Smartphones and tablets as medical devices

Smartphones and tablets as medical devices
A quiet revolution has been going on in the medical profession and the field of personal health in the last two years, spearheaded by smartphones and tablets, that will change forever the way we obtain and process medical information.

Called mHealth (Mobile Health), this industry phenomenon encompasses a wide range of applications – from self-treatment apps on sub-$100 Android phones in Kenya, through texting reminders for the immunization schedule of newborn babies in India, up to testing yourself for STDs with a smartphone kit, or your doctor panning and zooming radiology scans on the go.

Let's start off with the practical stuff and see what applications and gizmos are out there for disease prevention, self-diagnosis and treatment via your smartphone or tablet. Apple's iOS devices carry the lion's share of apps and accessories geared to physicians or your personal health, but Android is catching up in terms of available apps.

Devices for you and for your doctor

While you probably know that you can keep track and upload your vitals while exercising with gizmos like the Scosche myTrek or the Polar WearLink+ linked to your iPhone or Android handset, did you know that you can also measure your own BP, use a portable ultrasound, or spit on an STD diagnostic kit, and shortly have the results on your smartphone screen? Maybe you do, but still let's see what contraptions can we hook to the phone in our pockets, and play doctor.

Blood pressure monitors

A nice comparison of two blood pressure monitoring accessories – the iHealth BP3, and the Withings BPM can be found in the video below. The latter device can be combined with a Withings WiFi Body Scale as well, which measures body BMI and other vitals, which can then be uploaded to your Android or iOS app.

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Glucose meters

The latest hit is Sanofi's IBGStar blood glucose meter accessory, developed by AgaMatrix. It docks neatly in the iPhone's port and sends info to the iBGStar Diabetes Manager app that tracks your  glucose, carb intake, and the dosage of insulin that should be administered.

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Android users have apps like Glucose Meter that they can hook up to a Bluetooth-enabled meter like WaveSense to log the results, while Nokia phone owners can enjoy connections to Entra's MyClucoHealth Meter, for instance.

Now off to the wackier stuff out there. Said apps for glucose levels monitoring above require an actual meter to take samples from your finger, which is invasive and annoying, as all people with diabetes would confirm.

The nanosensor "tattoo" developed by an university team will allow to simply snap a picture of fluorescing nanoparticles planted in your skin with an iPhone inserted in a special case, and the handset will spit out the results.

Other medical accessories

You will also be able to prescribe your own glasses via MIT's low key Netra (Near-Eye Tool for Refractive Assessment) contraption, that hooks a plastic lens to your phone, and then runs red and green lines on the screen, which you have to align with the arrow keys and voila, here comes your prescription.

Doctors are at the front lines of the mobile health revolution, too. It is said that soon physicians might start prescribing mobile apps in addition to meds and regimen, and we couldn't agree more.

Moreover, your family doctor's good old stethoscope will soon be replaced by a digital one, like the ThinkLabs ds32a, which comes complete with its own iPhone app.

In addition, your doctor can take with them their portable MobiUS SP1 ultrasound, shown in the video below, plugging it directly into an iPhone.

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The valuable ECG measurements can also be collected on the go, via this cool iPhone contraption in the form of a case that you can see on the left.

An Android app is also on the way, and the tool allows for the smartphone to track, record and analyze your heart's rhythm info.

Tablets as healthcare assistants

Not to be left out of the mHealth trend, the tablet computer is slowly creeping up in popularity with medical professionals, and rightfully so, since it is the perfect replacement for numerous charts and reference literature doctors or students had to carry.

Due to a variety of reasons, iOS is the preferred platform of choice for medical professionals – remember how the iPad 2 keynote featured Dr John Halamka using his tablet by a patient's bed for showing her some images of her internals? It's not by accident that Apple explicitly mentions in the video how "the iPad will change the way doctor's practice medicine".

It is reported that over 80% of US physicians carry smartphones, and north of 30% carry tablets for their medical needs, overwhelmingly Apple's iPad, although slates like the BlackBerry PlayBook, or Android tablets like the HTC EVO View 4G with its capacitive stylus pen are also being adopted. We are curious if the Samsung Galaxy Note could make inroads too, with its 5.3" screen, as doctors will have to only carry one device then. 

Moreover, tablets are replacing books in the most famous medical schools, and mobile apps are changing the curriculum. Yale University, for example, will be giving all of its 520 first year students an iPad 2 with a keyboard, while Harvard is actually creating its own medical apps.


