This document discusses 10 new medical gadgets and apps that are changing the practice of medicine. It summarizes each technology, including video consults using smartphones, tablet computers like the iPad being used by physicians, speech recognition programs for documentation, handheld ultrasound devices replacing stethoscopes, "smart bandages" with sensors replacing Holter monitors, unified communication devices replacing pagers, smartphone apps turning phones into medical devices, automated medication adherence tools, electronic medical references on mobile devices, and social networking sites for physicians and patients. These technologies are making medical care more mobile, digital, and connected.

1. Neil Versel
Freelance journalist, Chicago, Illinois
Disclosure: Neil Versel has disclosed no relevant financial relationships.
From Medscape Business of Medicine
10 Totally Cool and Incredibly Useful Medical Gadgets and Apps
Neil Versel
Posted: 05/18/2011
Introduction
Some doctors find new gadgets, apps, and technology fun; some find them confusing; and others want nothing
to do with them. Whichever category you fall into, there's a good chance that some exciting and important new
tools will someday be part of your medical life. Here are some that are changing the practice of medicine.
1) Video Consults on Your Smartphone
Using new technology, some doctors -- particularly in rural areas -- are doing video office visits. A number of
companies 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 -- commonly
called 3G and 4G, respectively, for third-generation and fourth-generation mobile telecommunications
technology (3G and 4G refer to the speed of the network the phone is connected with) -- also are enabling
wider 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 patients
and clinicians in the emergency department when he's on call but not physically at the hospital. "The mobile
phone becomes kind of the enabler," Barbash says.
Joseph Kim, MD, MPH, curator of MedicalSmartphones.com, believes this is just the beginning. "You will see
more patients communicating with doctors via telemedicine," he says.
2) Tablet Computers
Touch-screen tablet computers are creating a new class of totally cool and incredibly useful gadgets and
applications that are helping to make life easier for physicians and their patients.
Let's face it, Apple's iPad has taken medicine by storm. Research firm Knowledge Networks reported in March
2011 that 27% of physicians in the United States had a tablet-style computer, or about 5 times the general
public's adoption rate. That study didn't break down tablet usage by platform or model, but healthcare industry
analyst Chilmark Research estimated that 22% of all physicians in the United States were using iPads at the
end of 2010 (Sharma C. "mHealth in the Enterprise: Trends, Opportunities and Challenges." Chilmark
Research, November 2010).

2. Tablets in general and the iPad in particular are more than just oversized smartphones without the phone. They
have processing power to rival that of desktop computers. Some of the smaller models -- the Samsung Galaxy
Tab and the BlackBerry PlayBook -- fit into the pocket of a lab coat. And they have touch screens.
"Whenever you're in a remote environment, it's much easier to draw things up than to try to explain on the
phone," says Kim.
3) Speech Recognition Programs
Iltifat Husain, MD, Editor-in-Chief and founder of the iMedicalApps.com blog and a new graduate of Wake
Forest University School of Medicine, is bullish on speech recognition as a breakthrough technology that
makes physicians' lives easier. "I think that doesn't get enough play," he says. It's already easing the transition
to electronic medical records (EMRs) by helping physicians document cases and changing medical
transcriptionists into higher-skilled editors. Husain says he is looking forward to the day that Nuance
Communications 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," Husain
says. He notes that one company, DrChrono, already makes an EMR specifically for the iPad that includes
real-time mobile dictation.
More Exciting Gadgets
4) Handheld Ultrasound Stethoscope
Goodbye to what has been the symbol of physician care for almost 200 years.
"In 2016, doctors aren't going to be walking around with stethoscopes," cardiologist Eric Topol, MD, Director of
the Scripps Translational Science Institute, Chief Medical Officer of the West Wireless Health Institute in La
Jolla, California, and Chief Academic Officer at Scripps Health in San Diego, said at the Consumer Electronics
Show 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 device
for physicians. In 2009, GE Healthcare introduced the Vscan, an ultrasound visualization device that looks like
an 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. Another
company, privately held Mobisante, this year gained US Food and Drug Administration (FDA) 510(k) clearance
for a similarly priced ultrasound system that runs on a Windows-based Toshiba smartphone.
5) Smart Bandage
The 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 chronic
ailments such as congestive heart failure ought to be wearing a "smart bandage," an adhesive patch containing
an array of sensors that measure vital signs.
It's a technology that patients can even take home with them. Wireless transmitters in the bandage send
readings either to a patient's smartphone or an Internet gateway such as an in-home wireless router, creating
what's known as a "body-area network" that keeps constant tabs on people who might otherwise require
hospitalization.
6) Unified Communications
Though cell phones are pretty much ubiquitous in society and smartphones have proliferated in hospitals, far
too many clinicians haven't been able to ditch the old-fashioned pager. But some companies are trying to
eliminate 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, and
text messages to portable handsets within a hospital or clinic. So you can get a portable handset that will still
page you but also provide other services, including voice and text messages. In the past couple of years, a

