Physical by smartphone becoming real possibility

Published on NewsOK Modified: May 2, 2013 at 1:23 pm •  Published: May 2, 2013
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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.

Simplicity is part of the idea. Take the AliveCor Heart Monitor. Snap it on like a smartphone case, place fingers on the sensors — no sticky wires on the chest — and you've got an EKG recording in 30 seconds. The FDA approved sale of the $199 device in December for doctors to use in exams or to prescribe for patients to use on themselves.

It doesn't measure as much as a full-scale EKG, and patients must email the recording to a doctor for analysis. But heart patients frequently experience palpitations that have ended by the time they reach a cardiologist — and emailing an on-the-spot EKG reading might help the doctor figure out what happened, said AliveCor co-founder Dr. Dave Albert.

"This is a brand-new technology. We're trying to understand how people will use it," said Albert, whose company also is seeking FDA permission to sell the device over the counter.

Welch Allyn's iExaminer taps the smartphone's camera to photograph deep inside the eye — the orange view of the retina filling the phone's screen.

Similarly, CellScope Inc. is developing an otoscope — that magnifier doctors use to peer into the ear — that can snap a photo of the eardrum. It's not for sale yet, but might parents one day email that kind of picture to the pediatrician before deciding whether Johnny needs an office visit?

"It was great to see it on the phone, rather than the pinpoints we get to see" through a traditional scope, said Dr. Bertina Yen, a Los Angeles internist-turned-health IT specialist. She turned the tables during her smartphone physical, taking over some of the equipment to try it out herself.

And University of Washington researchers are testing a way to measure lung function in people with asthma or emphysema as they blow onto the phone and it captures the sound. Usually patients blow into special machines at the doctor's office, while a use-anywhere version might help someone spot early signs of worsening before they see a doctor.

Insurers are studying what smartphone technology to pay for. For example, health care giant Kaiser Permanente is about to begin a project in Georgia to sell the iBGStar alongside other diabetes monitors in its on-site pharmacies. The project will determine whether patients like the smartphone monitor, if it improves care — and if so, whether the readings should beam into patients' electronic health records, in Georgia and in other Kaiser regions.

But ultimately these devices may have a bigger role in developing countries, where full-size medical equipment is in short supply but smartphones are becoming common. Even in rural parts of the U.S. it can take hours to drive to a specialist, while a primary care physician might quickly email that specialist a photo of, say, a diseased retina first to see whether the trip's really necessary.

"These tools make diagnosis at a distance much easier," said Dr. Nicholas Genes, an emergency medicine professor at New York's Mount Sinai School of Medicine, who helped with TEDMED's smartphone physical.

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