WirelessDoc

Quick links for medical wireless topics and related

"Conficker worm hits hospital devices"

"A few weeks ago, we discovered medical devices, MRI machines, infected with Conficker," said Marcus Sachs, director of the Internet Storm Center, an early warning system for Internet threats that is operated by the SANS Institute.

I went to the SANS Website and did some searching to find more about this story with no luck. I did look at their Internet Storm Center which told me that Adobe has released patches for the zero day threat associated with PDF readers.

"Implementing an Electronic Medical Record at a Residency Site: Physicians’ perceived Effects on Quality of Care, Documentation, and Productivity" (this links to a virtual viewer of the entire journal issue, but you can select certain pages and download as a PDF)

Published in this month's Wisconsin Medical Journal is this study that surveyed 38 physicians at a single family medicine residency clinic in which the NextGen EMR was installed. They "were surveyed at 3-month intervals regarding perceived impact of the EMR on quality of care, documentation, and productivity."

From the Abstract:

Conclusion:  Not only did physician production rise immediately, it stayed as the increased level for the duration of our study period. This may be due to improved documentation supporting more appropriate billing. However, physicians also perceived the EMR as taking up more of their time.

Pulse pen picks up sound and scribbles

I tried to order the Livescribe Pulse Smartpen when it first launched, but on checkout was told that it would take months to fill the order. Then I began to wonder if its microphone would really be capable of recording a lecturer's speech distinctly enough to make this purchase worthwhile. Recently, I've had several people recommend this product, but I'm still not sure if it will improve my workflow or just be another quirky gadget with another set of batteries I need to babysit.

The above link is to a review by a Vancouver reporter who vouched for the sound quality:

In one-on-one interviews, the recording is flawless—as good as any digital recorder’s. Writing with the pen has no effect on the audio, as expected. What surprised me, however, was how well the mike muffled background noise and picked up sound from speakers. When former prime minister Paul Martin made a speech at a noisy Chinese restaurant during the recent campaign, the Pulse picked up every word.

Maybe if I'm in a situation where I need to do multiple live interviews this product will be useful, but it seems intrusive if you want to engage in conversation. Mighty be too high on the scale of nerdiness for me.

NOTE: I keep updating this page throughout the day. I know that's not very blog-like, but it's more Twitter-like but with some permanence.

"Apple Introduces Revolutionary New Laptop With No Keyboard"

"I'll buy almost anything if it's shiny and made by Apple."

JavaScript zero day threat found in Adobe Reader and Acrobat

I'm listening to Steve Gibson's Security Now podcast #195 where he alerts his audience to the JavaScript zero day threat found in Adobe Reader and Acrobat that can be used for a remote code execution exploit. He mentions that he can think of no reason why a PDF reader should require JavaScript, but I'm guessing that it's to support some of the multimedia functions which aren't used for the typical PDF file. I could be wrong.

Adobe addressed this problem on their blog on April 28 where they provide the temporary fix:

1. Launch Acrobat or Adobe Reader.
2. Select Edit>Preferences
3. Select the JavaScript Category
4. Uncheck the ‘Enable Acrobat JavaScript’ option
5. Click OK

Leo Laporte, the host of the podcast, says that he's happy with Foxit Reader, which "is notable for its short load time and small filesize." But alas, pshaw and regrettably, you also have to disable its JavaScript option.

"Try to imagine that you have two phones: one is Pre and the other one is Palm OS device"

This is the response from the folks at MotionApps when I asked a question about using Agendus, a contact manager program from Iambic. This PalmOS app will run on the new Palm Pre through the use of Motion Apps' Classic software, I'm told, but it won't be able to access the contact manager that comes with the Pre.

OK, so I buy and new phone and can't use its contact manager. Or, I can give up on Agendus and use the new contact manager. This is assuming that I will be able to port my old PalmOS contacts without a glitch to the new phone. Wouldn't that be a kicker if that becomes a problem?

Another assumption is that the Palm Pre will be a smashing success enough so that the WebOS platform will be around in the next couple of years.

Unless I can see somehow that the Pre will increase my efficiency in the near future, I'll wait.

UPDATE: I updated my Agendus desktop software for Windows, and now it's completely unusable since it crashes everytime. Since this is the faster way to enter data, I'm back to the old Palm desktop software. It's pretty vanilla, but it's been the most reliable.

