Wireless devices and technology bring surge in advanced applications for health monitoring and treatment, but legal and privacy issues remain
The idea that medical providers would someday have mobile devices that allow them to monitor, diagnose and communicate with their patients isn’t exactly a new one. It’s been more than four decades since the cast of Star Trek appeared on TV with fictitious “tricorders” — handheld devices that allowed crew members to scan for life signs and diagnose patients. Fast forward all these years and advances in cellular and wireless Internet technology have made such devices a reality for doctors and patients.
A growing number of providers are adopting technology that facilitates more cost-efficient, timely and effective patient care through devices as commonplace as BlackBerrys, Treos and iPhones. And the recent introduction of the iPad—a portable wireless device that is certain to spawn knockoffs—provides doctors and patients with a more reader-friendly platform for sending and receiving more visually demanding information than can be facilitated by smart phones.
For many providers, mobile health adoption is part of a natural movement toward next-generation technology.
Four years ago, New York City Health and Hospitals Corp.—the city agency responsible for running 11 acute-care public hospitals and 90 clinics among other facilities—launched a telemedicine program that allowed medical providers to remotely monitor and instantly respond to diabetes patients’ fluctuating insulin levels. The program, dubbed House Calls, provided 500 diabetics with flip-phone-sized modems equipped with detachable glucometers. Participants use the glucometers to test their blood several times daily, and each reading is immediately sent via the modem to the House Calls nurse assigned to monitor the patient.
“If it’s outside of their high or low range, a message is triggered to the nurse’s BlackBerry, and the nurse makes a call to the patient and goes through their activity with them to determine the cause and effect rela-
Applications by Airstrip Technologies turn iPhones into a variety of health status monitoring devices, such as the one above.
tionships” of the incident, says Ann Frisch, executive director of the New York system’s home-care division. “There’s immediate feedback, so the patient knows what activity led to that type of reading.”
According to Frisch, the system has seen significant improvement in disease management in more than 85% of diabetics who have participated in the program. So much so that in late 2009 the provider began distributing a wireless version of the device for use by patients who don’t have land lines. The wireless version also has the benefit of being portable—allowing patients to take the device with them and continue having their glucose levels monitored by nurses while on the go.
“People are mobile,” says Mitch Morris, a physician who’s national leader of Health IT for Deloitte Consulting’s Life Sciences and Health Care division, discussing healthcare’s broadening adoption of mobile technology. “I may have Internet access if I’m at home, but not if I’m at a restaurant.”
While smart phones are helping to bridge the mobility gap, the devices do have limitations. Hand-helds “are small instruments, so it’s really impossible to read certain information” on them, says Morris, who noted doctors are increasingly interested in using mobile technology to access patient test results, including viewing imaging studies. “So, there’s a lot of work being done to make sure the info is being transmitted in an appropriate format. Instruments like the iPad are in-between solutions, but the battery life is a concern there, and for a busy physician that can’t be a problem.”
As a result, Morris and others say wireless technology will have to overcome some significant hurdles before it becomes a ubiquitous facilitator of healthcare services. But all also agree that it’s a question of when, not if, mobile-health technology will proliferate.
Two recent surveys show that the number of physicians relying on their smart phones and other mobile devices to conduct day-to-day business is rapidly growing. A March report issued by Manhattan Research, a healthcare market research company, projects that by 2012 81% of physicians will have smart phones—up from 64% in 2009—and more than half of that group will use their devices for administrative work,