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iPods Used for Medical Images
spagiola writes "There's a nice little story on CNN about a doctor in Geneva who has developed ways to use iPods to view medical images. His software, called Osirix (OSS, BTW) enables medical professionals to view medical images on their iPods, saving them and the hospitals they work for thousands of dollars in expensive equipment."
It looks like it started out as a simple, "portable hard drive" system... hardly different from the stories about storing BLAST data or Lord of the Rings clips on an iPod. The addition of the iPod's photo-display capabilities and - more significantly, I think - the iChat sharing makes this sound like a setup. I wonder when they will incorporate support for the iPod's video capabilities...
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it took some time to find it, didn't it?
So they managed to change their program to store files on the ipod, as well as pictures that the ipod could view? Which would have been really hard to do.
Somebody is in love with the Ipod.
Several patients diagnosed with "just a scratch".
You could have read the article, they just use the iPods to save the photo and carry it around (the photo capability of the iPod was added even after the project was started).
Not exactly what TFA says, they don't 'use' the iPod to 'view', they store the images on the iPod in file mode, so the article could re-written to say:
Some people have created sofware which allows images to be stored on an external hard drive.
In other words....
Nothing to see here, this is not the video/photo ipod in action.
Wouldn't they have to be 'secured' to compy with HIPAA regulations in any way? iPods are easily pocketed, and I would think an iPod with Medical Imaging files on it would be at risk...
Irony? Yea, it's like goldy and bronzy, only it's made of iron!
How this is more cost-effective--or more effective, period--than low-cost color PDAs with CF microdrives. Surely the higher resolution, larger screen, and more flexible OS would be better?
It's true that high-capacity microdrives are more expensive, but that's still a lot of photos at that resolution.
However it compares, it awfully neat, though, and a good example of how technology can be a real life-improvement above pure entertainment.
Before anyone gets into a tiff about viewing the images on a small iPod screen, I suggest you read the article. The physicians are merely STORING the images on the iPod and then hooking the iPod up to a personal computer (w/nice monitor) to view the images.
To sum up, RTFA
It just seems like they were looking for a bit of an excuse to use Mac technology. What I've got a bit of a problem with is using .Mac for a place to store medical images for sharing amongst colleagues. I don't know if that would really meet with security and confidentiality requirements for this kind of data. What they really need to do is set up their own secure server. Which raises this somewhat offtopic question: Does anyone know how to set up their own .Mac webdav server and tricking Tiger into thinking that it's a real server? I saw some hacks to do this ages ago, but have they matured?
Viewing/manipulating/storing visual medical data on a high-end desktop computer makes sense to me. I'd presume that such machines would exist in hospitals, and in doctor's offices, but I am lost as to any reason for the ipod, even after reading the article. Many people, during commutes by train/plain or what not, listen to music, watch video, or play games on devices such as ipods. Do physicians instead flip through MRI scan output to pass the time? I wouldn't feel comfortable knowing my doctor is walking around with digital imaging of my insides on the same device he's currently using to listen to music. If instead it's just a need to transfer data from their office to home, or between hospitals, why not use something more appropriate, such as a burned CD, or much better, through an networked inter-hospital database over an encrypted connection. Any chance that some company has been giving this guy just more than one apple a day?
Good to see they have addressed the risk of patient data being leaked (iPod being nicked or left on the bus), but the article isn't entirely clear on what the procedure for stripping the patient data is - does the user have to do it themselves, or does the software force you to do it each time you upload an image?
Still a very cool use - though maybe not one that could be easily rolled out across all areas of medicine unless it needs virtually zero technical know-how...
Shame really, our legal system is going to make adoption of new tools (in medicine in particular) difficult.
Still a neat concept. She should win an award or something just for outside the box thinking.
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Using an iPod to store medical images is not a very good idea. There is no security, and no data integrity. And iPods are much more likely to be stolen than, say, a burned CD. All of that said, having a portable storage medium for medical images makes some sense. Perhaps this is yet another application for USB thumbdrives. Add some encryption (TrueCrypt) and an application (Osiris) that can be run from the drive and you might have a nifty little product.