3. Sarasota, Florida-based startup called Voalte (pronounced "volt") has packaged similar technology to run on
the user's own smartphone, with a single phone number for all communications.
7) Remote Medical Devices and Functions via Smartphone
Some software developers have seized the power of the Apple iOS (iPhone) and Google Android operating
systems to design apps that effectively turn smartphones into low-cost medical devices, helping to create a
new category of mobile diagnostics.
In June 2010, the FDA cleared DiabetesManager from Baltimore-based WellDoc, a blood glucose measuring
system that links to a mobile phone app so patients with type 2 diabetes can collect, track, and share readings
with health professionals and learn how to better manage their conditions. Three months later, AgaMatrix of
Salem, New Hampshire, won premarket approval for its WaveSense Diabetes app for the iPhone that analyzes
data from the device maker's Jazz glucose monitor.
Researchers at the California Institute of Technology have even created a lens-free microscope using a $1.50
digital camera sensor that connects to a smartphone to help remote health workers diagnose malaria in
developing countries.
Others have created apps that mimic the functionality of a stethoscope by listening to the heartbeat through a
smartphone's microphone, but that approach doesn't work for everyone, according to Husain.
"People should be careful when using applications like that," says Husain. "There is a whole host of variables
where you can't use that." For example, Husain says it is difficult to get an accurate reading on overweight
patients without an external stethoscope attachment.
Technology That's Changing Medical Care
Some other attention-grabbing technologies include:
8) Automated Medication Adherence
"Smart" pill bottles can emit light and sound when it's time to take a pill and send automatic alerts to caregivers
if the patient skips a dose. That gives physicians a new way to monitor medication adherence in populations
with chronic disease. Automated text messages can serve a similar function. This is such a promising area that
biotechnology billionaire Patrick Soon-Shiong, MD, recently purchased Vitality, maker of the GlowCap wireless
Internet-connected medication bottlecap.
9) Electronic Reference Tools and Calculators
Mobile medical reference apps, including Medscape's, have been around for years, but they're becoming more
timely and functional. In April, Canadian mobile software vendor QxMD apparently made history by releasing
an update to its Calculate by QxMD app to incorporate new scientific knowledge about the risk for renal failure
and the need for dialysis in patients with chronic kidney disease at the same time a Tufts Medical Center
researcher publicly presented the evidence.
Husain is a fan of a free medical translator called MediBabble. "This is a terrific app," he says, noting that it's
particularly useful in international disaster relief. MediBabble is a history-taking and examination application
designed to improve the safety and efficiency of care for non-English-speaking patients.
10) Social Networking
Facebook has captured the imagination of the world, claiming 500 million active users, half of whom log in on
any given day. You can be sure that plenty of physicians are among those masses. But where do you go when
you 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 several
social and professional networking sites just for healthcare professionals, some of which offer secure
communications suitable for colleagues who already know each other to discuss specific cases. (Medscape's
discussion boards are popular landing spots for physicians).

4. For patients, there's an emerging field called participatory medicine. A group called the Society for Participatory
Medicine defines it as "a cooperative model of healthcare that encourages and expects active involvement by
all connected parties (patients, caregivers, healthcare professionals, etc.) as integral to the full continuum of
care." Patients facing serious health challenges have been flocking to sites such as Organized Wisdom and
PatientsLikeMe.
Medscape Business of Medicine © 2011 WebMD, LLC