June 1, 2015

Medicalized Smartphones: Giving New Meaning to “Selfies”

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Note: This is a guest post from Amanda Guerrero, a writer and marketing specialist for Medical Web Experts. She writes about healthcare IT and Meaningful Use and has a special interest in patient engagement. Follow her on Twitter at @amandague_hit.  

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We have reached a radical moment in medicine when consumers have more control over their health than ever before, and no device is more central to this revolution than the smartphone. By giving consumers quick, easy access to health information and by helping them record and interpret medical data, the device is democratizing  the analog, hierarchical health world.

With today’s shortage of 8,200 primary-care physicians, smartphones promise reduced healthcare costs and improved patient outcomes. Government support of digital health and the promising state of the medical app market has made it clear that the future of medicine lies in the smartphone’s capacity for more in-depth “selfies” than most Instagrammers and Snapchatters ever imagined.

A Federal Foundation

On January 30th President Obama unveiled his new Precision Medicine Initiative, which aims to generate prevention and treatment strategies that take the individual characteristics of each patient into account. A central component of the initiative are mobile health technologies. As Obama explained, “We want every American ultimately to be able to securely access and analyze their own health data, so that they can make the best decisions for themselves and for their families.”  

More than one million Americans are expected to join the research cohort that will share genetic data, biological samples, and diet/lifestyle information. In the Precision Medicine NIH Workshop, healthcare professionals said that ideally, this group will carry a smartphone and wear a smartwatch for continuous biometric measurement, which can lead to quick-response text message interventions and prevention of long-term health damage.

Federal focus on widespread, secure and accessible medical data indicates the growing benefits of using popular, personal technologies in medicine, especially smart technologies which can track complex public health trends. In the future, randomized clinical trials alone may no longer be considered the best approach to medicine; this standard may be replaced by a combination of observational science and big data.

Promising Progress

Nearly two-thirds of Americans are smartphone owners, and 10 percent of Americans own a smartphone but do not have any other form of high-speed internet access at home beyond their phone’s data plan. Because of this, the smartphone is becoming an increasingly important resource for healthcare activities such as checking symptoms and locating providers. According to a recent PEW study, 62 percent of smartphone owners have used their phone in the past year to look up information about a health condition.

It comes as no surprise, then, that the popularity of mobile health apps is accelerating rapidly. The consulting firm research2guidance found that the number of mobile medical apps for iOS and Android, the two leading platforms, has doubled in the past two and a half years to reach 100,000. Thirty-one percent of these apps target chronically ill patients; 28 percent target fitness-interested people; and 14 percent target physicians.

The FDA has already approved numerous medical apps. Smartphones can now monitor pesticides in food, perform blood pressure readings, and measure blood oxygen and glucose levels. They are capable of detecting abnormal heart rhythms and telling someone if they are having a heart attack. Smartphones can identify infections and propose treatments, as well as send medication reminders to patients. They can give patients the opportunity to have video consultations with doctors, and can monitor mental health by sensing facial movements, galvanic skin response, breathing patterns and more.

What Apps Are People Using?

One app that providers commonly recommend to patients is iTriage — Health, Doctor, Symptoms and Healthcare Search. iTriage allows patients to check their symptoms and easily locate a physician or hospital in the event of an emergency. Another popular app for patients is Diabetes App – Blood Sugar Control, Glucose Tracker, and Carb Counter. This app provides a food database for patients to track their consumption and allows physicians to monitor any fluctuations.

Arguably the most popular app for providers is Epocrates, which allows healthcare professionals to review drug prescribing and safety information, check drug-drug interactions, select national and regional healthcare insurance formulas for drug coverage information, and perform dozens of calculations, among other features. Epocrates is used by more than 50 percent of U.S. physicians. Figure 1 — Medical Image Sharing For Healthcare Professionals is also widely used by providers. This app provides a community composed of over 150,000 healthcare professionals who discuss presentation, diagnosis and treatment through the sharing of anonymous medical images.

Devil’s Advocate

It is important to note that medical apps do not trump the need for human physicians, although many claim to. According to Mother Jones, the FDA mainly focuses its regulation on apps that connect to external diagnostic tools, while many other apps use ambiguous language to sidestep regulation. Many pose as “informational” or “entertainment” apps while miscalculating data, dangerously misleading patients about their conditions. A 2012 study found that most simple pedometer apps don’t even count steps correctly, and one blood-glucose tracker had 59 “adverse events” since 2012.

Despite all the progress developers have made in mHealth, the most effective apps are mediaries between patients and real doctors. A study published in JAMA Dermatol in 2013 measured the performance of four smartphone applications that evaluate photos of skin lesions and provide the user with feedback about the likelihood of cancer. The only successful app from the study showed users’ photos to a physician, while the least accurate app used automated algorithms to analyze images.

What’s Next?

Smartphones are powerful tools with the potential to make medical work faster, easier and cheaper, but before we can reach the zenith of the mHealth zeitgeist, we need to perform more clinical trials that prove that our medical apps are not only safe, but capable of lowering healthcare costs and ensuring patient privacy.

Software integrity must be a priority for developers in coming years; patients need to be sure that their medical data cannot be breached. We also need to integrate individual devices with electronic health records (EHRs) through the cloud so that doctors can glean relevant information from the overabundance of patient data.

The large quantity of medical software already on the market is helping patients feel more secure in their everyday lives, and the popularity of medical apps is likely to continue growing steadily. For being relatively new, the smartphone has rapidly become emblematic of that greater concept buzzing around the technological world: consumer empowerment, a concept that drives innovation and which is now indivisible from modern medicine.

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