A Doctor's Touch
Treating Medical Conditions Via Smartphones
When Valerie Walsh’s teenage daughter began experiencing asthma attacks away from home, her pediatrician suggested she download a mobile app that would help her better control her breathing through meditating. It was practical advice, considering most teens would forget their heads if they weren’t attached but never their phone, says Walsh, a New Milford fitness-club manager.
Apps, or application software designed to run on smartphones, tablets, and other mobile devices, are one of the fastest growing segments of the consumer-driven health and fitness market. There are 5,820 medical, health, and fitness apps available for smartphones today, according to MobiHealthNews, which tracks global, mobile health news. And they are rapidly changing the way doctors and patients approach healthcare. Apps enable doctors to quickly reference medical information, and they allow patients to monitor their conditions at home and away, often for free or for a low subscription fee.
Even soon-to-come wearable software like the Apple iWatch will focus on fitness and health tracking. Industry experts say Apple is rumored to be working on a health and fitness app called iHealthbook, which will track steps taken and calories burned, along with more complicated records like glucose and hydration levels. “Smartphones are the 2014 version of house calls,” says Dr. Thomas Cigno, a primary-care physician with his own practice in Ridgefield. “I use my iPhone for everything,” he says. “If I don’t have it, I feel like I’m without my stethoscope. It’s totally revolutionized the way we practice because we have the most recent, more accurate information immediately at our fingertips.”
Pediatricians Dr. Matthew Abel and Dr. Evan Hack, with Candlewood Valley Pediatrics in New Milford, were early adaptors, first tapping out apps on their PalmPilots in the late 1990s. They still use Epocrates one of the earliest and best-established medical apps that provides doctors with basic information about drugs, dosages, and warnings about harmful interactions. Epocrates and similar apps like UpToDate have all but replaced the cumbersome staple, Physician’s Desk Reference, at many practices. In fact, most medical-reference material is five years out of date by the time it is published, says Cigno.
UpToDate, which tracks more than 10,000 conditions, is peer-reviewed and collated by over 5,000 doctors and clinicians. “That’s good because medicine is constantly changing,” says Dr. Hack. “Patients want information in real time.”
Other apps his practice uses can quickly analyze a patient’s condition. BiliTool is an app designed to help clinicians assess the risks of newborns developing jaundice, for instance. “We even use a translator app for those patients for whom English is a second-language,” says Dr. Hack.
In the operating room, an app called OR Scrub controls infections by rapidly displaying data on whether staff are being scrupulous about washing their hands. CliniCam allows physicians to take photos of a patient’s condition like a rash or wound, upload it to the patient’s medical record, and then erases it from the phone storage to protect patient confidentiality.
One of the fastest growing apps, Medscape, proved vital for Dr. Evan Rashkoff, chief of orthopedic surgery at Sharon Hospital and orthopedic doctor with Western Connecticut Orthopedic Specialists. In May, he volunteered on a medical mission to Haiti, where he treated patients with tropical diseases. He wasn’t familiar with some diseases, including malaria, Dengue fever, and parasitic worms, and Medscape proved crucial in diagnosing and determining drug dosage.
Many doctors also recommend apps to patients, particularly for tracking fitness, weight control, diet, and sleep quality. The Academy of Pediatrics website highlights several apps, including the Child Health Tracker that gives parents the power to access health education, check symptoms, and find doctors more specific than a Google search provides.
There are, of course, drawbacks to easily accessible healthcare information. “Anybody who has access to something like the Symptom Checker app can read into it something that is incorrect,” says Dr. Abel. “Apps aren’t meant to replace the doctor but to be a tool.”
For some, apps are a double-edged sword. “You’re opening Pandora’s box,” says Dr. Robert Jarrett, a cardiologist at Danbury Hospital. Today, patients now can get an instant EKG reading on their phone screen. But Dr. Jarrett cautions: “It may be no different than a home blood-pressure meter where they’re taking their blood pressure every ten minutes and driving themselves crazy. In the end it’s just a piece of data; it still has to be interpreted by a physician to be meaningful.”
Most physicians concur that hands-on is still the most important part of what they do that technology can’t replace. Dr. Cigno’s practice is a “concierge” physician practice. Patients pay an annual retainer to provide rapid call backs and a higher level of personal interaction. So technology helps facilitate communicating with his patients, he says. “I can Skype if a patient can’t make it to the office, use FaceTime or text. The only downside, he concedes: “If my iPhone dies, I’m dead.”