Tag: Smartphones

The Super Mobile Doctor Uses Smartphones and Tablets in Patient Care

Dec 1, 2018

By JANE SARASOHN-KAHN

Physicians who have adopted smartphones and tablet devices access online resources for health more than less mobile physicians. Furthermore, these “Super Mobile” doctors are using mobile platforms at the point of care.

Physicians adoption and use of mobile platforms in health will continue to grow, according to a survey from Quantia Communications, an online physician community. This poll was taken among 3,798 physician members of QuantiaMD’s community in May 2011. Thus, the sample is taken from the community’s 125,000 physicians who are already digitally-savvy doctors. QuantiaMD calls physicians with both mobile and tablet devices “Super Mobile” physicians.

The most common mobile devices among the Super Mobile doctors in QuantiaMD are iPhones, used by 59%; iPads, used by 29%; and, Android smartphones, used by 20% of the physicians surveyed. Blackberry devices are used by 14% of the doctors in the poll.

Just under one-half of these doctors plan to purchase a mobile device in 2011, notably an iPhone, an iPad, or an Android.

A Cowardly New World

Oct 1, 2018

By Brian Goldman, MD

Last month, the National Post’s Tom Blackwell reported that a growing number of hospitals say patients and their families are secretly recording doctors and nurses. Some say it’s a symptom of the breakdown of trust being patients and their physicians. Welcome to a Cowardly New World.

The biggest examples that reported in the National Post included a video camera installed in a clock radio to secretly record doctors and nurses as they treated a patient. The footage was used as evidence regarding substandard care at Sunnybrook Health Sciences Centre in Toronto. At Toronto’s University Health Network, a video camera was reportedly concealed inside a teddy bear. A camera concealed in a wrist watch was used to record evidence against a Calgary psychiatrist. Smart phones are also being used overtly and also surreptitiously.

I have experienced this first hand in the ER. On one occasion during a night shift, as I was about to stitch up a patient’s cut, his buddies asked if they could record me doing it. I thought it was kind of cute and innocent. The recording took place in a closed room away from other patients so there was no risk anyone else could be filmed surreptitiously.

To be clear, that example was overt. I had another patient encounter that was quite different. I remember seeing an elderly patient who came to the ER with a medical problem. Both the patient and a relative were present in the room the first time I saw him. I came into the room a second time to give the patient and the relative some test results. As I walked into the room, I noticed that a cell phone was on a chair in the room; it was seated in the middle of the seat cushion, sort of like an invited guest. I paid no further attention to it.

The relative said the patient’s daughter (a physician) and was en route the hospital to speak with me. I started to tell the patient and the relative my working diagnosis and my management plan. Suddenly, the cell phone talked! A voice emanated from the smart phone’s speaker disagreeing with me! The daughter had been surreptitiously listening in all along.

Caveat User: Understanding the Health Risks of Mobile Devices

Dec 23, 2013• 9

By DAVID KATZ, MD

Tis the season to, well, buy stuff. Increasingly, the stuff we buy is electronic. In fact, not only that, but increasingly the stuff we buy with is electronic, too. We are using gizmos to shop for gadgets, or possibly gadgets to shop for gizmos.

In any event, we are ever more frequently in the company of the energy fields our electronic devices, and in particular our smart phones, generate. This deserves more attention than most of us accord it.

Don’t get me wrong — I am not suggesting we return to the pre-cell phone days when we lived in dark caves. We are fully ensconced in the electronics era, and there appears to be no going back. I am as fully dependent on electronic devices as anyone, and maybe more than most, living much of my life these days online. Like so many, I am both beneficiary and victim of the attendant efficiencies. On the one hand, I can’t recall how we ever got anything done in the days before instantaneous communication and push-of-a-button document transmission.

On the other, I do long for the freedom of the time before an unending stream of emails became my manacles. I did sleep better in the days before bedtime meant checking one last time to see who in the world needed what, and/or finding out that someone in cyberspace thinks I’m a moron. Oh, well.

Some of the risks related particularly to mobile phone use are well known. The dangers of distracted driving are common knowledge, with cell phone use now implicated in at least 25 percent of all car crashes. There is some evidence that ambient levels of empathy — our ability to understand and connect to one another’s emotional state — are declining, and possibly due to the frequency with which technology comes between us. A recent study among college students finds that more frequent use of cell phones correlates with impairment of academic performance, and increased anxiety — although the study could not prove cause and effect.

