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Posted on Mar 1, 2012 in Articles, Editorial | 0 comments

The Evolution of E-Health – Mobile Technology and mHealth

 
 


Dr Chandrashan Perera MBBS1,2
1Editor-In-Chief, Journal of Mobile Technology in Medicine, 2Austin Hospital, Melbourne, Australia
Corresponding Author: editor@journalmtm.com
Journal MTM 1:1:1-2, 2012
http://dx.doi.org/10.7309/jmtm.1


Medicine has always been an information intensive field from the first days of practice, when pearls of wisdom were passed along the generations as word of mouth. Throughout history, informatics has been an integral part of medicine, facilitating the storage and accession of vast amounts of data. This has come to the culmination of present day medical practice, which is built on the foundations of Electronic-Health (E-Health). New information is rapidly disseminated through electronic access to medical journals and other relevant sources of information. Patient data is increasingly stored electronically, and reference information including textbooks are stored electronically in websites.  The E-Health revolution digitized the world, and medicine has benefited immensely. Whilst having this information available electronically has numerous benefits, the delivery of this information to medical staff has been less than ideal, requiring doctors to be tied down to devices such as immobile desktop computers. The next stage in digital informatics is to gain rapid access in both storing and creating material in a convenient manner; and smartphones have been an instrumental tool in this evolution.

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Posted on Mar 1, 2012 in Articles, Editorial | 0 comments

The Need for an Evidence-Base in Mobile Technology in Medicine

 
 


Dr Rahul Chakrabarti MBBS1,2
1`Editor-In-Chief, Journal of Mobile Technology in Medicine, 2Royal Eye & Ear Hospital, Australia
Corresponding Author: rahul@journalmtm.com
Journal MTM 1:1:3-4, 2012
http://dx.doi.org/10.7309/jmtm.2


Modern medical practice is undergoing a transformation in the way it communicates and provides healthcare. The evolution in medicine has been advanced by the human desire to provide and receive a high standard of affordable medical care within an appropriate time. A significant contribution to this has been facilitated by advances in modern technology and telemedicine. Whilst a tsunami of easily accessible technology has engaged the attention of the medical community and improved access to medical care, particularly in remote areas, there is always an element of concern regarding safety, reliability, reproducibility and accuracy of telemedicine methods.

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Posted on Mar 1, 2012 in Articles, Editorial | 1 comment

The (Ultra)sound of Things to Come

 


Dr Carlos Cabalag MBBS1,2
1Editor, Journal of Mobile Technology in Medicine, 2Monash Medical Centre, Melbourne, Australia
Corresponding Author: carlos@journalmtm.com
Journal MTM 1:1:5-7, 2012
http://dx.doi.org/10.7309/jmtm.3


The use of mobile technology in medicine is not limited to the tablet computer or the use of the ever-popular Apple® iPhone.  As semi-conductors become smaller, various devices are being redeveloped and transformed into portable miniature versions of their old previously large and cumbersome counterparts. In particular, we have seen the advancement and miniaturisation of piezoelectric transducers in the recent decade, leading to the development of portable ultrasound machines that can be utilised virtually anywhere and in settings of dire need.  The most tragic and recent of those events was the Haitian earthquake in 2010, where 230,000 people lost their lives with many more injured in a background of crucial infrastructural destruction that was seemingly endless to the naked eye.1RCA. Haiti Earthquake Appeal, 2010. http://www.redcross.org.au/haiti-earthquake-appeal-2010.aspx: Red Cross Australia, 2010.  Notably, one of the devices that had shaped the humanitarian effort to save lives, was (and still is) the humble portable ultrasound. (Refer to Figure 1).  Are clinicians ready for the next diagnostic tool, some branding it as the next ‘pocket stethoscope’?

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Posted on Mar 1, 2012 in Articles, Original Article | 0 comments

The Reliability of Mobile Multimedia Messaging (MMS) for Decision Making in Distal Radius Fractures: An Effective Alternative


Dr Gayan Padmasekara MBBS1, Dr Navid Nazarian MBBS1, Dr Christopher Wall MBBS1
1Department of Orthopaedics, Southern Health, Melbourne, Australia
Corresponding Author: gayan@padmasekara.com
Journal MTM 1:1:8-12, 2012
http://dx.doi.org/10.7309/jmtm.4


Background: Assessment of radiology is an integral part of fracture management in orthopaedic surgery.  Mobile multimedia messaging (MMS) can be utilised in the referral process of patients with fractures.  However, the reliability of using MMS in making management decisions in distal radius fractures has not been assessed.

Methods:Radiographs of 20 consecutive cases of distal radius fractures managed with closed reduction and plaster, and 20 cases managed with open reduction and internal fixation (ORIF) were analysed retrospectively by two blinded orthopaedic surgeons on a computer and anApple iPhone 3GS.  The inter- and intra-rater agreements were assessed.

Results: Inter-rater agreement between the MMS group and the picture archiving and communication system (PACS) group were consistent among the surgeons (K -0.55, 0.80, p<0.001).  However, the management decisions were different in seven cases (8.75%) in the study group.

Conclusion: MMS x-ray pictures can be useful in formulating management plans for patients with distal radius fractures.  With advancing technology smartphones will likely play a larger role in the communication process in delivering orthopaedic care.

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Posted on Mar 1, 2012 in Articles, Original Article | 0 comments

Orthopaedic Surgical Technique Guides: Are They Readily Available in an Electronic Format?