The more you regulate a company, the worse its products become.
I work in medical imaging, and I have used Osirix. It is easily one of the best open source image display programs around. The other most notable is Amide, but I digress. Osirix works well for scientists and others looking to save money, but I think physicians would have a difficult time saying it is better then the commercial vendors software. Commercial workstations are tens of thousands of dollars, and while the price is extremely inflated, you do often get a lot of functionality for that money. Osirix is no substitute for that. Osirix works fine as a third display terminal or something in the doctor's office, but I wouldn't want any radiologists I know using it as their primary reporting station.
The part about the iPods is interesting too. Having ready and portable access to images is neat, but of course, this is not used as a primary reporting tool. It is useful to take to conferences to share interesting cases, etc, but not for any other great purpose.
Plus, the doctors can have musical discussions with their patients, everything from "Doctor, doctor, gimme the news" to "I can see clearly now, the pain is gone"...
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I do medical imaging in the U.S. for a livelihood. I'm pretty sure nobody has ever done a clinical read (e.g. medical evaluation resulting in a report) on the iPod. Anyone who would do that should have their board cert pulled and probably would do something else equally stupid. OSIRIS has been around for a while -- I don't see why it's news. The real issue is medical record privacy and the thought of med images running around on an iPod scares the bejeezus out of the boards or people responsible for HIPAA compliance at most institutions. If leaked, the header info that comes with a DICOM formatted data set easily violates privacy at a level sufficient to trigger a $15k slap on the wrist and/or 6months jail time.
For most imaging modalities reading on a 14 or 15" is not enough -- though I suppose PET/SPECT and UltraSound may be exceptions. Heck even high quality jpg compression can be lossy enough to cause missed stress fractures.
From the article: "IChat may not always provide the best video-quality images, depending on the network bandwidth available, but it's cheap and easy to use in comparison with the alternatives."
Just what I want to hear from my doctor: this isn't the best, but it's cheap!
And using Apple's .Mac for MEDICAL DATA BACKUP?! If this were done in the U.S., the HIPAA laws (Health Insurance Portability and Accountability Act) would slap him down very, very fast. And sure, $100/yr gets him 80gb of data... but why not talk to the hospital IT department and spend $1000 one time to get a cheap, secure Linux server with many times that capacity?! Oh wait, Linux servers don't come with nifty earbuds that let you listen to your own music while on-the-go....
$nice = $webHosting + $domainNames + $sslCerts
If you read the artical it states the store and run the diacom images off the ipod but doesnt say naything baout viewing the images on the ipod screan. After reading the artical i intrepreted it as the ipod is a cheap portable hard drive.
Personally, I like to look at the geysers of blood. Those are always a good sign.
You want to use a portable 40GB device to store images? I'm not sure about this, but I think there are products out there like that that cost a little less than $300
I would agree that the functionality of viewing these images on the 2.5" iPod screen does not make me feel too cosy...
I agree - the doctor in this case is really just using the iPod as a portable hard drive. All physicians have to know is "plug in iPod, pictures go in. Plug in iPod, and select the picture you want to see". The software takes care of the rest.
There's nothing stopping someone from modifying the display software to encrypt the messages. I work in health care (systems and security architecture), and this would be a simple enough add-on.
Besides, people stealing the iPod are more likely to wipe out the files and just use it as a music player than spend time looking at some guy's X-ray images. (Unless they *really* get off on those kind of things.)
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Before this gets modded flamebait, i want to offer the disclaimer that i'm a thorough mac addict. That said, though i hate it when stock analysts harp on the half empty side of apple's decisions, I'm also getting tired of tech journalists using articles to imply that because a common feature or use (often implemented better and cheaper with other products) is available on an ipod it's somehow something new and great. Personally I look at it as financially wasteful. If it's storage portability a flash drive or firewire drive will hold more and cost less, and if it's image display then an old pentium 3 laptop costs $250-$350 used. If these professionals were really being innovative, the headline would read "doctors find new ways to recycle old laptops" To me it's only a slight variation from misrepresentations of bittorrent. It's one thing for the news to have a slight slant, but to omit the rest of the market for the purpose of glorifying one company's product is not a news story, it's an ad. I hope apple paid well for it.
