The ability to download medical apps on mobile devices has made a wealth of mobile clinical resources available to HCPs.15 Medical apps for many purposes are available, including ones for electronic prescribing, diagnosis and treatment, practice management, coding and billing, and CME or e-learning.9,10 A broad choice of apps that assist with answering clinical practice and other questions at the point of care exist, such as: drug reference guides, medical calculators, clinical guidelines and other decision support aids, textbooks, and literature search portals.7,13,15 There are even mobile apps that simulate surgical procedures or that can conduct simple medical exams, such as hearing or vision tests.6,7 Many mobile apps are not intended to replace desktop applications, but are meant to complement them in order to provide a resource that has the potential to improve outcomes at the point of care.7 The use of medical apps has become frequent and widespread; 70% of medical school HCPs and students reported using at least one medical app regularly, with 50% using their favorite app daily.1,9
11 Useless Apps Available With Strange And Interesting Features
Specialized apps are also available for remote viewing of medical imaging scans.10 Mobile MIM is a free app for the iPad and iPhone, approved by the Food and Drug Administration, that allows remote viewing of x-rays and imaging scans when users cannot access imaging workstations.6 This software works with a paid subscription or pay-per-use plan using MIMCloud, a HIPAA-compliant server that allows users to store and share medical images.6 Images can be downloaded from the cloud and viewed with the MIMViewer paid app in any setting, whether during discussions with team members or patients.6
The increased use of these devices by clinicians in their personal and working lives has also raised important medicolegal and ethical implications.8 Consequently, establishing standards and policies within health care institutions will be necessary to ensure ethical and transparent conduct.7,11 A call has also been made for the examination of the effect of mobile devices and medical apps on clinical education.4 Adoption of these recommended measures will be greatly helpful in guiding clinicians, administrators, educators, and researchers in determining how to best incorporate these increasingly sophisticated tools into clinical practice.10 Best-practice standards for medical app developers should also be established.11 These standards will raise the barrier for entry into the medical app market, limiting the overwhelming quantity and increasing the quality of the apps currently available to HCPs and patients.11
(2) Identify and describe the features of available accessible seating in enough detail to reasonably permit an individual with a disability to assess independently whether a given accessible seating location meets his or her accessibility needs; and
(i) Series-of-events tickets sell-out when no ownership rights are attached. When series-of-events tickets are sold out and a public entity releases and sells accessible seating to individuals without disabilities for a series of events, the public entity shall establish a process that prevents the automatic reassignment of the accessible seating to such ticket holders for future seasons, future years, or future series so that individuals with disabilities who require the features of accessible seating and who become newly eligible to purchase tickets when these series-of-events tickets are available for purchase have an opportunity to do so.
If a covered entity chooses to release unsold accessible seating for sale on a season-ticket or other long-term basis, it must meet at least two conditions. Under 35.138(g) of the final rule, public entities must leave flexibility for game-day changeouts to accommodate ticket transfers on the secondary market. And public entities must modify their ticketing policies so that, in future years, individuals with disabilities will have the ability to purchase accessible seating on the same basis as other patrons (e.g., as season tickets). Put differently, releasing accessible seating to the general public on a season-ticket or other long-term basis cannot result in that seating being lost to individuals with disabilities in perpetuity. If, in future years, season tickets become available and persons with disabilities have reached the top of the waiting list or have met any other eligibility criteria for seasonticket purchases, public entities must ensure that accessible seating will be made available to the eligible individuals. In order to accomplish this, the Department has added 35.138(e)(3)(i) to require public entities that release accessible season tickets to individuals who do not have disabilities that require the features of accessible seating to establish a process to prevent the automatic reassignment of such ticket holders to accessible seating. For example, a public entity could have in place a system whereby accessible seating that was released because it was not purchased by individuals with disabilities is not in the pool of tickets available for purchase for the following season unless and until the conditions for ticket release have been satisfied in the following season. Alternatively, a public entity might release tickets for accessible seating only when a purchaser who does not need its features agrees that he or she has no guarantee of or right to the same seats in the following season, or that if season tickets are guaranteed for the following season, the purchaser agrees that the offer to purchase tickets is limited to non-accessible seats having to the extent practicable, comparable price, view, and amenities to the accessible seats such individuals held in the prior year. The Department is aware that this rule may require some administrative changes but believes that this process will not create undue financial and administrative burdens. The Department believes that this approach is balanced and beneficial. It will allow public entities to sell all of their seats and will leave open the possibility, in future seasons or series of events, that persons who need accessible seating may have access to it.
This provision, however, does not require public entities to seat an individual who holds a ticket to an accessible seat in such seating if the individual does not need the accessible features of the seat. A public entity may reserve the right to switch these individuals to different seats if they are available, but a public entity is not required to remove a person without a disability who is using accessible seating from that seating, even if a person who uses a wheelchair shows up with a ticket from the secondary market for a non-accessible seat and wants accessible seating.
The Department was concerned that applying the new construction requirements for residential facilities to educational housing facilities could hinder access to educational programs for students with disabilities. Elevators are not generally required under the 2004 ADAAG residential facilities standards unless they are needed to provide an accessible route from accessible units to public use and common use areas, while under the 2004 ADAAG as it applies to other types of facilities, multistory public facilities must have elevators unless they meet very specific exceptions. In addition, the residential facilities standards do not require accessible roll-in showers in bathrooms, while the transient lodging requirements require some of the accessible units to be served by bathrooms with roll-in showers. The transient lodging standards also require that a greater number of units have accessible features for persons with communication disabilities. The transient lodging standards provide for installation of the required accessible features so that they are available immediately, but the residential facilities standards allow for certain features of the unit to be adaptable. For example, only reinforcements for grab bars need to be provided in residential dwellings, but the actual grab bars must be installed under the transient lodging standards. By contrast, the residential facilities standards do require certain features that provide greater accessibility within units, such as more usable kitchens, and an accessible route throughout the dwelling. The residential facilities standards also require 5 percent of the units to be accessible to persons with mobility disabilities, which is a continuation of the same scoping that is currently required under UFAS, and is therefore applicable to any educational institution that is covered by section 504. The transient lodging standards require a lower percentage of accessible sleeping rooms for facilities with large numbers of rooms than is required by UFAS. For example, if a dormitory had 150 rooms, the transient lodging standards would require seven accessible rooms while the residential standards would require eight. In a large dormitory with 500 rooms, the transient lodging standards would require 13 accessible rooms and the residential facilities standards would require 25. There are other differences between the two sets of standards as well with respect to requirements for accessible windows, alterations, kitchens, accessible route throughout a unit, and clear floor space in bathrooms allowing for a side transfer.
Two commenters recommended that the Department develop rules for four types of for-sale projects: single family pre-built (where buyer selects the unit after construction), single family post-built (where the buyer chooses the model prior to its construction), multi-family pre-built, and multi-family post-built. These commenters recommended that the Department require pre-built units to comply with the 2004 ADAAG 233.1 scoping requirements. For post-built units, the commenters recommended that the Department require all model