Wednesday, April 23, 2014
Lauran Neergaard / The Associated Press
WASHINGTON — It's not a "Star Trek" tricorder, but by hooking a variety of gadgets onto a smartphone you could almost get a complete physical -- without the paper gown or even a visit to the doctor's office.
A medical student prepares to photograph the inside of an eye using a special tool that uses a smartphone camera during a recent TEDMED conference in Washington.
Blood pressure? Just plug the arm cuff into the phone for a quick reading.
Heart OK? Put your fingers in the right spot, and the squiggly rhythm of an EKG appears on the phone's screen.
Plug in a few more devices and you could have photos of your eardrum (Look, no infection!) and the back of your eye, listen to your heartbeat, chart your lung function, even get a sonogram.
If this sounds like a little too much DIY medical care, well, the idea isn't to self-diagnose with Dr. iPhone. But companies are rapidly developing miniature medical devices that tap the power of the ubiquitous smartphone in hopes of changing how people monitor their own health.
"We wanted to make sure they have all the right tools available in their pocket" is how Joseph Flaherty of AgaMatrix describes his company's tiny glucose monitor. Diabetics can plug the iBGStar into the bottom of an iPhone and check blood sugar on the go without carrying an extra device.
This mobile medicine also might help doctors care for patients in new ways. In March, prominent San Diego cardiologist Eric Topol tweeted "no emergency landing req'd" when he used his smartphone EKG to diagnose a distressing but not immediately dangerous irregular heartbeat in a fellow airplane passenger at 30,000 feet.
And the University of California, San Francisco, hopes to enroll a staggering 1 million people in its Health eHeart Study to see whether using mobile technology, including smartphone tracking of people's heart rate and blood pressure, could help treat and prevent cardiovascular disease.
The question: Do smartphone devices really work well enough for the average patient and primary care doctor to dive in, or are early adopters just going for the cool factor? Many of the tools cost $100 to $200, there's little public sales information yet and it's not clear how insurers will handle the fledgling trend.
"Technology sometimes evolves faster than we're ready for it," cautioned Dr. Glen Stream of the American Academy of Family Physicians. "We're recognizing more and more that not all care needs to be delivered face to face," but only if people measure the right things and have a relationship with a doctor to help make good use of the findings, he stressed.
Addressing a recent TEDMED conference in Washington, Dr. Susan Desmond-Hellmann, UCSF's chancellor, put the challenge this way: "How does mobile monitoring become something more than a toy or something interesting? How does it connect to how I'm cared for by my caregiver?"
About 300 doctors, health policy wonks and others attending that high-tech meeting received what was dubbed a "smartphone physical" from medical students using 10 of the latest devices. The Food and Drug Administration has approved a number of the gadgets for sale; others are experimental prototypes gathered for the demonstration by Nurture by Steelcase and the doctor website Medgadget.
The FDA cites industry estimates that 500 million smartphone users worldwide will use some type of health app by 2015. Today's apps mostly are educational tools, digital health diaries or reminders and fitness sensors. The new trend is toward more sophisticated medical apps, some that work with plug-in devices, that provide information a doctor might find useful.
Some of the devices sell by prescription or on drugstore shelves, while others like the diabetes monitor and blood pressure cuff have entered a new venue for medicine -- the Apple store.
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