Neil VerselFreelance journalist, Chicago, IllinoisDisclosure: Neil Versel has disclosed no relevant financial relationships.From Medscape Business of Medicine10 Totally Cool and Incredibly Useful Medical Gadgets and AppsNeil VerselPosted: 05/18/2011IntroductionSome doctors find new gadgets, apps, and technology fun; some find them confusing; and others want nothingto do with them. Whichever category you fall into, theres a good chance that some exciting and important newtools will someday be part of your medical life. Here are some that are changing the practice of medicine.1) Video Consults on Your SmartphoneUsing new technology, some doctors -- particularly in rural areas -- are doing video office visits. A number ofcompanies have sprung up, such as MDLiveCare, that offer consultations via real-time video.But mobile video is going even a step further. Faster connections over newer cellular networks -- commonlycalled 3G and 4G, respectively, for third-generation and fourth-generation mobile telecommunicationstechnology (3G and 4G refer to the speed of the network the phone is connected with) -- also are enablingwider use of mobile video in healthcare.Andrew Barbash, MD, head of the neurosciences and stroke program at Holy Cross Hospital in Silver Spring,Maryland, uses the free Google Talk application on his smartphone to conduct video consultations with patientsand clinicians in the emergency department when hes on call but not physically at the hospital. "The mobilephone becomes kind of the enabler," Barbash says.Joseph Kim, MD, MPH, curator of MedicalSmartphones.com, believes this is just the beginning. "You will seemore patients communicating with doctors via telemedicine," he says.2) Tablet ComputersTouch-screen tablet computers are creating a new class of totally cool and incredibly useful gadgets andapplications that are helping to make life easier for physicians and their patients.Lets face it, Apples iPad has taken medicine by storm. Research firm Knowledge Networks reported in March2011 that 27% of physicians in the United States had a tablet-style computer, or about 5 times the generalpublics adoption rate. That study didnt break down tablet usage by platform or model, but healthcare industryanalyst Chilmark Research estimated that 22% of all physicians in the United States were using iPads at theend of 2010 (Sharma C. "mHealth in the Enterprise: Trends, Opportunities and Challenges." ChilmarkResearch, November 2010).
Tablets in general and the iPad in particular are more than just oversized smartphones without the phone. Theyhave processing power to rival that of desktop computers. Some of the smaller models -- the Samsung GalaxyTab and the BlackBerry PlayBook -- fit into the pocket of a lab coat. And they have touch screens."Whenever youre in a remote environment, its much easier to draw things up than to try to explain on thephone," says Kim.3) Speech Recognition ProgramsIltifat Husain, MD, Editor-in-Chief and founder of the iMedicalApps.com blog and a new graduate of WakeForest University School of Medicine, is bullish on speech recognition as a breakthrough technology thatmakes physicians lives easier. "I think that doesnt get enough play," he says. Its already easing the transitionto electronic medical records (EMRs) by helping physicians document cases and changing medicaltranscriptionists into higher-skilled editors. Husain says he is looking forward to the day that NuanceCommunications comes out with a version of Dragon Medical speech recognition software that supports real-time voice dictation on mobile phones."The beauty of real-time mobile speech recognition is that the physician no longer needs a keyboard," Husainsays. He notes that one company, DrChrono, already makes an EMR specifically for the iPad that includesreal-time mobile dictation.More Exciting Gadgets4) Handheld Ultrasound StethoscopeGoodbye to what has been the symbol of physician care for almost 200 years."In 2016, doctors arent going to be walking around with stethoscopes," cardiologist Eric Topol, MD, Director ofthe Scripps Translational Science Institute, Chief Medical Officer of the West Wireless Health Institute in LaJolla, California, and Chief Academic Officer at Scripps Health in San Diego, said at the Consumer ElectronicsShow in Las Vegas. "There’s a whole lot better technology coming."Topol called the handheld ultrasound the "new stethoscope," something that will become a must-have devicefor physicians. In 2009, GE Healthcare introduced the Vscan, an ultrasound visualization device that looks likean oversized cell phone with an attached scanning probe.The Vscan costs about $8000, but that price is expected to come down as the technology improves. Anothercompany, privately held Mobisante, this year gained US Food and Drug Administration (FDA) 510(k) clearancefor a similarly priced ultrasound system that runs on a Windows-based Toshiba smartphone.5) Smart BandageThe Holter monitor is also on its way out. Topol has called it, "another obsolete