But the greatest and most insidious risk of cell phone use pertains to the electromagnetic fields of non-ionizing radiation they produce. What makes this risk insidious is our potential to dismiss it altogether, in part because it is convenient to do so, and in part because it’s hard to take seriously a potential menace that is totally invisible. I suspect we are all at least somewhat prone to a “what I can’t see, feel, taste, smell or hear can’t hurt me” mentality.

But of course, that’s clearly wrong, as we all have cause to know. Anyone who has ever had an X-ray has experienced first hand the power of an invisible force, in this case ionizing radiation, to penetrate deeply into our bodies. Anyone who has had a MRI has experienced the capacity of non-ionizing electromagnetic fields to do the same. What we can’t see or feel can, in fact, reach to our innermost nooks and crannies, both to produce vivid images of our anatomy — and exert other effects.

Making Health Addictive

Oct 26, 2013• 3

By Joseph Kvedar, MD

I first posed the question, “Could Mobile Health Become Addictive?” on August 20^th. Since then I’ve done more thinking and I’m warming to the concept.

To start with, addiction is a word laden with negative meaning. When we hear the word, we think of opiates, street drugs, cigarettes, or possibly gambling. In fact, Wikipedia defines addiction as, “the continued repetition of a behavior despite adverse consequences.” So, with that definition as backdrop, is there any way health can really be addictive? Probably not.

What I’m really talking about is the juxtaposition of motivational health messaging with some other addictive behavior, specifically checking your smartphone.

New evidence shows that people are in love with these devices, checking them more than 100 times per day! I’ve heard people are tapping in 110, even 150 times a day. Of course this varies, but let’s face it, we check our smartphones a lot and it’s hard to stop. A somewhat disturbing video makes the case well. It’s easy to build a case that smartphones are addictive.

Recent research shows that checking your phone results in a small release of the neurochemical dopamine. Dopamine release has long been associated with ingestion of addictive substances such as heroin and tobacco. In fact, once the pattern of ingestion and dopamine release is established, even thinking about the ingestion triggers the dopamine release, the biochemical explanation for cravings.

For this post and a series to follow, I choose not to question whether this compulsive relationship with smartphones is good or bad, but simply to acknowledge that it is common, almost universal among smartphone users and to ask if we can exploit it as tool to improve your health.

Could Mobile Health Become Addictive?

Aug 22, 2013• 11

By Joseph Kvedar, MD

The hype over mobile health is deafening on most days and downright annoying on some. So it is with some reluctance that I admit that mobile has the potential to be a game-changer in health. I’ve professed enthusiasm before, but that was largely around the use of wireless sensors to measure physiologic signals and SMS text as a way to deliver messages to patients and consumers. For several years, the industry has been awash with smartphone apps (by a recent count more than 40,000). At the Center for Connected Health, we started looking at mobile health as far back as 2008 and could not justify the excitement around smart phones and apps at that time, mostly because our patient population did not demonstrate significant enough adoption of smartphones to justify development in this area.

I felt very unpopular at all of the major conferences. I talked about our success with text messaging as a tool for engaging pregnant teens in their prenatal care and helping patients battling addiction to stick with their care plan, while others were touting the virtues of their various apps.

It’s worth noting that our primary focus at the Center for Connected Health has been patients with chronic illness. As such, we are every bit as concerned about the 85 year old with congestive heart failure as we are about the young professional with hypertension. However, across the population of people with chronic disease, smartphone adoption has lagged. I felt like our strategy was vindicated when my friend Susannah Fox published research showing that folks with two or more chronic illnesses (independent of other variables such as age and socioeconomic status) use technology in the context of their health less than others.

The world of patient care appears to be catching up to the rest of mobile. Not that I would ever endorse the irrational exuberance shown for mobile health apps in general, but some recent data points that changed my thinking are worth noting.

The Economics of Google Glass in Healthcare

Apr 14, 2013• 4

By Kyle Samani

A lot of people think Google Glass can be used as a development platform to create amazing healthcare apps. So do I.

Many of these ideas are relatively obvious, and many of them could be relatively simple to develop. But we won’t see most of them commercialize in the first year Glass is on the market. Maybe even 2 years. Why?

The most obvious analogy to Glass is the iPhone. It’s a revolutionary new technology platform with an incredible new user interface. Glass practically begs the iPhone analogy. Technologically, the analogy has the potential to hold true. But economically, it does not. Because of the economics of Glass, many of these great ideas won’t see the light of day anytime soon.

