Prime Time for iPadOr Not?

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Rodrigo Ayala, RT (R) (CT), imaging technologist in the Imaging Data Evaluation and Analytics Lab at Weill Cornell Medical College, views an abdominal CT on an iPad.

Launched in April, the iPad continues to make waves across the world. Technophiles, teenagers and grandmas alike love the iPad, which has been touted as the tool to mobilize business users. Apple has sold about 8 million, with many physicians among those who have been bitten by the iPad bug.

In a February survey by Epocrates, 20 percent of U.S. physicians planned to buy an iPad. A larger group, however, remained somewhat cautious; 38 percent of physicians expressed interest in the iPad, but wanted more information to solidify their purchase decision.

At first glance, radiology seems to be a logical target for the iPad. Radiologists are, after all, a notoriously techno-savvy, gadget-happy group. And the iPad’s form factor is appealing. At 1.5 pounds with 10 hours of battery life, it’s a powerhouse in a featherweight package.  

Some physicians are utilizing Citrix to run healthcare apps supporting  HIPAA requirements by not storing data on the device and by using secure remote connections, while others are using a WYSE Cloud app that uses the iPad as a portal. A more secure iPad version (iOS 4.2) is expected to be available in a couple of months.

The 1024 x 768 resolution suffices for CT image browsing. Prime-time television ads even plug medical imaging apps (albeit, somewhat misleadingly, as its resolution does not suffice for primary diagnostic x-ray review).

So Health Imaging & IT, along with radiologists everywhere, are asking: Is the iPad ready for prime time? Early data suggest a cautious approach with patient education and consultation apps more viable than diagnostic image review.

The research realm

“There are several ways iPad can impact our work in radiology,” says Kamran Shah, a radiology resident and informatics fellow at the University of Maryland in College Park, who is presenting at RSNA 2010 on the subject. While the iPad’s small display and technology couldn’t suffice as a diagnostic workstation, he notes, it could provide a portable viewing application for clinical staff. “As a portable viewing device, iPad could have value if you envision a thin client powered on the iPad that could interface with an existing PACS and allow a surgery resident to review a CT of the abdomen before surgery.”

“I don’t see myself using the iPad for primary diagnosis; I still see myself sitting at a workstation with a proper monitor and in a proper environment, but there are roles for the iPad in radiology,” says Krishna Juluru, assistant professor, department of radiology, co-director of the Imaging Data and Evaluation and Analytics Lab at Weill Cornell Medical College in New York City. Juluru and colleagues have experimented with thin client tools on the iPad for visualization of axial images and 3D visualization of radiographic datasets where the 3D post-processing is done on a central server and images are streamed over to iPad.

According to Juluru, iPad’s success in radiology will hinge on the utilization of the multitouch screen for image manipulation. “With a keyboard and mouse, there are a lot of buttons available for a radiologist to manipulate the images. With the preliminary tools with which we were working, there weren’t enough options on the multitouch screen to allow us to manipulate the datasets in a way we felt comfortable with.” However, the technology continues to improve and radiologists are becoming more creative in their approach to the multitouch screen, he says.

Inside an early adopter

As researchers explore applications and utility, early adopters are tiptoeing into the market. Take for example Advanced Radiology Consultants in Trumbull, Conn. The practice uses iPads on a limited basis to assist consultation, collaboration and education. Neuroradiologist Gerald J. Muro, MD, has leveraged the iPad for consultation since July.

“If a referring physician wants to review a case and I’m not in the office, I have access to those images over the internet,” says Muro. “The iPad increases communication and connectivity, so there are fewer delays, and we’re more easily accessible by radiologists and referring physicians.”

As Muro waits for vendors to step up with iPad apps, he anticipates apps that could be used to show patients their images on the iPad, which could increase patient engagement and satisfaction.

The iPad for radiology is a work in progress. Early adopters and researchers are still determining its utility. Although it’s unlikely to replace traditional workstations, the iPad could provide