Ultrasound imaging with smartphones using a USB-based probe

This is the application developed by Washington University scientists led by Associate Professor William Richard and researcher David Zar which uses commercial USB ultrasound probes with Microsoft Windows smartphones. (The images are from their poster session presented at the 2009 meeting of the World Health Congress.)

Along with the traditional uses of clinical ultrasound imaging, its convenience can be utilized for imaging veins arteries for starting IVs and central lines (I wish I had this while a surgical resident), as well as for gathering data in remote regions of the developing world for analysis on the spot, or sneding that data back to a centralized service if needed.

Here's their Wiki.

Here's the press release

Medical Wireless quick links

Searching the key term "medical wireless":

We need a robust technology infrastructure from Hindu.com. An interesting take on this interview with a CEO of a tech company is the acknowledgment that India's focus on outsourced IT services has kept the focus away from the development of technology-embedded products for clinical use.

Has the time come for wireless IT in health care? Wes Rischel says IT managers and hospital officials shouldn't get carried away with optimism about the tools, using RFID as a cautionary tale. But you could apply the caveat about getting "carried away with optimism" to any and all projects. Besides, who says the door is forever closed to RFID clinical apps?

While he sees products such as wireless heart monitor patches as "incremental advances," he thinks the real revolution in health care IT is the emergence of the widely networked EMR. He is sanguine about wireless network, predicting "accelerating growth" in a market that has matured over the past two years.

I think each medical specialty will find it is able to transform its practice using wireless tech in a unique way. Meanwhile, we'll see if the development and adoption of a pervasive EMR is hamstrung by incrementalism.

You say you want a revolution
Well you know
We all want to change the world
                 - J. Lennon

Palm Pre better at multi-tasking than the iPhone?

Says Tom Krazit of CNET:

While the iPhone has set the standard for future smartphones, Palm's WebOS delivers two important improvements that the iPhone can't yet match: true multitasking between applications, and a subtle notifications system that doesn't interrupt your train of thought. It does that while unveiling its own stamp on the multitouch user interface that Apple introduced to the masses with the iPhone and finding room for a slide-out hardware keyboard favored by CrackBerry addicts.

I haven't seen an independent evaluation of the Palm Pre's multitasking card system. There must be a limit to how many apps can be open until the system crashes. I like the idea of the alert system, which automatically is reduced to thin text bar, not requiring you to stop your work. The iPhone requires you to dismiss the alert.

Kindle DX: the ivory tower gets a silo

The Kindle DX is now listed on Amazon.com for $489. It's using Amazon's WhisperNet based on Sprint's EVDO for wireless connectivity.

I checked out both the NYTimes ("Mr. Bezos is summarizing the features of the Kindle DX.") and Engadget for their live blogging of this release announcement.

While the coverage by the NYTimes seemed as gray as this Kindle's screen, the Engadget blogger noticed a slow refresh rate as well as search function.

"It's a great life had at sea, when you're not in the Navy," goes the Harrisong. While the idea of using this device as a way of managing textbook material, the commitment you make to Amazon is forever. Sure it makes perfect sense to have a device that eliminate carry around pounds of dried pulp, but the books are not really yours, as in possessing them, but rather you are promised them by Amazon as far as it can.

I remember trying to redownload Branagh's Hamlet which I purchased from them, only to be told that their contract had expired with the company that held the rights. I was offered another. Maybe Mel Gibson's version? (I see now that it's relisted.) Others report how Amazon can prevent further purchases for your Kindle if you return too many items.

"But you're getting free wireless without a monthly service contract!" What would impress me more would be a plan that would allow students to rent textbooks at a reasonable rate with the option to "buy," and allow the instructors to push PDFs of other readings to the device. I don't know if that's part of the plan.

Wireless devices will only be truly innovative if they can escape the high walls of the silos built with contracts, TOS, and lifelong commitments. Someone's has to open source this, and really make some news.

UPDATE: Here's a useful review comparing the Kindle 2 to the Kindle iPhone app by Nicole Lee. For me reading text on a iPhone or iPod Touch is not a problem. I'd be willing to go with this solution (and enjoy the color screen) if I could actually download, and store the books I bought.