Orthopedic Surgeon uses a “Sterile” iPad every day in the Operating Room

Some hospitals and health systems are working on customizing their clinical information systems so that doctors making their rounds can access patient data on iPads. But some physicians are taking things one step further by taking iPads into the operating room with them.

One of those pioneering surgeons is Felasfa M. Wodajo, MD, an assistant professor of orthopedic surgery at both the Virginia Commonwealth University School of Medicine’s Inova Campus and Georgetown University Hospital.

“I use the iPad every day in the operating room,” says Wodajo, who specializes in musculoskeletal tumor surgery. The iPad is inserted into an X-ray cassette sterile bag. The top is cut off, folded back and clamped with a hemostat, allowing the iPad to be used in the sterile environment. Wodajo has found that the touch screen works well through the plastic bag even when he is wearing gloves.

“For me the most important use in the operating room is for reviewing imaging studies,” he explains. “Traditionally you look at a CD-ROM at a PC workstation, and once you are scrubbed you can’t easily go back and change the images. With the iPad you can continually change which slices you look at wherever you are.” It also offers the capability to review relevant anatomy at the point of care, he adds.

Wodajo also uses Apple’s iPad camera adapter to transfer photos he has taken with a digital camera during the operation to the iPad. Sometimes he shares those photos with family members in the post-op waiting room.

The mobility of the iPad is valuable outside the OR as he prepares for cases. Here is one recent example: He had a patient with a tumor in the pelvis. This patient had previously been treated for a pelvic tumor. Was this a recurrence or a new tumor? Was it operable or inoperable? “It was hard to see what was what,” he remembers. “I kept looking at it over the weekend on my iPad slice by slice and finally saw that it was operable.”

DICOM solutions

Wodajo described a couple of different ways surgeons can access images on the iPad in the OR. One is using a cloud service called Mobile MIM from MIM Software. It allows DICOM (Digital Imaging and Communications in Medicine) data to be uploaded directly from a CD-ROM to MIM’s cloud, and then viewed from there via the iPad.

Another option is to use OsiriX, a free and open source Macintosh DICOM reader application. On a laptop, Wadajo opens OsiriX, identifies the images of interest, exports images from a patient’s CD-ROM as JPEGs into a Dropbox folder on the computer and then views the images using the Dropbox app on the iPad.

What’s next?

Wodajo says surgeons are just starting to scratch the surface of the potential uses of the iPad and other tablet devices.

Apps have been written to help surgeons with administrative tasks such as tracking the surgeries they have done. But the surgeon is also intrigued by the possibility of incorporating the built-in sensors in the iPad, such as the accelerometer and gyroscope, to create assistive surgical tools.

But while all these innovations are exciting, Wadajo says, hospital IT organizations need to make sure they are helping rather than hindering mobile technology efforts. (In a recent survey conducted by

HealthcareInfoSecurity, 38%of healthcare IT leaders said they don’t allow employees to use their personal mobile devices for work and 28% said they have no mobile device security policy.)

“The software being written for the iPad is driving such rapid adoption,” Wadajo says. “Hospital policies and business models have to catch up.”