Mineral Wells Index (Mineral Wells, Tex.), Vol. 114, No. 58, Ed. 1 Thursday, July 25, 2013 Page: 4 of 10
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Tech
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PAGE 4
Could a smartphone
physical be in your future?
By RAVI WUWKH
Th* WMhwyoo Pom
A# my attending phy-
sician walked in with
the next patient; I quick
ly stutted mv iPhone
into my pocket Then*
wax a strict “no cell-
phone policy in the
pediatrn clink where I
w as w orking
as a third-year
medical stu-
dent M my
attending had
caught me. I .
would have
received a
stern lecture
about how
cellphones
were not to be
u«‘d w hile
patients wen*
m the room
We proceed-
ed to examine
the patient, a
v oung boy
named Tim,
w ho had an
earache* As
part ot the routine phys-
ical exam, I used my
otoscope • a device first
described in IVvt to
examine Tim s eardrum
l ntortunatelv. it was
difficult to see the char
actenstic cone-shaped
membrane The more I
maneuvered the oto-
scope, the rriore Trm
yelped in pain I tinallt
gave up and admitted
that I couldn t find the
eardrum Til" had been
subjected to enough
agony, and wo sent him
home w ith a course of
antibiotics (or a pre-
sumed ear infection Mv
attending later confessed
that after H) years of
practicing, she still
sometimes had trouble
seeing the eardrum
I remembered Tim *
eardrum when reading
the 201 ^ program of
I M)MFD. an annual
conference in
Washington showcasing
the most promising
medical advances in the
country A medical tech-
nologs blog that I w rite
lor had organized an
i-xhihit tailed The
'smartphone Physical ‘ to
showcase smartphone
apps - many of them
already commercially
available • that doctors
could us«> in a physical.
As part of the exhibit,
the team used CellScope,
a mobile phone attach-
ment to show attendees
a picture-perfect magm- '
fication ot their inner ear
canal - much clearer
than I d seen with my
otoscope
I recently mentioned
the device to a pediatri-
cian. “That'll he the day,"
she replied
Many doctors share •
her skepticism ot smart-
phones in medicine less
than half ot attending
physicians in a recent
survey reported using
smartphones tor patient
care. Many doctors
worry that these* tech-
nologies will hurt their
relationships with
patients In a 2012 essay
in the* journal of the
American Medical
Association. Georgetown
University physician
Caroline Wellbery
warned that “these
devices deprive us of the
very essence of presence.
. . We may be surren-
dering our capacity to be
in the moment."
But what if these tech-
nologies not only make
physicians physical
exams easier but also
improve our interactions
with patients?
Smartphones can offer
doctors a more reliable
exam while increasing
patient involvement in
their care. Within the
next decade, the smart-
phone physical might
replace the traditional
physical exam. Even
now, the long-standing
routine* physu al may
no longer be so routine.
The traditional physi-
be over-
all pneumonias A study
found that stethoscopes
w ielded by young doc-
tors correctly identified
only one-fifth of previ-
ously diagnosed .neart
conditions
So while the tradition-
al physical exam may be
hands-on, it's probably
time to find ways to
improve it; to me, smart-
phones otter that posxi-
biht\
SMARI PHONE IRC
Mow can doctors
wielding smartphone*,
make a physical exam
more effective? ,
technologies such a*.
C ellScope are often
smaller and less
unwieldy than oto-
scope's, stethoscopes and
ultrasounds. “The
Smartphone Physical"
included a smartphone
case that doubles as an
I KCi machine
Participants could get
readings ot their heart
rhythms just by placing
•their fingertips on sen-
sors located on the back
ot the smartphone case
By contrast, a standard
single-lead FKG usually
requires a technician to
attach sensors to a
patient s bod\ in a clinic,
doctor s office or, often,
ambulance.
A study of the smart-
phone EK(i presented at
the 2012 American Heart
Association annual
meeting showx*d that its
results were as accurate
as a single-lead EKG at
detecting atrial fibrilla-
tion and other arrhyth-
mias. (Hospitals and
emergency rooms use
12-lead thC.s to detect
heart attacks and other
conditions.)
Furthermore, the new
device allows patients to
participate in their own
exam. The F.KG readings
can be transferred
directly fr»»m iPhone to
the Web, enabling a doc-
tor to remotely look tor
specific heart wave
abnormalities in real
time - as opposed to
having the patient go to
an F.R or doctor s office
to be evaluated
One doctor has used
the app on two occa-
sions to diagnose life-
threatening heart condi-
tions on airplane passen-
gers in distress
These devices also can
increase patients' ability
to understand their own
care Smartphone tech-
nologies provide user-
friendly visual and
audio output that
patients can have literal-
ly at their fingertips and.
with help from their
doctor, can be shown
how to use and under-
stand at home as well
Imagine, for example,
that you didn't have to
wait days to get your
blood pressure checked
at the doctor's office
(where blood pressure
readings are often artifi-
cially high due to ‘white
coat syndrome*, but
could instead measure it
whenever you wished
using a smartphone
blood pressure cuff
attachment whose
results would be trans-
ferred blatantly toyour
doctor. This would not
only be easier for
patients but COuid pro
vide more accurate
4-
plume devices are
already being used by
patients to collect and
storx* their data, mi when
they see their clinicians
they can have produc-
tive and informed con-
\ ersations *
smartphone medical
application* are also, on
average, less expensive
for physician*
and clinks
than tradition-
al diagnostic
tools Some
insurer* charge
$*> per EKG to
insured
patient*; unin-
sured ones,
though, can
pay over
91,000 for one
By contrast,
the mobile
F KG attach-
ment has a
one-lime exist
of iiw. which
means doctors
will he able to
charge their
patients less
As difficult as (tmd
them, the otoscope and
other traditional tools
w ill remain a large part
x*t nu-dical practice tor
the iu*ar future. And to
he tair, doctors grew up
training With these tools;
learning the smartphone
physical would come
i\ ith time and opportu-
nity costs. But doctors
should also realize the
deficiencies in some of
these older technologies
and how smartphones
can address them
Hopefully, the "no cell-
phone policies will then
also turn into a relic of
the* past
Pankh, a student at
Harvard Medical .Sctfuo/
and the fofiii f Kennedy
School- of Government, i>
an editor of MedCadget
the hlty that i o-orqaiuzed
the ">martfthane Ptm-ncal'
exhibit at TEOMBP 2011
M
a*
mWwi
The Mineral Wells Index
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Cluett, Libby. Mineral Wells Index (Mineral Wells, Tex.), Vol. 114, No. 58, Ed. 1 Thursday, July 25, 2013, newspaper, July 25, 2013; Mineral Wells, Texas. (https://texashistory.unt.edu/ark:/67531/metapth1038840/m1/4/?q=stolen%20land: accessed April 27, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting Boyce Ditto Public Library.