551918 research-article2014
RSH0010.1177/1757913914551918Current Topics & OpinionsCurrent Topics & Opinions
Current Topic & Opinion
Smartphone healthcare: technology comes with caution! Syed Raza Shah, a medical student at Dow University of Health Sciences in Pakistan, looks at the rise of the smartphone in healthcare provision and points out consequences we should be cautious of. While most smartphone healthcare interventions have shown positive outcomes so far, the evidence base is challenged by methodological limitations and is not yet conclusive. Ever since the invention of the ‘smart’ cellular device, people have wondered where the boundaries will end. That is the idea behind smartphone healthcare, a re-innovation of the physical exam using only smartphones and a few devices that connect to them. With the global prevalence of mobile phone technology, accessing health-related applications through mobile phones seems a logical step in a patients’ management of their own medical conditions.1 A smartphone connected to a medical device can allow patients to monitor their health outside the doctor’s office. But what makes medical applications truly revolutionary is that they use Internet-enabled smartphones and tablets to connect patients directly to their family physicians and medical professionals. Patients can now measure their glucose levels, blood pressure and other vital statistics at home and transmit them daily to their physician. According to a US study, 25% of smartphone users are already using such health applications and almost half of those asked would be interested in doing so.2 However, technology comes with consequences. Applications (apps) like ‘3D4Medical’ use innovative three-dimensional (3D) technology to navigate through the body effortlessly. Similarly, ‘Medscape’, a revolutionary medical application available free of cost, can retrieve news articles from many different health fields, including a very useful clinical reference section. ‘Muscle Trigger Point’ is another useful app for researching muscle trigger points and tight places in the body that
can cause pain. Several other apps are also available. A recently announced innovation, the new iPhone electrocardiogram (ECG), is an iPhone case that connects to the device and allows users to obtain an instantaneous ECG in the palm of their hands. It is a case that attaches to the iPhone device and plugs into its 32 pin connector at the bottom seamlessly, while doubling as a phone case. The device has a case where a user places their index fingers in order to conduct the electrical rhythms to the onboard smartphone application. The device can also be held up directly to the chest as instructed in the application. While this seems like just another piece of gadgetry hitting the medical world, these innovations pave the way to a whole new line of home medical products. While these applications educate the user so that they have far more knowledge than they previously may have had about a condition, they come with cautions. With different applications on board that interpret different medical tests, for example, ECG tracings, medical information can be falsely interpreted by untrained individuals. The outcome of such a manoeuver leads to either a false sense of security or a frantic interpretation of a possibly normal tracing. Additionally, this could encourage self-medication, which may lead to incorrect self-diagnosis, dangerous drug interactions, delays in seeking medical advice when needed, risk of dependence and abuse, infrequent but severe adverse reactions,
320 Perspectives in Public Health l November 2014 Vol 134 No 6
incorrect manner of administration and dosage, polypharmacy, incorrect choice of therapy and the masking of a severe disease. This poses serious health consequences in people dependent on smartphone healthcare. Most interventions have shown positive outcomes, but the evidence base of smartphone healthcare-based interventions is challenged by methodological limitations and is not yet conclusive. Both monitoring systems, including a partnership between physicians, patients and pharmacists and the provision of education and information on safe healthcare usage via smartphones are proposed strategies for maximising benefit and minimising risk. Future studies should use suitable sample sizes to provide greater statistical power for identifying theorised effects and should clearly report the calculations performed to estimate power. Reports on proper measures as to how participants were treated, along with theoretical constructs being targeted in these studies, should also be described more elaborately. All these limitations must be addressed in order to enhance further testing and developments applicable to this new tool of healthcare management. Presently, the Food and Drug Administration (FDA) has been careful in certifying these devices for use, and they are considering these devices for use by medical professionals only due to the necessity for their interpretation by trained professionals.
References 1.
2.
PriceWaterhouseCoopers. Emerging mHealth: Paths for Growth. 2012. Available online at: http://www.pwc.com/en_GX/gx/healthcare/ mhealth/assets/pwc-emerging-mhealth-full.pdf (Last accessed 18th August 2013). Fronstin P. Findings from the 2011 EBRI/MGA consumer engagement in health care survey. EBRI Issue Brief No. 365, December 2011, pp. 1–26. Washington, DC: Employee Benefit Research Institute.