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I could see it now: I'm having surgery performed and the doctor is beside me trying to keep up with the beat to his music, which is causing him to vibrate slightly, cutting one of my arteries. It's cool though, because he was probably listening to "Scars" by Papa Roach.
Ideas are always great, the practice is something else.
As mentioned in the article they are using is as a storage mechanism. While DVDs probably are big enough, they are also a lot more hassle to create quickly. In itself there isn't anything news worthy. They added the ability to save previews, that can be viewed on the iPod. While most people wouldn't want to do a detailed analysis, it is an easy way to see the obvious and even verify what you saved on your iPod. Plenty of other media devices could be used, but these guys are Mac developers, so they stick with what they know. Had they been MS-Windows developers, then they probably would have been using an iRiver device and MSN Messenger.
The tablet PC defeats the purpose of having a small portable device that you can take with you, and that tablet PC probably don't have the resolution need for displaying the images. iPods don't either, but you can easily plug them into a computer that does.
These guys are essentially trying to share news of their product. The fact that CNN gave them an article to do so is kudos to them.
Jumpstart the tartan drive.
This is interesting. My first thought was why not use an external HDD - it would cost a fraction of the price, and would not be nearly as appealing a target for thieves.
Having worked in a hospital for a number of years, the real purpose behind this is evident. Hospitals like to give doctors stuff. Expensive stuff like PDAs and wristwatches, as well as basic stuff like umbrellas, pens, satchels and the free food and drinks well stocked in the physician break rooms. Hospitals make their money by having patients, and besides the Emergency Department, all patients are admitted to the hospital (or referred to for various procedures) by doctors. So hospitals like to give things to physicians to thank them for making them money. In the USA laws exist, and have been strengthened in the last several years, seriously limiting what hospitals can provide for physicians. This is of course to keep these gifts from becoming outright bribes.
Now in the case of these iPods we see a loophole. A way for the hospital to purchase really, really nice gifts for their doctors, under the pretense that it has some medical use. Quite interesting indeed.
Dan East
Better known as 318230.
We've hooked an iPod shuffle to our new phone system. When customers are on hold now, they get to listen to cool music not some synthiepop mozart castration. No pictures on the phone system though.
One customer even asked if he could get the music from our phone system on CD.
Carrying around images and viewing them FROM the ipod on a computer is one thing but I don't want my radiologist to diagnose me from a 2in square screen.
I can say that there are a LOT of things wrong with this article. This is pre-school journalism at its best. Hear me out...
My job title is PACS Administrator, which means I run the servers, network, diagnostic systems, etc for medical imaging in Radiology and other departments in a major healthcare organization.
Let me tell you, there are A LOT of problems with something like this. Some of this will be redundant, but I'm trying to capture everything into one post. First of all, the iPod is seen as a generic external hard drive. Big deal, they made their free DICOM viewer software have the ability to export to an external drive. Second, this is a MAJOR patient confidentiality issue, and I believe is considered legal under HIPAA, but if a physician, clinician, etc lost the iPod, they could go to JAIL. I'm not kidding.
Also, they also allude to actually viewing images on the photo iPods. I cannot imagine any image that could even be useful to a non-Radiology (referring phsyician, surgeon, etc) on those screens. About the lowest quality image that is useful even for referrals or comparisons is a 2MP monitor that displays at least 1280 resolution. Anything less than that is pretty much medically worthless, and for Radiologists, you typically need a 3MP display for proper detail, not to mention special graphics hardware.
I'm not quite sure if this CNN article is a cry for publicity from the developers of OsiriX, or Apple. The product page for Osirix barely even mentions the iPod functionality (in the changelogs), yet I doubt Apple would bother publicizing this.
As for the journalistic integrity, c'mon... I mean, the reporter spelled DICOM (format for medical image storage and transfer), "Diacom". They even spell out what it stands for after that, I don't see any A's in there!
