Phone apps can help docs tend to patients
BY DR. PATRICK NEUSTATTER
Christmas came early for me this year when Verizon told me I was eligible for an upgrade.
I have now joined the ranks of smartphone users and discovered that this is a portal to a wondrous world of “mHealth”—the practice of medicine and public health supported by mobile devices.
It’s a world where your smartphone can serve as a pathology lab, nurse, eye doctor, psychologist, security guard, librarian and, of course, very slick communication device.
There are so many health-related apps I can’t tell you about them all here. But one that caused something of a sensation in the British press—and is illustrative of the kind of science-fiction stuff we’re talking about—is an app that can tell if you’ve caught a sexually transmitted infection.
Dr Tariq Sadiq, senior lecturer and consultant physician in sexual health and HIV at St George’s, University of London, is the primary developer of the “eSTI 2.” The app uses miniaturized lab techniques; you put a urine or saliva sample on a special sensor plugged in to your phone to tell if you have caught any one of several STI’s.
As The New York Observer wickedly suggests, wouldn’t it “make more sense for prospective partners to swap fluids beforehand, get a reading on their cell phones, and then decide whether or not to ‘finish the download?’”
But on a more serious note, this same miniaturized path lab technology also can be used to detect multiple pathogens, allergens, toxins, cancer markers and the like.
Less sensational but far more utilitarian are a whole range of apps that have evolved hand in hand with the skyrocketing advance of mobile phones.
There are apps with micro-sensors that can be injected through a hypodermic needle or incorporated in an adhesive patch on the skin to monitor all your vital signs—and send them to your doctor’s phone, whether you are a patient at home or in the ICU.
Other apps can continuously monitor sugar or oxygen levels in the blood; monitor pressure on the skin to anticipate pressure sores; and provide a unique ID to make sure drugs are delivered to the right patient. Still others can trigger alarms in wandering elderly patients.
With some apps, you can convert your phone into an electronic stethoscope or an ultrasound. You can even monitor uterine contractions and fetal heart rate in a woman in labor on your phone, with the AirStrip OB.
There also are apps that monitor your mental state based on the tone of your voice or the frequency and wordiness of your texts.
And there’s a gizmo you can attach to use a phone’s display screen to assess a person’s vision. This is anticipated to be a real boon in the third world.
A large part of what makes the smartphone such a boon to doctors is the same as for anyone else. It makes you available—to the hospital, pharmacy, lab or patient—without having to interrupt your golf game.
It’s not like the old days when my colleague David Lynn always had a quarter taped to his pager so he could use a pay phone (remember those?) if he got a call on the road.
The contact these days can even involve “facetime.” An inventive doctor from the University of Southern Arizona’s Limb Salvage Alliance reportedly used the technology to get input he needed from a colleague attending a conference. He used his phone not to have a face-to-face conversation, but rather to show the diabetic foot wound he was worried about.
On smartphones, X–rays can be read no matter where they’re from—even if they originate in the North Pole. (Santa injured in his work shop?) It’s all the same.
Your phone gives you access to medical sites like Cochrane Review and PubMed, or just good old Google as sources of reference.
The first app I downloaded was Epocrates. It’s a drug information service that will tell you more than you ever want to know about any medicine without having to get a hernia trying to consult the massive and ungainly, 3,480-page, Physicians Desk Reference.
“There’s no such thing as don’t know” quipped plastic surgeon Dr. Howard Heppe in a recent meeting, pulling out his iPhone in response to a question he didn’t know the answer to.
Every silver lining has a cloud.
“Mobile phones have made a bigger difference to the lives of more people than any previous technology,” according to the Economist.
But there is concern our phones have become distracting and addictive—people talk of digital attention deficit disorder. The about-to-be published new psychiatric Diagnostic and Statistical Manual VI includes a new category of “Internet Use Disorder.”
Still, if you see me looking like so many other people these days, lost in space, just staring at the screen of my new phone, I may not be addicted and playing Angry Birds.
With all these medical apps, I could be taking care of my patients.
Dr. Patrick Neustatter, a longtime family practitioner, is the medical director of the Lloyd F. Moss Free Clinic. He can be reached at healthyliving@freelance star.com