Ipad Doctor

[Rell Jette]

Iwas skeptical about the iPad Mini. I've used my Retina display iPad (third-generation) for the past 6 months and been satisfied with the experience.

I've used it in the hospital setting during rounds, and even while talking to patients in the emergency department. I'm able to easily pull up Epic's electronic medical record (EMR) using the Citrix app, and I can easily store the iPad in my "iPad-customized" white coat.

With the smaller screen size and the loss of a retina display, I assumed I would hate the Mini. But since I'm the editor of iMedicalApps, I felt it was my duty to report how the Mini functioned in the clinical setting, so I decided to give it a shot.

Plenty of "analysts" have written how and why doctors will adapt to the Mini. Most of them have named price and size, but they have no idea how the typical patient encounter works, or about the workflow of a physician.

When you slide the Mini into your white coat pocket, you instantly notice a difference from the full size iPad. No longer does one side of your white coat feel more weighty than the other. With the full size iPad, I would often have to "balance out" my white coat during rounds because one side of my white coat would drag versus the other.

The other instance, and the reason why I have switched to the iPad Mini, is its handling when talking to patients. The full sized iPad feels like a brick in your hands during a patient encounter. You have to hold it with two hands, or worse, you have to cradle it in one arm while you tap on the EMR with a stylus in your other hand.

With the iPad Mini, no arm-cradling is required. It doesn't feel like a brick in your hands by the time you're tapping the physical exam portion into the patient chart. You can comfortably hold it in one hand and the weight doesn't distract you from your patient encounter. The Mini feels like the typical clipboard you would use for a patient encounter, rather than an electronic brick.

If you have a Retina display iPad, you will definitely miss the higher screen resolution. But after a week you get used to a non-retina display, and you enjoy not having sore wrists after talking to a patient with your iPad.

Some analysts have argued that it's harder to use an EMR with the Mini's display. This is garbage. The great thing about the Mini is you get the same screen real estate that you would on a full sized iPad. Of course, the objects and text are slightly smaller. I used Epic -- the most popular Hospital EMR, and had no issues with doing parts of my chart and also putting in patient orders with the Mini.

Yes -- the iPad Mini's smaller size makes it easy to fit into your white coat -- you no longer need a custom white coat for your iPad. Yes -- the cheaper cost is another advantage. But no, those are not the two main reasons why the physician community will adopt the iPad Mini.

On my birthday several weeks ago, I was lucky to get an iPad Mini from my husband. I already have an iPad and have shared my experience. In fact, we gave all of our residents iPads (one of them contacted Steve Jobs and got a response), and documented an improvement in efficiency on the wards. So why the Mini? What is all the fuss? Well, after finishing 2 weeks on service, I can finally tell you why the Mini is the new must-have for doctors and future doctors.

So what is the verdict for the Mini? Well, as we say in medicine, the risks of the Mini are outweighed by its benefits making it the perfect prescription for all the physicians or physicians to be in your life.

"These days iPads are given as Christmas gifts and schools give our kids personal Chromebooks," she said. "Kids today are streaming videos, playing games and watching movies on their phones. Instead of going out and kicking a ball and practicing using their vision to look far away."

Today, about 41.6 percent of Americans are nearsighted, up from 25 percent in 1971. In fact, projections suggest that almost 50 percent of the world will be myopic by 2050, according to the National Eye Institute (NEI). The problem is even worse in Asia and Southeast Asia, where in certain developed countries there, up to 80 to 90 percent of 12-year-olds are nearsighted, according to the NEI.

"The U.S. is starting to parallel a similar trend in Asia. People are becoming more nearsighted in places like Japan, Singapore and China because so much time is spent looking up close at things like phones and computers instead of far away," said Dr. Matossian.

"Just like little bodies develop and become bigger, their eyeballs grow and become stronger. When they are small, their eyes are still growing," she explains. "When we grew up at age 2 and 3 we were not exposed to blue light. iPads, smartphones, laptops and computers are definitely here to stay, and the users are getting younger and younger."

Dr. Matossian strongly recommends putting a protective shield, such as Zagg VisionGuard, on your phone, iPad or computer. These screen guards decreases the amount of blue light that emanates from the device, sometimes by as much as 70 percent.

18 months and younger: The American Academy of Pediatrics says no screen time at all for children 18 months and younger "except for things like video chats with grandparents," says Dr. Matossian.

2-5 years: Continue to minimize and limit screen time. "Keep an eye on what your kids are watching," she says. "I hate to put a strict time on it, but I would say the less, the better. Keep it to half an hour a day for a toddler and no more than that."

For kids ages 5 and up: Make sure smartphones and screen time do not affect sleep, behavior and going outside and getting exercise. "We also have an epidemic on childhood obesity in the U.S. and part of that is based on not doing physical activities and being a coach potato," said the eye doctor. Also, encourage children and teens to sit further away from the screen, such as by watching traditional TV.

Good advice for anyone staring at a screen, regardless of age: "Keep blinking! The further away an object is, the more we blink, which is good for our eyes," says Dr. Matossian. "For example, in a normal conversation you blink 20 to 22 times a minute and you're not even aware of it."

Bring kids to get a baseline eye exam. Children should get a very basic eye checkup at their pediatrician's office, usually around age 5 when the child knows the alphabet, says Dr. Matossian. "This baseline visit can't hurt even if the child is not exhibiting eye issues," she says.

Be a role model when it comes to devices. The best thing parents can do is consider using vision guards themselves, and overall limit the amount of time spent texting, Googling or hunched over our phones.

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Since 2010, there has been sizable growth in the percent of physicians using mobile devices to review diagnostic images and data from medical devices. Within the next five years, most surveyed providers expect that virtual visits have the potential to replace one-third to one-half of office visits.

So the next time you are in your doctors office or visiting a loved one in the hospital; you may be surprised at how much technology that you find. Before you jump to the conclusion that your healthcare provider is slacking off; you may want to consider the fact that the provider is using technology to review information to make a diagnosis. The technology found in healthcare systems today is meant to cut down on time needed to view patients in person in order to gain perspective on a patient's symptoms and faster results. (And maybe to cut down on the need to read doctors handwriting...) There have even been 'virtual doctors visits' made using mobile devices in order to test the future of medical care.

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