Conclusion: you should all be very scared of careless happy-go-lucky doctors and clinicians running around with your patient data on their iPod at the gym trying to see whether you have a brain tumor while jogging in the park, when someone steals their iPod and sells it on eBay!
THE MAGIC WORDS ARE SQUEAMISH OSSIFRAGE
Let's try to interpret people to mean something that's not incredibly unreasonable. Yes, Switzerland doesn't have the specific law referred to as HIPAA. She does have medical privacy laws nonetheless. These would almost certainly affect the use of the iPod in medicine. You shouldn't be so focused on a small error in the GP that you ignore the broader point about the conern for medical privacy. If someone said to me, "How could doing X be legal in Switzerland? The Banking Act prohibits it." I wouldn't say "hahahahhahahahahaha you idiot that law doesn't apply there!", I would say something like "Well, that's just a US law, but the relevant Swiss regulations say that ..."
That would probably save a bunch of redundant posts and back-and-forth. Just a thought.
Rank my idea: http://www.sinceslicedbread.com/node/531
Come on, this is a puff piece about the ipod. The exact same thing could be done on a number of devices, including mobile phones, PDAs, notebooks all that cost less than the 1000s of dollars quoted in the article.
It is not even using the ipod in a way different to how it is supposed to be used, except for the fact that medical images are being stored rather than other images.
This might fly in Switzerland, but it's not going to comply with US laws.
I'm afraid that you have cancer. I am deeply sorry. However, with proper chemotherapy and a positive outlook, chances are high that you can beat this dis...... wait.. wait.... That discoloration on your chart looks to be a Cheeto from breakfast. Nevermind!
Any medical department that uses
The anonymizer functions in Osirix are a good step towards security but this is only of value when doing research studies over a lot of patients (like population studies). To do diagnostic work, you need to be able to identify the image set to a given patient. You don't send two three sets of images to a doctor saying, image set #1 is patient X so on and so forth. The risk of error is too great. Plus, anyone who has worked with dicom knows it's close to impossible to identify a patient by it's dicom file name (a CT slice would look like CT.1.3.45.123456.20051024.1.100.01) if the metadata has been anonymized. Whatever. Most physicians have a PC on their desk, so the tool is not accessible to them thus negating the "huge processing power" of the Mac.
I won't say i'm the best or portray that role, but i'm up to top two and my father's getting old.
d, the header info that comes with a DICOM formatted data set easily violates privacy at a level sufficient to trigger a $15k slap on the wrist and/or 6months jail time.
They stripped the files of identifiable information prior to saving on the iPod. And if this was still an issue, there's no reason the files couldn't also be encrypted.
Having said that, I'm still not sure its the most cost-effective way of doing things (vs. a generic external HD).
I think I'd trust my health to a scary-looking guy in native dress waiving a chicken over me before I'd go to someone who has my medical information sharing disk space with illegally downloaded mp3s.
The three most important words in a relationship are "I love you." The two most important are "Humor me."
The problem comes with the article poster's claiming that they "use iPods to view medical images." No one RsTFA, seeing that it ought to have been more clearly phrased, as the CNN article (and the title of the /. article) does, "use [iPods] to store medical images."
Well, you could have a deadly cancerous mass but my screen is scratched so I can't tell. We'll have to wait for a real diagnosis. Would you like to spend what could be the remaining minutes of your life watching an episode of "Lost"?
Over here in the US, we put MRI's on DVD's (and CD's) all of the time. Unless you are manipulating the images, the actual data burden of an MRI isn't all that high. The standard presentation form for an MRI is an approximately 13 x 19" piece of film, on which are printed around 20 "slices" of information. (Can't recall exact number at the moment). That's about 20 3 x 4 inch grey scale images. Not the last word in bandwith hogging pixel numbers.
Faster! Faster! Faster would be better!
If leaked, the header info that comes with a DICOM formatted data set easily violates privacy at a level sufficient to trigger a $15k slap on the wrist and/or 6months jail time.
