By Amber Smith
The (Syracuse) Post Standard
A patch attached to a patient's skin measures cardiac fluids and pressures, alerting the medical caregiver of developing congestive heart failure long before the patient feels any symptoms.
A patient recovering from knee replacement surgery goes home from the hospital with Kinect – the Xbox 360 technology which is sensitive enough to detect facial expressions and tone of voice – to conduct and monitor rehabilitation.
A patient swallows a pill that contains an embedded chip that is activated by saliva and transmits data to the caregiver, tracking the patient's movements, body temperature and other data.
The practice of medicine is evolving in ways that make use of smart phones and mobile devices, and even though your doctor's office doesn't yet have the patch or the pill or the Kinect, a new breed of doctor/geek is busy crafting the technology. And regulators in the United States are scrambling to keep up.
"The FDA has come out saying 'we need to regulate these areas,' but unfortunately the technology is moving faster than the regulatory agencies can keep up," Dr. Joseph Kim told AHCJ members at Health Journalism 2011 in Philadelphia. Kim is vice president of medical affairs and technology at Medical Communications Media.
He pointed out that the Food and Drug Administration in March, for the first time, approved a medical application called Medical MIMS that helps analyze radiographic images on iPhones, androids, iPads and other mobile devices used by caregivers.
Kim cautioned that at this point, anyone can create a "health" or "medical" app for sale on iTunes. For example, during the height of the swine flu pandemic, at least two apps were marketed as swine flu detectors. And while educated people knew better, Kim says "there are certainly people who might have used this."
Privacy is another valid concern, he said.
A person with HIV may use an iPhone to search online for information about the disease and treatments. Any application on the phone could be used to track such searches. Kim said he has no evidence any apps are doing this currently, "but the capability certainly exists."
The ability to collect multiple sets of data is key to developing technology that can help patients, said Mohit Kaushal, executive vice president of business development and chief strategy officer for West Wireless Institute.
His institute is an independent nonprofit that is experimenting with how best to transmit data, store it and analyze it. He said the goal is to use wireless health to reduce costs. In the process, this is liable to makeover the American health care model which has the hospital as the end point. Through continuous monitoring, Kaushal said patients will be empowered to get and stay healthy.
Hemang Patel, a market development manager for Microsoft, said mobile technology will help meet some of the new health care regulations that call for better oversight of patients.
Some smart phone plug-ins and hand-held devices move diagnostics to the patient's bedside, and some texting and instant messaging technologies mean the doctor may not need to be at the bedside. Some hospitals already use iPads so that doctors can monitor hospitalized patients from outside of the hospital.
Issues that became apparent when the Internet first became popular are resurfacing through the use of mobile devices, Kim warned. Diabetic patients who rely on an app to gauge insulin levels, for instance, could accidentally overdose, and someone who turns to a symptom checker for chest pain may mistakenly believe they have only indigestion rather than a heart attack.
AHCJ members raised questions of the panelists, among them:
* How will we get these mobile devices, which can be expensive, into the hands of patients from lower socioeconomic groups?
Many devices are not expensive, Kim explained, and his medical experience has shown him that even people on fixed incomes have smart phones. "They are more connected than we probably realize."
* Will the collection of data help improve patient compliance rates?
"Good question," Kaushal and the other panelists agreed.
Amber Smith is a staff writer at The (Syracuse) Post Standard.
