New software means doctors can use cell phones to make diagnoses

Thanks to a first-of-its-kind OK by the FDA this month, doctors can use their cell phones to examine imaging scans and even make diagnoses for conditions ranging from heart problems to bleeding in the brain.

U.S. Food and Drug Administration officials gave clearance on Feb. 4 for a new app that allows results from MRI and similar scans to be shown on Apple iPhones and iPad. As of Monday, doctors have been able to acquire the new application, further igniting the already exploding world of telemedicine.

“You can actually diagnose a disease on a mobile device,” said Dr. Khan Siddiqui, chair of an information technology committee at the American College of Radiology, a national group of 34,000 radiologists and other health care providers. “At the patients’ bedside, they (doctors) can open up the application and not only make a treatment decision but explain to the patient what they can do.” Produced by MIM Software Inc. in Cleveland, the app comes with restrictions. Doctors can only use it when they’re away from the office and can’t get to their own computers and work stations. It is approved for viewing and making diagnoses from many types of scans including magnetic resonance imaging, computed tomography or CT and the nuclear medicine test called positron emission tomography or PET.

But the phone apps aren’t cleared for other forms of imaging, including X-rays.

In Ventura County, news of the cell phone imaging triggered a mix of excitement about the possibilities and skepticism over patient privacy and the reliability of using mobile devices to determine what’s wrong.

At a Starbucks in Camarillo, financial planner Eric Swanson worried about screen resolution. His concerns didn’t dissipate with the news that the FDA ruled the quality good enough for diagnoses.

“I’d have to see one to believe it,” he said, fearful also that his doctor wouldn’t be the only one able to view his medical tests. “As long as there are hackers out there, they can get into anything.” Doctors worry about patient privacy too in what they call the medical ether of cyberspace, though MIM Software officials offered assurances the images are encrypted and transmitted on tightly secured networks.

Physicians also focus on the ways the technology can improve care.

“I think that’s an amazing advance,” said Dr. Vishva Dev, a Thousand Oaks cardiologist who sees conveying information on mobile devices as a way to save lives. He noted that being able to immediately see a CT scan of a stroke patient can change the way doctors respond to the injury.

“The timing window changes the treatment options,” he said, suggesting waves of new apps are coming. “I think the evolution is rapid and very soon handheld devices accessing imaging and graphics and other data will almost be routine.” It’s already common to transmit images of spine or brain injuries on the Web, allowing radiology specialists on the other side of the country to examine the images. One difference of the new application that concerns radiologist Dr. Irwin Grossman is the size of the screen, resolution and limits on the amount of information doctors will see at one time.

“I don’t think I’d be giving a final diagnosis and report from my iPad,” said the medical director of Grossman Imaging Centers in Ventura and Oxnard. He suggested the handheld images may be more valuable in offering a way radiologists away from the office can offer instructions to imaging technologists.

Siddiqui predicted the software may be mostly used not by radiologists but by other doctors who will use the high-resolution images to explain a diagnosis to a patient. Often, doctors now resort to scribbling a diagram on a piece of paper at a patient’s bedside.

“It just enables a lot more communication,” he said of the new technology.

Mark Cain, chief technology officer at MIM Software, said the company also is developing an application that will allow patients to access their own imaging scans. He said the reality of the doctors app is that when physicians don’t have access to an MRI, they either bypass it or the patient waits.

Dr. William Goldie, a pediatric neurologist at Ventura County Medical Center in Ventura, said he thinks doctors likely won’t use the images on their mobile devices as the sole basis of treatment. Rather, they’ll see the images as a way to confirm or challenge earlier diagnoses.

The value of technology comes partly from giving doctors a tool that can reduce health care delays for the patient, said Goldie. He worries about privacy and the chance doctors could be tempted to focus more attention on their handheld devices than on the patients.

But he also noted that telemedicine is everywhere, reflected in the national push to embrace electronic medical records and the growing number of websites aimed at helping patients understand their health problems. He pointed too at the software companies lining up to sell new ways of merging medicine and technology.

The changes are necessary, he said. They are also inevitable.

“This is something that is exploding in front of our eyes,” he said.