Ahh, another sucker who bought the consultants' scare stories... You don't get the big fines and jail times for inadvertent disclosures. Those are explicitly reserved for deliberate disclosure for gain, in other words selling medical records under the table. It's of course still good to be concerned about the potential for accidental disclosures, but as another poster pointed out, they strip the DICOM headers before saving to the iPods.
Portable data is something that is of great interest to NIH. They're not scared of it at all, actively encouraging it, in fact. There's at least half a dozen SBIRs out there now on the very topic (of which my company is placing bids). One of the things that is of major interest to them is Informed Consent. That is, NIH wants to have PCs in every doctor's surgery and have them gathering medical information, putting it into a simple to view application and sending it home with the patient. The first target is MRI and CAT scan data - those very DICOM images you're talking about.
Another side to this is that NIH/NLM are seriously looking at how to combine large scale medical databases. That also is feeding into this desire to distribute patient data to the patient. They have a number of projects that have been funded for the last couple of years for creating huge single-subject, national level databases, particularly of research data. Now they have a couple of open-bid SBIRs on providing integration applications for those. That is, someone should be able to combine the virus database, with the visible human data, with the heart disease databases into a single visual system. This can then either be used for teaching/training, general education, or combined with individual patient records on that take-home CD so that they can see how the individual compares to The Masses(TM). We're doing a lot of this work in combination with UW here in Seattle.
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This story should be followed up by the one about the chap who discovered that a new BMW could be used to move important medical files from one location to another. After making this remarkable discovery, the entire department quickly put in purchase orders for "medical information transit devices".
/. story the IT adminstrator purchased iPod as "boot" devices.)
The story is sort of in the "duh" catagory...chap discovers that iPod can be used to store data, justifies purchase. (There was a
As medical imaging/storage devices go...the PDAs (Axim with 640x480 & wireless) or tablets are a better choice. The TCO (total cost of ownership) savings betweeen a $300 iPod and a $2000 tablet are relatively small when you add in the security, training and deployement costs.
You're probably right when you assume most people just read the title and go off of that, but I would like to point out the following paragraph:
My guess is they mean view thumbnails of the images, not to make medical diagnostics from them, but hey, IANAD@UHG.
It being established that the initial function was merely to store these images, and without getting into the whole security issue since so many others already did, can someone who praised this "innovation" please reveal to me, after acknowledging that iPods are not nearly the cheapest form of portable storage out there, why exactly this is such a brilliant use of technology?
IIRC, iChat uses libgiam for the AOL OSCAR compatability. And among the recent Google Summer of Code projects was adding support to Giam for the iChat ad-hoc instant messenger networks set up using Apple's Bonjour.
Read the article. The doctor had an iPod, and started using it to move large files around. That in itself isn't news. It's the additional details.
.Mac to conveniently post images - stripped of identifiers for anonymity - to protected web space for additional consultation and reference purposes.
They can take a patient's data with them and study it at the office, at home, at a colleague's office. This doesn't require an iPod.
They added an image export function to put pictures in iPod-viewable format once the iPod Photo came out. That's pretty minor, but you can use it for reference, or output it to a TV for viewing. The resolution is still lower than original quality, but I can't speak to those details.
Then they used iChat AV for full-motion video streaming to other doctors. Again, the quality is lower, but the ability to consult with other doctors in real-time with the data can be invaluable. They also used
The real imaging work can't be done on the portable because it is very demanding... it's a 3d video of sorts. A tablet might be able to do the work, but the real point isn't using the images on-the-go, it's taking the images with you or sharing them.
The costs are negligible because the equipment is there... they have the Mac to use Osirix. That means they have the iChat software. They were using their own iPods. Sure, some medical facilities might end up buying a few iPods for this use... is that so terrible? I think the additional costs of training and deployment for Windows Tablet PCs and a different DICOM viewer far outweigh the costs of iPods... if they even have to buy them. Remember, for most of the uses - excepting the iPod-viewable photos and videos - any portable drive would do.
That what was all this school was for... to teach us how to solve our own problems. -- janeowit