mHealth provides surgeons with a new set of instruments

While mobile technologies have found a place in a host of healthcare specialties, including cardiac care, radiology and neurology, the one department they hadn't penetrated until recently was the operating room.

But that's changing, and rapidly. New tools and new uses for consumer-focused apps are quickly putting mobile devices into surgeons' hands, both figuratively and literally.

"The iPad has the potential be a game changer in surgery because of its small size, built in sensors and wireless networking capabilities," writes blogger Felasfa Wodajo of iMedicalApps. "The only restriction is the imagination of future surgical innovators."

Some highlights of surgically related apps and devices your OR staff may be asking for soon include:

Informational apps: Especially for complicated procedures, surgeons need the latest information on the protocol and the patient.

Apps like AO Surgery Reference are going mobile, allowing surgeons to look up technical aspects of procedures. SurgiChart can help a surgeon track his or her cases, while Surgery Risk has put consent forms and documentation on a mobile platform. Still others have created mobile versions of the common pre-surgery checklist to prevent OR errors.

Surgical plug-ins: Researchers are refining existing accelerometers and gyroscope apps to create tools surgeons can use to check for the position of an organ or internal body structure, Wodajo explains. New apps like BrainLabs also are replacing multi-device positioning systems that surgeons now use to navigate deep inside the patient's body and place or repair implants, Wodajo adds.

Surgical imaging: Some new apps provide access to patient images; Hallux takes that concept a step further, creating three-dimensional, color-coded model images that help surgeons map out structures they can't see under muscle or tissue, Wodajo says.

Sterile protection: New products, like the waterproof barrier for iPads called Frog Skin, are making it possible to safely bring mobile devices into the OR suite, according to mobile fan and Beth Israel Deaconess Health System CIO John Halamka. The Frog Skin is a film-like covering that creates a sterile envelope for the device while still allowing doctors to use the touchscreen, he says.

Pharmacy cross-checks: One immediate use for mobile devices is accessing drug information during surgical procedures, Dr. Claudio Palma, a pain management physician at Soma Orthopedics in San Francisco, tells Becker's Hospital Review.

"Using the iPhone/iPad and Epocrates [has given me] real-time access to medications, interactions and clinical information in the palm of my hand in the OR," he says.

In-surgery video conferencing: With Apple's announcement that FaceTime can be made HIPAA compliant, surgeons may soon use their iPads to conduct video-conference consults before, during and after surgery, according to Wodajo.

"The most basic and fundamental function of mobile devices is communication," Wodajo writes. "In the surgical realm, this often means sharing visual information since intraoperative observations are critical to understanding surgical options and prognosis."

One area that needs work yet is workflow for mobile-enabled tools in the OR, according to Mark Antoszyk, chief CRNA for the Carolinas Medical Center Northeast Health System in Concord, N.C. He tells Becker's that mobile tools in the OR can dramatically improve efficiencies, such as allowing nurses to complete post-op documentation outside the operating room, rather than being stuck at the in-suite computer screen after the procedure is completed. But the tools need to be carefully aligned with OR workflows, and right now, just aren't quite there yet.

"A lot of times what I see is that a program is purchased because it works with the rest of the system but not necessarily with the workflow of end users [in the OR]," Antoszyk says.

To learn more:
- read the Becker's Hospital Review story on mobile use in the OR
- check out Becker's companion piece on OR workflow issues for mobile tech
- here's John Halamka's blog post
- check out iMedicalApps' projections for mobile surgical tools
- get more detail from