COMMENTARY: 10.28.19- There’s been a short (or long, depending on your sense of time passing) hiatus here in the “Mac Potpourri” column and for a good reason as this writer has been out on medical leave for the past 25 days (as of Friday afternoon, October 18) and the entire experience has spawned the idea for the first story back from the unexpected break: Apple and its influence on the tech gadgets and devices in use by medical personnel.
In all of the time spent in the hospital (12 days) and in a medical rehab facility (13 days) — from the rides on the ambulance and a home health nurse being sent to my house after discharge for follow up, to both the hospital and the medical rehab facility itself — I noticed some technology items in use that have a direct correlation to innovations Apple has previously released prior to the similar devices being employed and in ubiquitous use in the medical field.
First is the iPad, the tablet computer Apple made popular with its unveiling in 2010. Before that, Microsoft attempted to create one but failed (as expected) on its attempt until its rival created their own and with that, the photocopiers, so to speak, of other competitors were started, with subsequent roll outs of its own (knockoffs) in order to try and beat the iPad.
On my ambulance ride over to the hospital, one of the EMTs/paramedics asked for my signature so they could bill my medical insurance and expecting to sign on a piece of paper attached to a clipboard, instead, I was handed a tablet computer (brand unknown) which capture my signature using my finger.
At the medical rehab facility, the dietician would come visit me every afternoon to get my meal orders for that night’s dinner and the next day’s breakfast and lunch. I thought they were reading a piece of paper with the menu on it and writing in my selections and/or checking off boxes on the form (as was being done in the hospital).
Then I had a thought which finally dawned on me after hearing the dietician cross reference past meal orders I had placed. I figured correctly only after hearing them repeat some of my previous choices/preferences and knew they had to be accessing the information electronically. They either had to be on the computer the nurses and other medical personnel use to look up my health records and information, or, using a tablet. Of course, I confirmed that fact when I asked them if they were filling out a menu on a piece of paper or using a tablet. (I had assumed it was being done on paper because when you receive your meal tray, there is a slip of paper included that outlines what you ordered so if anything is missing — short of not being there due to your dietary restrictions on file — your nurse could call down and have the missing item(s) brought up to your room).
I didn’t get a chance to ask the dietician what brand the tablet computer was.
At home, during my follow up appointments with the home health nurse (who comes to your house to check on how you’re doing and recovering, among other things like recording your vitals like blood pressure, temperature, and oxygen saturation), after my session was over, to complete the process, I was asked once again for a signature. Not to my surprise, I was given a tablet computer to sign with my finger and after I handed it back to the nurse, I asked if it was an iPad. To my disappointment they said no, it was Samsung. They did note that they preferred Apple products better, to my sheer delight!
Second is the device that begat the iPad which is the iPod touch which was unveiled in 2007 subsequent to the release of the iPhone (its original iteration, the iPod, created in 2001). But the medical device in use is not a miniature version of a tablet computer with apps (based on my limited knowledge of the gadget).
The first time I was hospitalized in 2012 (before that was when I was a child with a broken ankle), the machines that monitor your oxygen saturation, pulse, blood pressure, and heart were attached to a box mounted on the wall behind your bed above your head. The next time I would be hospitalized again after that would be in 2014, in the same hospital I was recently admitted in to, and back then, they still had those boxes on the wall. Now? The devices are much smaller and are battery powered and wireless. I held it in my hand and noticed it was designed similar to an iPod touch except nominally larger and thicker. The device had a circular button on the bottom much like the Home button on an iPod touch. And to seal the deal, it had a touch screen to operate the controls. Due to me being visually impaired (since 2013, a fact that most of my regular readers already know), I could not see whether there were apps or icons on the screen. I knew there was a touchscreen on the device because my nurse had to change the battery on it and I asked them if there was a touchscreen on it (which prior to that, I had only assumed was there because of the way it felt in my hands).
What fascinated me about the device the most was that it allowed the nurse to monitor all those things that it did by looking at the device and it also wirelessly transmitted that important information to the main nurses’ station outside in the hallway plus to a central location on another floor where technicians monitored the same information on what I can only surmise to be multiple flatscreen panels on the walls for each patient hooked up on that floor or even the entire hospital.
For instance, one time my oxygen saturation was below acceptable parameters, the nurses outside were alerted by someone in that control room of sorts since they were getting alerts about my status on their screens. The newer system has a system of checks and balances, providing vital information to three sources rather than just in the room itself with only audible alarms to alert nurses of one’s status. (One thing I did not confirm was wether this information was also being transmitted and relayed to each nurse’s smartphone provided they were responsible for the patient).
Speaking of screens, the third device in use is not technically medical related, per se, but was being employed in use in one of the rooms in the medical rehab facility I was in. The device was a simple bedside flatscreen TV mounted on a swinging arm. This reminded me of two versions of the iMac: the iMac G4 unveiled in 2002 and, of course, the current slew of aluminum unibody iMacs with its all glass screens minus the lower “chin” (as it is known as) with the black Apple logo on a bar of aluminum below the screens.
