Mobile app development: A new frontier

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 - Mobile medical apps and radiology

Mobile apps are playing an increasingly significant role in all industries and markets—and healthcare is no exception. Hospitals, freestanding facilities, and even some private practitioners are building and leveraging a wide range of these apps, from clinical decision support and case management options to those designed for such tasks as patient registration.

George Shih, MD, MSEE is associate professor and vice chairman, informatics, at Weill Cornell Medical College, New York City, N.Y. Addressing viewers of “Mobile Development of Consumer and Enterprise Apps in Healthcare,” a recent webinar sponsored by the Society for Imaging Informatics in Medicine (SIIM), Shih noted that while the healthcare segment may have been slow to adapt to the apps world at the outset, a desire among constituents to improve clinician education, patient care, workflows and operations has spurred development and deployment on the enterprise and consumer app fronts alike.

More widespread availability of app configuration and management tools is pushing the envelope as well, according to webinar presenters Charles T. Lau, MD, MBA, a cardiothoracic radiologist with the VA Palo Alto Health Care System in Palo Alto, Calif., and Ahmed H. El-Sherief, MD, a thoracic radiologist at West Los Angeles VA Medical Center, Los Angeles.

According to Shih, enterprise mobile apps—apps intended for mass distribution and internal use across an institution—can be created and distributed using a variety of development tools and programs. Apple’s iOS Developer Enterprise Program, which has been leveraged at Weill Cornell, falls into this category. The program is open only to entities with a Dun & Bradstreet (or D-U-N-S) number, at a fee of $299 per year. Program components encompass an iOS software developer kit, tools for testing apps on iOS devices, code-level technical support and ad-hoc distribution.

The BYOD connection

No matter their content, enterprise apps are delivered using enterprise mobile app deployment models—“bring your own device” (BYOD) and shared device. In a BYOD scenario, apps and other content, such as e-books, are downloaded on end-users’ personal smartphones or tablets. In a “shared device” model, multiple individuals utilize the same non-personal device, such as an iPad, to access a specific app. An iPad app used by patients to register at an outpatient-imaging site constitutes a good example of the latter, Shih said.

Weill-Cornell has had success with Apple Configurator, a tool designed to allow entities, including healthcare institutions, to mass-configure and deploy iPhone, iPad, and iPod Touch devices via a shared model. The tool includes workflows for preparing, supervising, and assigning devices.

  • In addition to configuring multiple devices at the same time and updating devices to the latest version of iOS, the preparation workflow allows users to create and restore backups of settings and app data from one device to another device or devices, import apps into Apple Configurator and sync them to new devices, produce and install iOS configuration profiles with a built-in editor and enroll devices for remote management through a mobile device management (MDM) solution.
  • The supervision workflow paves the way for organizing supervised devices into custom groups, automatically apply configurations to supervised devices (and re-apply them once a previous user’s data has been removed), import apps into Apple Configurator and sync them to supervised devices, define and apply common or sequential names to all devices and restrict supervised devices from syncing with other computers.
  • The assignment workflow makes it possible to add users manually or auto-populate via Open Directory or Active Directory, perform check-in and check-out of devices to individual users, import and export documents between Mac computers and Apple Configurator, and more.

“One of the most important things that must be done with a shared model is to (harness) MDM to enforce a single-app mode, which means locking devices so they cannot be used for something other than their intended purpose,” Shih advised.  Again citing the example of a patient registration app deployed at an outpatient-imaging center, he explained that single-app mode enforced through MDM would prevent patients (or employees) from downloading any other app for use on the iPad.

MDM software is equally valuable in the BYOD realm; such solutions permit administrators to revoke or re-assign apps as needed,