Use of Mobile Devices for Medical Imaging

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Mobile devices have fundamentally changed personal computing, with many people forgoing the desktop and even laptop computer altogether in favor of a smaller, lighter, and cheaper device with a touch screen. Doctors and patients are beginning to expect medical images to be available on these devices for consultative viewing, if not actual diagnosis. However, this raises serious concerns with regard to the ability of existing mobile devices and networks to quickly and securely move these images. Medical images often come in large sets, which can bog down a network if not conveyed in an intelligent manner, and downloaded data on a mobile device are highly vulnerable to a breach of patient confidentiality should that device become lost or stolen. Some degree of regulation is needed to ensure that the software used to view these images allows all relevant medical information to be visible and manipulated in a clinically acceptable manner. There also needs to be a quality control mechanism to ensure that a device’s display accurately conveys the image content without loss of contrast detail. Furthermore, not all mobile displays are appropriate for all types of images. The smaller displays of smart phones, for example, are not well suited for viewing entire chest radiographs, no matter how small and numerous the pixels of the display may be. All of these factors should be taken into account when deciding where, when, and how to use mobile devices for the display of medical images.

Section snippets

Overview

Mobile devices have become an integral part of life in modern society and have achieved high penetration among health care professionals. By comparison, it is almost laughable what used be called a personal computer. Mobile devices are far more personal insofar as they serve as the primary communication devices for many people and are as important as one’s wallet. They are already used to store and access personal information such as contacts and family photos. In places where devices are used

Bandwidth

Mobile devices can run programs and access data stored locally or on a separate server. Apps and frequently used information are typically stored locally. When seeking additional information, from a website, a server, or the “cloud,” data must be transferred to the device. When a mobile device is plugged into a computer, data can be directly and rapidly transferred through a cable. Universal serial bus 3.0 protocol cables are most commonly used to connect mobile devices to computers. Wireless

Security

Mobile device security falls into several realms. First, there is the task of securing direct access to the device (ie, who gets their hands on it). Next, there is the need to secure access to the device’s memory, either from different application processes or from external hacking. Additionally, there is communication with other devices, typically performed wirelessly through Wi-Fi or cellular networks. Each of these areas is subject to security vulnerabilities, and an appropriate

Regulation

In the United States, the practice of medicine is regulated by state governments, not the federal government. Each state government decides what is considered the standard of care, normative practice, and substandard care and malpractice. Medical devices, on the other hand, are regulated by the FDA. Doctors are at liberty to use both medical and nonmedical devices to practice medicine and treat patients. For example, a stethoscope is a regulated medical device, but a general purpose magnifying

Apps

Mobile apps for radiology can be categorized into one of the following: image viewing, education, decision support, and journals and societies.

Image viewing apps allow referring physicians to access imaging studies anywhere. Although many of these applications are self-described as “not for diagnostic use,” the FDA and Health Canada have cleared a number of iOS applications, such as MobileMIM, for diagnostic reading when no dedicated workstation is available. These applications typically

Image Types

To understand the appropriateness of using mobile devices to view radiologic images, it is worthwhile to review the varieties of radiologic images and their relevant digital image display parameters.

Radiographs are typically the largest images radiologists view in terms of the number of pixels. A full-resolution image ranges from 4 to 12 megapixels (MP), and 1 MP accounts for 1 million pixels. Furthermore, to properly assess such an image usually requires a view somewhat close to life sized.

Summary

Mobile devices are here to stay and are already in the pockets and handbags of most physicians, radiologists, referring clinicians, and patients. Radiologists need to consider a mobile strategy that not only enables viewing images for diagnosis on a consultative basis but also enriches referring clinicians’ electronic medical record experience and the personal health records of the patients they serve. Solutions abound from both PACS and electronic medical record vendors, but careful product

Take-Home Points

  • Every radiology facility needs a strategy to make its images accessible for mobile viewing for both doctors and patients.

  • Medical image viewing software needs to be intelligently designed to make effective use of the low bandwidth of mobile networks; poorly designed software will cause frustration, especially when trying to navigate large image sets.

  • Mobile software needs to ensure the security of patient data, preferably by using encryption during transmission and not keeping any data on the

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