These bedside TVs allowed a patient to enjoy watching (or listening to, in my case) TV on a personal basis rather than one large TV in the room and everyone having to watch the same thing. It swiveled and could be angled just like the screen of the iMac G4. The only difference was that it was literally sporting an all glass front and was operated by touchscreen controls to power it on, change the channels, or turn up or down the volume. (I discovered this by accident when repositioning the TV closer to me and inadvertently changed the channel when I touched a lower part of the screen which had no physical border or buttons at all). Of course, I asked the nurse if the TV was operated by touchscreen controls and they confirmed this fact.
Finally is the digital voice assistant used by the medical personnel at the medical rehab facility which is very similar to Siri, first in use as a standard feature integrated into the iPhone 4S which was unveiled in 2011.
At the hospital I was at, the medical personnel use what appear to be an in-house smartphone (brand unknown) in order to communicate with each other. When the smartphone rings, it will be either a patient who has pressed their call light requesting assistance or another nurse or other team member asking for help with attending to their patient (or a doctor requesting an update on a patient). Problem is that when it rings, you physically have to pick it up to answer.
Conversely, at the medical rehab facility, the medical personnel do it all hands free and with the power of their voice using a digital assistant called Vocera.
I first noticed this technology in use at the same medical rehab facility back in 2014 (although it was located in another city at the time) after being sent there for recovery from the initial hospitalization. When a patient pressed their call light for assistance, they would either get relayed to the main nurses’ station, or in other cases, directly to their assigned nurse(s) via the Vocera system. All hands free on the nurse’s part. They would get an alert from the digital voice assistant asking them if they would like to reject or accept and based on the response, the appropriate result.
If a nurse was in need of help with their patient, they would simply give the command to call a colleague by saying “call _____.” If the Vocera system recognized the name requested, it would repeat the name, except in the recorded voice of that person, and ask the nurse for confirmation before placing the phone call to the other medical personnel. If the requested person wasn’t available to answer or logged in to the system, the nurse would be given the option to leave a voicemail.
Unlike Siri though, Vocera doesn’t appear to be as comprehensive in its features or abilities. (Nor is it as smart as Siri as I hilariously found listening to nurses outside in the hallway make multiple failed attempts to connect with other colleagues as it would not recognize the names of persons being requested by the nurses).
According to its website — the only medical device in this article that I have confirmation of its name and therefore a link to its features that I can share here — Vocera, to my surprise, predates Siri (which I did not know until I looked up the technology on Google). It is an app for smartphones or a standalone hands free badge worn by the user (I’m not sure if this is a Bluetooth device connected to the smartphone). The San Jose, California-based company debuted in 2000 and is now used by more than just medical personnel. While the technology predates the release of Siri by more than a decade, comparing the two to each other is, well? Like apples and oranges, so to speak!
Now this calls to mind the modern versions of the “Star Trek” television series where crew members use a communicator badge to contact each other) (ironically, by… touching their badges). And remember those tablet devices called PADDs (acronym for personal access display devices) used as props on “Star Trek: The Next Generation” which predate the iPad by more than two decades as a fictional science-based technological device which crew members used in the future?
But I digress.
Of course, I totally would be remiss if I didn’t mention the role that the iPhone plays in this since it is the first modern smartphone that transcended the previous iterations and would transform the design of all mobile phones to follow thereafter with every other company trying hard to copy the device’s design. Medical personnel use in-house issued smartphones to communicate with each other and most likely other things like accessing patient information on there rather than having to go to a computer terminal to do so, thanks to what smartphones can do today with its apps, web access, et al.
A good example of a smartphone’s benefits is its built-in camera. And with its evolution over the years matching or besting those found in standalone compact digital cameras, the smartphone’s usefulness in this case is just one instance of its use as a tool in the medical field. During my recent visit to the hospital, I obtained a bedsore due to being bedridden for a number of days and nurses simply took pictures of the wound with their smartphones and would, I assume, transmit the images wirelessly over the network instantly and directly to the wound care department. (I joked with them to share the shots with me so that I could post the pictures to my Facebook timeline). This pales in contrast to only five years earlier when I was hospitalized at the same location in 2014 and among my major ailments, had an infected wound that nurses had to keep tabs on by taking pictures of the area with a separate compact digital camera specifically designed just for that purpose (which then would require the images to be transferred to the computer by inserting the memory card into a memory card reader in order to upload).
The smartphone has become a major technological tool for medical personnel just as it has done for us regular people due in part to the reinvention of the phone by Apple with its iconic iPhone.
With the sole exception of Vocera, based on what I have observed over the past seven years in the medical field, the devices in use at hospitals and related facilities has changed and I think if it were not for the influence of Apple putting these innovations out of its Cupertino, California-based headquarters and making these products mainstream, the medical field would not look as it currently does today.