Ingenious Medical Imaging

While sitting in the doctors lounge at Advocate Illinois Masonic Medical Center, I noticed that an ENT physician Dr. T. K. Venkatesan had a new Apple iPhone 4. I have an older model the 3g and was curious what new app he was using. He was emailing a photo of a patient's surgery to his practice partner Dr. Michael Friedman to get his input on the case. The photo was of extremely high resolution and the display on the iPhone 4 was very sharp and bright. T. K. was able to show me extreme detail in the surgical site by zooming in on the image. Dr. Friedman did not need to be in the room and could view the same image on his own iPhone and give immediate feedback or take a look at the image later on his home or office computer. This technology can help physicians collaborate on difficult cases. The physicians need not be in the same room or the same hospital or even in the same country. I use my iPhone for tracking patients and looking up drug interactions and clinical data. It also is a great tool for communication. I had limited the communication use mostly of text and emails with my nurses and patients. I felt the camera was not a very useful addition to a cell phone. I now can see that I was mistaken. The high resolution cameras and displays on the newer cell phones open a new way of exchanging clinical information now in living color.

Click Here to view an image of a patient who had a nasal tumor resection and was undergoing a reconstructive flap procedure. Use the back button on your browser to return to the blog. WARNING this is a graphic medical image.

I came across another example of high resolution imaging also in the same doctors lounge.

Dr. Frank DiMaria a wound care specialist uses an inexpensive

point and shoot digital camera to document his work in healing complex wounds. We were able to discuss a mutual patient by looking at images stored on his thumb drive on one of the PCs in the doctors lounge. While not as sexy as the iPhone it is quite an effective use of imaging technology which is of low cost and high quality.

Click Here to view an image of an pressure ulcer in various stages of healing. Use your browser's back button to return to the blog. WARNING this is a graphic medical image.

In wound care and otolaryngology, a picture is worth a thousand words. I could see this technology being useful in other specialties like dermatology to view skin lesions or even cardiology to look at ECGs. Let me know if you have come across any other other examples of Ingenious Medical Imaging.

Versions Eleven

The original purpose of the blog was to blog about my practice's conversion to a full electronic health record (EHR). I have been a big proponent of the EHR for many years but until this point it has been financially unfeasible to take the plunge. Enter HITECH new legislation which will provide cash incentives for physician practices to convert to an EHR. Our office was to go electronic this year (hence the blog) but ironically the conversion has been put on hold as the current version of the EHR doesn't meet the meaningful use requirements to obtain the incentive payout. A new version "Eleven" will be out next year. So rather than convert to version ten then have to reconvert to eleven it makes sense to wait.

The stimulus package passed by Congress caused us to wait another year for an EMR. I guess in the long run we will have more doctors using an EMR but in the short run still waiting.

Stay tuned fans of medicine and tech. Until we "go live", I will blog about trends and historical musings related to technology and medical informatics.

The Wired Doc Ten Years After

I became the Wired Doc in 2000 at the height of the dot com bubble. Armed with a Newton Message Pad 2000 I was writing about using hand held computers in patient care and the possibility of a hand held electronic prescription pad. That dream has come true with an iphone and my trusty Lenovo X61 tablet and Allscripts Eprescribe. Now ten years and two stock market crashes later my practice is weeks away from installing it's first electronic medical record. I have decided to blog about the experience of it's installation and hopefully it's "meaningful use". Wish me luck.