As usual, it's all about the apps, and there is no shortage of them both in the App Store and Android Market. From diet helpers, through online medical records management with your HMO, to 3D visualization of the body that is replacing the atlases of human anatomy or interactive step-by-step treatment guides - the possibilities here are endless. As usual, Apple's App Store holds the lead, although the best apps are increasingly starting to appear with Android versions as well.

They have become so prolific and comprehensive, that the federal Food and Drug Administration felt the need to craft a review and approval process for medical apps, which is about to be enforced for the most vital ones out there. On the chopping block first will be those that transform the smartphone or tablet into a medical device, such as glucose meters or blood pressure monitors, and which control existing FDA-approved gear like insulin pumps.

General fitness and diet apps, or medical reference compilations won’t need the FDA approval, and there are many of those, for almost each and every field of modern medicine. While in the beginning they were simply digital copies of medical encyclopedias and popular journals, now they have entered the Medicine 2.0 era with interactivity and search functions galore.

Some good examples include UpToDate, the huge interactive encyclopedia of medical knowledge, which doesn’t come cheap, at nearly $200 per year. Despite the price, it has half a million subscribers, and is now sporting an iOS app. There is a free alternative, Medscape by webMD, which has both iOS and Android versions, and its database is similarly mind-boggling - 3,500 disease clinical references, twice as much drug references, 2,500+ clinical images and procedure videos, drug interaction tool, and so on.

HMOs are embracing the mobile era as well – Aetna, for example, launched its own mHealth alert service last month. The patient has a link to its history and medical records at any time, while doctors can prescribe meds via their smartphones or tablets, as well as receive recommendations for better treatment of their patients based on the clinical data from them, juxtaposed against best practices database.

These are, however, the broad examples, there are thousands of medical apps making doctors' and patients' lives easier, with new and better ones appearing every day. We will show just two examples, one for iOS, and one for Android, to illustrate what's out there.

Visible Body is arguably one the most graphically intense and comprehensive atlases of the human body out there, and costs $29.99 for use on the iPad 2. Compare that to the $120 individual annual subscription for the respective website.

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Now on the patient's side you can also have myriads of helpful apps, and iTriage is one of the most easy to use and comprehensive symptom checkers, available for Android, and free. You can quickly see which diseases correspond to your kid's sudden onset of ear pain, for instance, find a doctor, or just use it as a medical reference.

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mHealth in emerging markets

There have been numerous examples lately that places with developing healthcare infrastructure are benefitting greatly from the mobile health revolution. Access to doctors and hospitals there is cumbersome, and people often lack sufficient funds for proper diagnosis and treatment.

We were intrigued by a couple of case studies that illustrate how the proliferation of affordable connected devices can help overcome insufficient medical care in developing countries. The entry-level Huawei IDEOS Android phone, for example, which costs $80 off-contract in Kenya, is making strides there, enabling access to better healthcare. It sports the MedKenya app, which is a symptom checker, diagnosis and treatment reference, as well as doctor/hospital finder, rolled in one, but tailored to the Kenyan healthcare realities.

Even if we leave smartphones aside for a second, everyone with a cell phone can be part of the mHealth phenomenon. India, for example, is creating a database with pregnant women's cells, planning to send immunization schedule reminders via text messages to all of them when it finishes the project by year-end, in order to improve vaccination rates. Text messages have also been used in Kenya to improve malaria treatments by health workers in the field, sending them reminders like "advise mothers to finish all doses over three days even if the child feels better after two doses" daily.

Now back to the more high-tech stuff, but with developing markets in mind. Researchers are working towards an affordable cancer detection gizmo, operated by battery and solar cells, which is intended for use in areas with no access to elaborate medical equipment. Mortality rates from treatable forms of cancer there are much higher, largely due to late diagnosis. The Gene-Z device hooks up to an iOS or Android gadget, and uses their silicon brains for genetic analysis of certain cancer markers, which is a low-cost way to catch the disease at the onset with high probability.

Smartphones and tablets are going to forever change the way we practice medicine and go about our healthcare routines. The motion sensors in our phones can already collect our movement routines and send the data directly to our family doctor or fitness app. Physicians can now receive and read X-rays or MRIs on the go straight from the machine that produced them, and examine them on their mobile device interactively.

Who knows what else will the future bring, and, as illustrated in the article, the mHealth phenomenon is sweeping both across established, as well as emerging markets.

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