Dr Navid Nazarian MBBS1, Dr Christopher J Wall MBBS 1, Dr Gayan Padmasekara MBBS 1
1Department of Orthopaedics, Southern Health, Melbourne, Australia
Corresponding Author: nanazarian@yahoo.com
Journal MTM 1:1:13-15, 2012
http://dx.doi.org/10.7309/jmtm.5


Background: New developments in mobile technology have had a profound effect on medical care worldwide.1 In orthopaedic surgery a variety of implants and devices are used, and knowledge about their designs, specific features and surgical techniques is essential. The purpose of this study was to assess whether orthopaedic surgical technique guides are readily available in an electronic format.

Methods: A list of thirty-two orthopaedic device companies currently trading in Australia was generated through a structured internet search and by reviewing a tertiary hospital database. The Apple store was searched for iPhone or iPad surgical technique applications for each company. Company websites were searched for downloadable surgical technique guides. Companies without downloadable surgical technique guides or iPhone applications were contacted via email or telephone to ask whether such products were in development.

Results: Of the thirty-two orthopaedic device companies studied, twenty-two (68.8%) had surgical technique guides available for download on their websites. Four (12.5%) companies had an iPhone or iPad application available in the Apple store.

Conclusion: Although many orthopaedic device companies have downloadable surgical technique guides on their websites, only a few had iPhone or iPad applications for their products. Further development of such products may be beneficial for orthopaedic surgeons.

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Posted on Mar 1, 2012 in Articles, Original Article | 0 comments

Use of a Smartphone for Monitoring Dermatological Lesions Compared to Clinical Photography


Dr R Asaid MBBS1, Dr G Boyce MBBS2, Dr G Padmasekara MBBS2
1Royal Melbourne Hospital, Melbourne Australia, 2Southern Health, Melbourne, Australia
Corresponding Author: raf.asaid@yahoo.com.au
Journal MTM 1:1:16-18 201
http://dx.doi.org/10.7309/jmtm.6


Background: To compare the use of a personal device such as an Apple iPhone 4 against formal clinical photography in monitoring skin lesions.

Methods: Clinical photography was used to photograph 10 skin lesions and these images were compared to photographs taken by an iPhone. These images were then reviewed by 5 different dermatologists to determine whether a discernible difference in image quality was apparent, and if sufficient detail was present to use the images taken from the iPhone in the clinical setting.

Results: All 5 dermatologists correctly identified all 10 skin lesions taken by clinical photography and those which were taken by the iPhone.  Forty seven of the 50 dermatologist responses indicated both photographs provided enough detail to be clinically useful, although only 9 of the 50 responses indicated the same detail was seen in both images.

Conclusion: Although the quality of images produced using clinical photography is superior to those produced by the iPhone, pictures taken by an iPhone may provide sufficient detail for clinical assessment of skin lesions.

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Posted on Mar 1, 2012 in Articles, Original Article | 0 comments

Qualitative Study on the Applications of Smartphones in Medical Research


L Abeynaike BSc1
1Centre for Inflammatory Diseases, Department of Medicine, Monash University, Melbourne, Australia.
Corresponding author: latasha.abeynaike@monash.edu
Journal MTM 1:1:19-23, 201
http://dx.doi.org/10.7309/jmtm.7


Background: Mobile technology advancements have bought many benefits to professionals across all industries, particularly an increase in productivity. There is a paucity of information regarding the use of smartphone applications in medical research, particularly within the laboratory has not been examined.

Method: We performed a qualitative study on the use of smartphones in the laboratory. Medical researchers were surveyed regarding use of their smartphones in the laboratory, as well as the use of apps, or “applications”. We also performed analysis on available applications and current standing of smartphone integration with laboratory equipment.

Results: Survey responses indicated researchers to be more productive as a result of owning smartphones, however most did not utilise applications, and none utilised field-specific applications in the laboratory. Several issues preventing researchers from using their smartphones and applications in the laboratory were identified. These included occupational health and safety reasons, security, potential for distraction, absence of wireless connectivity, and a lack of awareness. Analysis of iPhone applications demonstrated availability of a range of reference and functional applications performing essential laboratory tasks.

Conclusion: This study demonstrates that smartphones are currently not used to their full potential within the laboratory, and there are hurdles to overcome before wider use in the field of medical research. However as time and technology progresses further, and with increasing integration of smartphone technology with current laboratory equipment, researchers will embrace the smartphone as a cost-effective and timesaving device.

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Posted on Mar 1, 2012 in Articles, Case report | 0 comments

Use of a Tablet to Enhance Standardisation Procedures in a Randomised Trial


Dr Melissa Parker, MD, MSc1,2
1Paediatric Critical Care Medicine and Paediatric Emergency Medicine, McMaster Children’s Hospital, Ontario, Canada, 2Department of Paediatrics, McMaster University, Ontario, Canada
Corresponding Author: parkermj@mcmaster.ca
Journal MTM 1:1:24-26, 2012
http://dx.doi.org/10.7309/jmtm.8


Case Report
Standardised operational procedures are important in randomised controlled trials as these help to minimize unwanted sources of variability.  Standardisation procedures may be used to orient and train participants as well as research staff with respect to study protocols.  In interventional trials involving task performance, use of a standardisation procedure helps ensure that participants have an adequate understanding of the intervention and are able to perform this correctly and consistently prior to formal assessment. This report describes the use of a video displayed on a tablet device to enhance the standardisation procedures of a recently conducted randomised controlled trial. Participants received uniform exposure to instructions. The process was successful and was found to be acceptable.

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