Copyright © Royal Society for Public Health 2014 SAGE Publications Downloaded from rsh.sagepub.com at Bobst Library, New York University ISSN on April 19,1757-9139 2015 DOI: 10.1177/1757913914551918
RSH0010.1177/1757913914551918Current Topics & OpinionsCurrent Topics & Opinions
Current Topic & Opinion
Smartphone healthcare: technology comes with caution! Syed Raza Shah, a medical student at Dow University of Health Sciences in Pakistan, looks at the rise of the smartphone in healthcare provision and points out consequences we should be cautious of. While most smartphone healthcare interventions have shown positive outcomes so far, the evidence base is challenged by methodological limitations and is not yet conclusive. Ever since the invention of the ‘smart’ cellular device, people have wondered where the boundaries will end. That is the idea behind smartphone healthcare, a re-innovation of the physical exam using only smartphones and a few devices that connect to them. With the global prevalence of mobile phone technology, accessing health-related applications through mobile phones seems a logical step in a patients’ management of their own medical conditions.1 A smartphone connected to a medical device can allow patients to monitor their health outside the doctor’s office. But what makes medical applications truly revolutionary is that they use Internet-enabled smartphones and tablets to connect patients directly to their family physicians and medical professionals. Patients can now measure their glucose levels, blood pressure and other vital statistics at home and transmit them daily to their physician. According to a US study, 25% of smartphone users are already using such health applications and almost half of those asked would be interested in doing so.2 However, technology comes with consequences. Applications (apps) like ‘3D4Medical’ use innovative three-dimensional (3D) technology to navigate through the body effortlessly. Similarly, ‘Medscape’, a revolutionary medical application available free of cost, can retrieve news articles from many different health fields, including a very useful clinical reference section. ‘Muscle Trigger Point’ is another useful app for researching muscle trigger points and tight places in the body that
can cause pain. Several other apps are also available. A recently announced innovation, the new iPhone electrocardiogram (ECG), is an iPhone case that connects to the device and allows users to obtain an instantaneous ECG in the palm of their hands. It is a case that attaches to the iPhone device and plugs into its 32 pin connector at the bottom seamlessly, while doubling as a phone case. The device has a case where a user places their index fingers in order to conduct the electrical rhythms to the onboard smartphone application. The device can also be held up directly to the chest as instructed in the application. While this seems like just another piece of gadgetry hitting the medical world, these innovations pave the way to a whole new line of home medical products. While these applications educate the user so that they have far more knowledge than they previously may have had about a condition, they come with cautions. With different applications on board that interpret different medical tests, for example, ECG tracings, medical information can be falsely interpreted by untrained individuals. The outcome of such a manoeuver leads to either a false sense of security or a frantic interpretation of a possibly normal tracing. Additionally, this could encourage self-medication, which may lead to incorrect self-diagnosis, dangerous drug interactions, delays in seeking medical advice when needed, risk of dependence and abuse, infrequent but severe adverse reactions,
320 Perspectives in Public Health l November 2014 Vol 134 No 6
incorrect manner of administration and dosage, polypharmacy, incorrect choice of therapy and the masking of a severe disease. This poses serious health consequences in people dependent on smartphone healthcare. Most interventions have shown positive outcomes, but the evidence base of smartphone healthcare-based interventions is challenged by methodological limitations and is not yet conclusive. Both monitoring systems, including a partnership between physicians, patients and pharmacists and the provision of education and information on safe healthcare usage via smartphones are proposed strategies for maximising benefit and minimising risk. Future studies should use suitable sample sizes to provide greater statistical power for identifying theorised effects and should clearly report the calculations performed to estimate power. Reports on proper measures as to how participants were treated, along with theoretical constructs being targeted in these studies, should also be described more elaborately. All these limitations must be addressed in order to enhance further testing and developments applicable to this new tool of healthcare management. Presently, the Food and Drug Administration (FDA) has been careful in certifying these devices for use, and they are considering these devices for use by medical professionals only due to the necessity for their interpretation by trained professionals.
References 1.
2.
PriceWaterhouseCoopers. Emerging mHealth: Paths for Growth. 2012. Available online at: http://www.pwc.com/en_GX/gx/healthcare/ mhealth/assets/pwc-emerging-mhealth-full.pdf (Last accessed 18th August 2013). Fronstin P. Findings from the 2011 EBRI/MGA consumer engagement in health care survey. EBRI Issue Brief No. 365, December 2011, pp. 1–26. Washington, DC: Employee Benefit Research Institute.
Copyright © Royal Society for Public Health 2014 SAGE Publications Downloaded from rsh.sagepub.com at Bobst Library, New York University ISSN on April 19,1757-9139 2015 DOI: 10.1177/1757913914551918