technology, soon to be buried."It just contains too many wires and is uncomfortable to wear. Instead, Topol said, patients with serious chronicailments such as congestive heart failure ought to be wearing a "smart bandage," an adhesive patch containingan array of sensors that measure vital signs.Its a technology that patients can even take home with them. Wireless transmitters in the bandage sendreadings either to a patients smartphone or an Internet gateway such as an in-home wireless router, creatingwhats known as a "body-area network" that keeps constant tabs on people who might otherwise requirehospitalization.6) Unified CommunicationsThough cell phones are pretty much ubiquitous in society and smartphones have proliferated in hospitals, fartoo many clinicians havent been able to ditch the old-fashioned pager. But some companies are trying toeliminate the need for multiple devices by promoting what they call unified communications.For years, Vocera has offered wireless voice-over-Internet protocol (VoIP) phones that send paging, voice, andtext messages to portable handsets within a hospital or clinic. So you can get a portable handset that will stillpage you but also provide other services, including voice and text messages. In the past couple of years, a
Sarasota, Florida-based startup called Voalte (pronounced "volt") has packaged similar technology to run onthe users own smartphone, with a single phone number for all communications.7) Remote Medical Devices and Functions via SmartphoneSome software developers have seized the power of the Apple iOS (iPhone) and Google Android operatingsystems to design apps that effectively turn smartphones into low-cost medical devices, helping to create anew category of mobile diagnostics.In June 2010, the FDA cleared DiabetesManager from Baltimore-based WellDoc, a blood glucose measuringsystem that links to a mobile phone app so patients with type 2 diabetes can collect, track, and share readingswith health professionals and learn how to better manage their conditions. Three months later, AgaMatrix ofSalem, New Hampshire, won premarket approval for its WaveSense Diabetes app for the iPhone that analyzesdata from the device makers Jazz glucose monitor.Researchers at the California Institute of Technology have even created a lens-free microscope using a $1.50digital camera sensor that connects to a smartphone to help remote health workers diagnose malaria indeveloping countries.Others have created apps that mimic the functionality of a stethoscope by listening to the heartbeat through asmartphones microphone, but that approach doesnt work for everyone, according to Husain."People should be careful when using applications like that," says Husain. "There is a whole host of variableswhere you cant use that." For example, Husain says it is difficult to get an accurate reading on overweightpatients without an external stethoscope attachment.Technology Thats Changing Medical CareSome other attention-grabbing technologies include:8) Automated Medication Adherence"Smart" pill bottles can emit light and sound when its time to take a pill and send automatic alerts to caregiversif the patient skips a dose. That gives physicians a new way to monitor medication adherence in populationswith chronic disease. Automated text messages can serve a similar function. This is such a promising area thatbiotechnology billionaire Patrick Soon-Shiong, MD, recently purchased Vitality, maker of the GlowCap wirelessInternet-connected medication bottlecap.9) Electronic Reference Tools and CalculatorsMobile medical reference apps, including Medscapes, have been around for years, but theyre becoming moretimely and functional. In April, Canadian mobile software vendor QxMD apparently made history by releasingan update to its Calculate by QxMD app to incorporate new scientific knowledge about the risk for renal failureand the need for dialysis in patients with chronic kidney disease at the same time a Tufts Medical Centerresearcher publicly presented the evidence.Husain is a fan of a free medical translator called MediBabble. "This is a terrific app," he says, noting that itsparticularly useful in international disaster relief. MediBabble is a history-taking and examination applicationdesigned to improve the safety and efficiency of care for non-English-speaking patients.10) Social NetworkingFacebook has captured the imagination of the world, claiming 500 million active users, half of whom log in onany given day. You can be sure that plenty of physicians are among those masses. But where do you go whenyou want to discuss medicine or simply connect with other doctors?LinkedIn, a business-focused networking site, has at least 100 million users worldwide, but there are severalsocial and professional networking sites just for healthcare professionals, some of which offer securecommunications suitable for colleagues who already know each other to discuss specific cases. (Medscapesdiscussion boards are popular landing spots for physicians).