Mobile phones and the future of medicine

Samsung Galaxy Note (Source: Wikimedia Commons)

When I attended the first UCT Faculty of Health Sciences Postgraduate Research Day, last year, one of the talks concerned using cell phones to empower community healthcare workers. As I recall, this was primarily focussed on rural health-care, where funds and equipment are especially tight. Cellphones, however, are quite common. More than 75% of South Africans use cellphones, making them more popular than radio, television or computers. Some side-effects of this have been a photo series of disguised towers and Mxit, a local chat application, going international. All these phones also have the potential to help improve medical care.

After the research day I was talking about what cellphones could do and a friend directed me to this app, Instant Heart Rate. It measures your heart rate using the phone’s camera and changes in colour as blood flows through your finger. It’s pretty cool and seemed to work when I used my other hand to check your pulse to make sure the graph changed with each beat. If we have cellphones, smartphones in particular, easily available and they can be used to improve healthcare then that seems like something worth pursuing. It turns out many people are, all over the world.

In May 2012, Darrell West wrote a summary about mobile devices transforming health care. It has many different examples from all over the world. This can involve sending patients appointment or medicine reminders, remotely monitoring patient’s progress, providing diagnoses to patient’s who would otherwise have to travel far to see a doctor or giving doctors easy access to recommended protocols. These technologies could save a lot of time and money while improving access and quality of healthcare if people are willing to use them. It seems that they are.

77 percent in a national survey said they would like to get reminders via e-mail from their doctors when they are due for a visit, 75 percent want the ability digitally to schedule a doctor’s visit, 74 percent would like to use e-mail to communicate directly with their doctor, 67 percent would like to receive the results of diagnostic tests via e-mail, 64 percent want access to an electronic medical record to capture information, and 57 percent would like to use a home monitoring device that allows them to e-mail blood pressure readings to their doctor’s office.

Similarly a report in the South African Medical Journal sent weekly short texts to midwives as a way to examine whether it could be used as a way to improve continuing education. Only 4% said that didn’t improve their clinical practice, 86% said they discussed the information with their colleagues most or some of the time and 100% of the interviewed midwives said they would like further text messages on important topics.

Although there are some encouraging successes here, such as a recent report of diagnosing worms through a field microscope attached to an iPhone, there are also dangers. Apps, such as the heart rate monitor I mentioned earlier, are not regulated and tested so may not be reliable and are certainly not an alternative to a trained doctor.

A paper published this year (It’s not open access but there are news articles on Reuters and Science Daily) tested 4 apps that claimed to analyse photos of skin lesions to see if they were malignant. The most expensive one actually sent the photos to a dermatologist but three of them analysed the photos with algorithms. Of those, even the best one only got the correct diagnosis 70% of the time (98% for the app that sent photos to a dermatologist) and the worst only managed 6.8%. This leaves a real danger that if people use these apps as an alternative to a doctor they might receive incorrect advice.

With smartphones growing in processing power all the time we can be sure that healthcare will move to a mobile platform, in some cases it’s already there now. What we do need to bear in mind, though, is that apps are unregulated and are not a substitute for a doctor. Undoubtedly apps aimed at providing health services will be regulated in the future but at the moment developers are ahead of regulation and it’s important to be careful what and how you used these technologies.

On a related note you might find it interesting to read how internet searches can help uncover what combinations of drugs give side-effects before we would be able to tell from patients’ reports.

The researchers then looked for 62 other drug pairings, half known to cause hyperglycemia and the other half known not to. They found that the data-mining procedure correctly predicted whether the drug combo did or did not cause hyperglycemia about 81% of the time.

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