbox on iPad, without additional apps—simply tap the file icon for a quick look. Pages Write, edit, and format professional-looking documents on iPad. Import Word and text files, and share your documents as Word, Pages ’09, or PDF files. Numbers Manage data and perform calculations on iPad with this powerful spreadsheet app. Import Excel files and email as Numbers ’09, Excel, or PDF files. Quickoffice Pro HD View, edit, and email business documents. Includes Quickword for Word docs and Quicksheet for Excel spreadsheets. SharePlus: SharePoint Mobile Client Access and manage your SharePoint documents wherever you go, and sync them back to the SharePoint server via Wi-Fi or or a mobile network.3

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More in healthcare. iPad offers countless ways to help you deliver better patient care. Access vital business tools, search the most up-to-date medical reference materials, and keep track of your clinical activities faster and more accurately than ever. The App Store features thousands of professional-grade apps for healthcare providers. Discover even more apps in these categories: • Medical • Healthcare & Fitness • Business • Productivity Check out Top Charts in the App Store for highly rated free and paid apps, and find other helpful apps listed under “New and Noteworthy” and “What’s Hot.” Search by keyword for your medical specialty or topic, then check out the ratings to hear what your colleagues are saying.

Deploy apps to your healthcare providers. Buy apps in volume. Easily find, buy, and distribute the apps your physicians need. www.apple.com/business/vpp Buy custom B2B apps. Purchase custom B2B apps built by third-party developers to meet the unique needs of your physicians. www.apple.com/business/vpp Build in-house apps. Build breakthrough apps that access your EMR, consolidate disparate clinical systems, and provide timely lab results to physicians using iPad. http://developer.apple.com/programs/ios/enterprise

Learn more. iPad Apps for Business Discover more apps for every business. www.apple.com/ipad/business/apps Discover Apps for Healthcare Professionals. Find more great healthcare apps in the App Store. www.itunes.com/healthcareprofessionalsipadapps

iPad in Business Profiles See how iPad is changing the way businesses work. www.apple.com/ipad/business/profiles

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life varies by use and configuration. See www.apple.com/batteries for more information. 24G LTE is supported only on AT&T and Verizon networks in the U.S., and on Bell, Rogers, and Telus networks in Canada. Data plans sold separately. See your carrier for details. 3Requires iPad with cellular capability and data plan (sold separately). 4Requires a FaceTime-enabled Mac with an Internet connection or a FaceTime-enabled iOS device with a Wi-Fi connection. Not available in all areas. © 2012 Apple Inc. All rights reserved. Apple, the Apple logo, FaceTime, iPad, iPhone, iTunes, Keynote, Mac, Numbers, and Pages are trademarks of Apple Inc., registered in the U.S. and other countries. Multi-Touch is a trademark of Apple Inc. iTunes Store is a service mark of Apple Inc., registered in the U.S. and other countries. App Store is a service mark of Apple Inc. Other product and company names mentioned herein may be trademarks of their respective companies. Product specifications are subject to change without notice. This material is provided for information purposes only; Apple assumes no liability related to its use.