For Medtech, Lessons Learned from Aviation (and from the iPad)

As Atul Gawande, MD has explained in The Checklist Manifesto, the medical field has learned much from the use of checklists in aviation, which have been used for decades to reduce errors. In medicine, checklists are used, for instance, in surgery to reduce morbidity and mortality. In addition, simulation technology, which has been used extensively in aviation, is also increasingly being adopted by the field of medicine, where physicians are using it to train for difficult procedures.

February 21, 2012

4 Min Read
For Medtech, Lessons Learned from Aviation (and from the iPad)

As Atul Gawande, MD has explained in The Checklist Manifesto, the medical field has learned much from the use of checklists in aviation, which have been used for decades to reduce errors. In medicine, checklists are used, for instance, in surgery to reduce morbidity and mortality.

In addition, simulation technology, which has been used extensively in aviation, is also increasingly being adopted by the field of medicine, where physicians are using it to train for difficult procedures.

The iPad has shaken things up in aviation and has made its presence felt in medicine, too. (There are iPad-based textbooks and scores of medical apps. There are even labcoats with iPad-sized pockets designed for clinicians.)

In an e-mail correspondence, pilot and Full Spectrum Software president Andrew Dallas shared some insight on how the iPads have influenced aviation—and how they will continue to influence medical technology as well.

Dallas first shared some background information: Pilots navigate under two general flight rules. “One can fly under visual flight rules (VFR) or instrument flight rules (IFR),” Dallas explains. “VFR means you have to stay out of clouds. You are responsible for avoiding other aircraft and a few other rules,” he says. “IFR means that you are under the watchful eye of air traffic control (ATC), which handles separation of aircraft so you can ‘fly in the soup’ and be reasonably well assured you won't bump into anyone.”

As Dallas explains, the FAA produces different charts for each of these modalities. “VFR charts are much like road maps with topology.” These are known as sectional charts and they cover different areas of the United States, usually covering several states at a time. “They are big pieces of paper,” he says.

IFR charts include low-level and high-level airways. “For IFR you also need special charts for various procedures such as when approaching an airport for landing or departing an area,” Dallas says. “Basically, these are also like road maps but have some special information about how to avoid flying into terrain and where you should be when flying from point to point.”

In aviation, GPS is a primary means of navigation (although it is used in conjunction with a number of other methods). “GPS allows you to see where you are on these charts,” Dallas says. “It's much easier to navigate with GPS than by reference to paper maps and it is especially nice to not have to fold and unfold a huge map in a small cockpit.”

The iPad 2 has a built-in GPS. The first version of the iPad can be used with an external GPS. The iPad has the benefit of having a relatively large screen and can be used with software like ForeFlight and WingX Pro. “You can have a ton of maps in one tiny package,” Dallas says. “That package also provides a lot of additional features such as radio frequencies, live weather, and more. “

Installed certified GPS units can be used as a primary means for navigation in IFR conditions, while handhelds cannot. “However, handhelds can be used to increase what the FAA likes to call ‘situational awareness,’” Dallas says. “Basically, if it makes you safer, you can use it.

Older aircraft may not have GPS or may have older GPS units. New, certified GPS units are extremely expensive at a base installed price around $10,000 plus an annual subscription for data updates at about $500.00 more. The iPad is about a grand and the annual subscription for services runs about $100 to $200. You can buy more services for more money but this is a rough equivalent.”

Dallas points out that a major airline has approved iPads as a replacement for paper charts in the cockpit. “This is a major statement given the challenges faced in getting FAA approval for instruments,” he says. “In fact, there's talk of ending the prohibition of non-radio electronics on takeoff and landing.”

Summarizing, Dallas explains that for a fraction of the price, the operator of a small aircraft can now have “a really effective tool for efficient navigation with tons of features like weather, traffic detection, backup instruments, and more,” he says. “This is a huge sea change and a boon to aircraft safety.”

As with medicine, aviation is a highly regulated field. “While there are tough regulations at the FAA, the utility of the iPad is so evident that it is being adopted incredibly fast and to huge benefit,” he says. “I can see that the same will be true for medical instruments but rather than GPS and weather data, we get blood pressure, glucose levels or the like. My greatest concern is that innovation might be stymied by burdensome regulation but as we have seen in other industries, a good idea is sometimes hard to hold back. ”

—Brian Buntz

Dream Devices that Would Revolutionize Healthcare

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