First, there’s the cost. Glass will run a cool $1500 when it lands in the US this holiday season. The most obvious analogy to Glass is the iPhone. It’s a revolutionary new technology platform with an incredible new user interface. Glass practically begs the iPhone analogy. Technologically, the analogy has the potential to hold true. But economically, it does not. Because of the economics of Glass, many of these great ideas won’t see the light of day anytime soon. There’s no opportunity for a subsidy because Glass doesn’t have native cellular capabilities.

What the Story of a Much Talked-About Bay Area Startup Tells Us About the Future of Health IT

Mar 24, 2013• 7

By Jacob Plummer

In 2004, I was managing a hospital division at the University of Chicago and our clinic director walked into my office and asked whether I thought that all physicians should be issued with smartphones. My first internal thought was, “Hmm, what’s a smartphone?”

Today, we all know how dramatically different mobile phones are than they were a year or two ago, much less back in 2004. But as the power of mobile technology increases, tech entrepreneurs have taken a lead on challenging old rules that haven’t been discussed in decades. What if the development of the smartphone could give us some clues into the future of healthcare IT?

Recently, I was on a business trip to Boston and met a friend for dinner. As we discussed where to go, I wanted to go someplace close, thinking that getting a taxi would be a pain. My friend pulled out his smartphone and requested a car to pick us up through the car-sharing service Uber. If you haven’t heard of Uber, or Sidecar, or Lyft, the essence is that the headache, the wait, and sometimes the expense of getting a taxi are virtually eliminated.

Four Healthcare Trends Hospital Executives Cannot Ignore

Mar 7, 2012• 2

By KENT BOTTLES

Hospital leaders are busy trying to cope with the changes brought on by the Patient Protection and Affordable Care Act and the realization that the federal budget deficit translates into less money for all healthcare providers in the future. The seemingly inevitable transition from fee-for-service to global payments creates anxiety about how quickly the financial incentives will shift.

While the above-described issues are certainly enough to monopolize any busy hospital executive’s time, there are other large-scale changes on the horizon that may impact hospital operations just as much. Leaders who ignore these trends will do so at their organization’s peril.

The important trends include: personalized medicine that concentrates on the individual not the population; the “quantified self” movement with constant remote physiologic monitoring; the smartphone health applications explosion, and the artificial intelligence, healthcare robot movement.

Personalized medicine: Advances in genomics and digital technology are making it possible to shift the focus of evidence-based medicine from the population to the individual patient. Today drug treatment and disease screening follow a one-size-fits-all approach that leads to overtreatment and unnecessary expense. Genetic testing allows us to individualize the treatment for the patients.

For example, about 20 percent of diabetic patients treated with metformin do not respond to the drug, a condition that can be identified by genotyping that is not routinely done today. Likewise, cancer screening by mammography after age 40 in women and colonoscopy after age 50 in men and women does not take into account the different genetic predispositions for breast cancer and colon cancer in individual patients. Two new books should be on every hospital executive’s reading list because they explore the implications for hospitals of personalized medicine: Eric Topol’s “The Creative Destruction of Medicine” and David Agus’ “The End of Illness.”

Physician Executives Should Not Ignore How Smartphones Will Transform Healthcare

Jan 31, 2011• 15

By KENT BOTTLES

Physician executives who ignore smartphones and their healthcare applications will miss the most important disruptive technology trend in the next five years. Physician executives who understand how smartphones will transform the industry for providers, payers, patients, and employers will thrive in their careers.

Rajeev Kapoor, a former executive at Verizon, describes the smartphone-enabled transformation: “The paradigm of healthcare has changed. You used to bring the patient to the doctor. Now you take the doctor, hospital, and entire healthcare ecosystem to the patient.” (http://ow.ly/3GIir) Susannah Fox of the Pew Research Center’s Internet and American Life Project offers a specific example when she talks about the celiac disease patient who uses her smartphone to evaluate food products in the grocery store.

“You cannot call your gastroenterologist every time you buy a new product.” (http://e-patients.net/index.php?s=fox) David Jacobson of Wellpoint notes that “The technology of telehealth is well ahead of the socialization of the telehealth idea and we are at a tipping point for utilization to begin taking off.” (http://ow.ly/3GIir)

The Global mHealth Developer Survey found that today 78% of respondents said that smartphones offer “the best business opportunities for mobile healthcare” in 2011; by 2015, 82% said smartphones would dominate the industry. Cell phones, tablets, and PDAs trailed smartphones in popularity according to the survey. (http://ow.ly/1aVf9V)