Medical technology includes tools that extend a physician’s access to information and help them magnify and clarify the precise physical need of patients. These medical apps enable remote consultations and map the human body.
CodeHeart: Cardiac consultations at the click of an app
The free CodeHeart app from Vidyo for mobile Apple and Android devices is available via an encrypted link. For more information, visit MedStarHeartInstitute.org or contact Eileen.M.Searson@MedStar.Net.
Using any device with wireless access and a camera, a referring physician can contact an interventional cardiologist at MedStar Heart & Vascular Institute—the busiest and largest private, not-for-profit hospital in the nation’s capital—for a consultation complete with ECG images, says Lowell Satler, M.D., medical director of the Cardiac Cath Lab with MedStar Heart & Vascular Institute.
When an ER physician orders an ECG for a presenting patient, they must evaluate it and follow with a treatment plan. For a second opinion, they would previously have had to fax the ECG to a tertiary care facility, such as the MedStar Washington Hospital Center, and place a voice call for the consultation.
“This process takes time—about 10 minutes or more. Even a one-minute delay can be critical for a patient having a heart attack,” Satler says. CodeHeart compresses that time through real-time consultations via secure, HIPAA-compliant, two-way video calls with digitally transmitted ECGs.
To use the app, physicians click on the CodeHeart desktop icon to open the app, automatically connect, and join a split-screen video call with a cardiac specialist. “Physicians conduct concurrent, face-to-face conversations in real time. The referring physician holds the ECG up to the computer camera or uses their smartphone to capture the image, which the system then transmits to our consulting cardiologist,” says Satler. The system saves all video call data so either physician can call it up again at any time.
John Schnabel, M.D., is medical director of Emergency Medical Services at Calvert Memorial Hospital in Prince Frederick, Maryland, which sees 42,000 patients annually and also runs three urgent care centers locally that see 20,000 more in acute care patients.
Before using CodeHeart, Schnabel’s team had to share an ECG on a physical print out via fax.
As in any hospital, the ED at Calvert Memorial must care for patients with acute myocardial infarction and heart attack symptoms. “This easy-to-use application allows us to communicate seamlessly with internationally renowned interventional cardiologists at the MedStar Heart & Vascular Institute,” Schnabel says. “We use an HD camera to read the EKG while we communicate with the interventional cardiologist, who is able to ask us to zoom in on the EKG or otherwise share information.”
Schnabel’s favorite CodeHeart features include the simplicity of launching the app, the high image quality, and the fact that he has not seen any real glitches with the app. “That’s amazing these days,” he says.
The BioDigital Human: Viewing the body in 3-D
The BioDigital Human app from BioDigital, Inc. works on Apple and Android devices. A basic version is free; a premium version is available for $48 per year. Customization is available and priced on a case-by-case basis.
“Built as an entirely cloud-based simulation platform, the BioDigital Human presents thousands of medically accurate anatomical subjects and health conditions within an immersive, interactive, 3-D environment,” says BioDigital CEO and cofounder Frank Sculli. Once a physician chooses a visual from the content hierarchy, they can add detail, then print a snapshot to instruct the patient. Each visual comes with links and descriptive data.
The value in the tool lies in its efficacy in clarifying the human body and informing patients about their health and conditions so they can make medical choices with confidence.
The tool offers a layering capability for adding multimedia content over the 6,000 pieces of human anatomy. “Similar to the way geo-browsers such as Google Earth have revolutionized the way we navigate our planet, the BioDigital Human provides a powerful body visualization platform. Once integrated with patient health records, the platform has the potential to deliver increasingly personalized views of the body,” says Sculli.
Roberto L. Flores, M.D., is a reconstructive plastic surgeon at NYU Langone Medical Center and an NYU Associate Professor of Surgery. Flores was looking for an easier way to explain procedures to patients and to his residents and fellows when he found the BioDigital Human app.
Before adopting the app, he used anatomy textbooks to explain procedures. “The textbooks were limited in that they could only express 2-D information, and only from one perspective at a time. I found myself jumping around to 20 or more pages to explain a procedure,” Flores says.
Textbooks were equally perplexing in preparation for actual operations. “If I was going to prepare for a complex surgery, I found myself referencing several anatomic textbooks in order to obtain all the vantage points of the anatomy that I needed in order to process the surgery to my satisfaction.”
With the BioDigital Human, Flores can explore and manipulate all aspects of the human body in virtual 3-D. “There is no limit to the type of anatomy you can study or the vantage point from which you can view it,” Flores says. The app enables a highly sophisticated study of the relationships between bodily structures that is impossible with textbooks. “I can convey complex anatomic and surgical information to my patients and trainees using the app as my visual guide,” says Flores.
BioDigital is adding disease-specific tutorials to the app; Flores would like to see that work continue. “I think there is also a great opportunity to make versions of the BioDigital Human that are suitable for children at different ages, so they can learn about the human body,” he says.
RubiconMD: Remote specialist consultations for PCPs
The RubiconMD platform is available to primary care providers through a smartphone’s web browser and to specialists online and through an app for any Apple device via a monthly subscription or a pay-per-case basis. For more information, visit rubiconmd.com.
Primary care physicians use the RubiconMD app to contact specialists online for remote consultations. On receiving the patient’s case, the specialist returns a clinical opinion.
“The PCP selects from 32 specialists and sends any labs or photos with the patient case and question,” says Gil Addo, RubiconMD’s CEO.
RubiconMD maintains a panel of specialists from elite U.S. academic medical institutions who are available to field consult requests. “We have designed the platform to fit seamlessly into a PCP’s clinical workflow so providers can efficiently send questions to specialists and receive timely answers,” Addo says.
Tom Brown, M.D., is an internist and medical director at four AFC-Doctors Express Urgent Care center franchises: one in West Hartford and three in Danbury, Connecticut. Brown develops best practices for streamlining patient flow and improving the efficiency of care while also caring for his patients. He was looking for a more expedient way to access and leverage the expertise of subspecialists when he found RubiconMD.
“I use the platform with patient diagnoses where I do not have a great amount of experience or a high confidence level. For example, I use RubiconMD with orthopedic fractures to determine in a timely manner whether or not patients require orthopedic evaluation,” Brown says. “I like that I can upload images and X-Rays, and also ECGs to RubiconMD for cardiologists. I get a response in a few hours and receive an email alert notifying me.”
David Geer is a regular contributor to PracticeLink Magazine’s Tech Notes department.