Smartphone, MD – A Doctor At the Tip Of Your Fingers

This ist part I in a series of posts about how technology interacts with the modern patient and physician. 

I have always considered myself as a technology junkie and I thank my father for that. He always had the newest, fastest and amazing computer (back in the day it was a Gateway 486 – moo!). So when it was my time to start med school, my father gave me the most awesome of gifts saying: “I know how difficult med school can be; this will help you organize your time,” and handed me his old Palm m500. I felt like Luke Skywalker when Obi-Wan gave him the lightsaber for the first time. Little did he know that organizing my time was the least of tasks I would achieve with this new amazing piece of technology I  had just received.

Palm Vader

During my anatomy course, a professor showed interest in my device, so he introduced me to my first medical app: Epocrates. It really ran on my black and white m500! I instantly thought “this could be big”. After my m500, I upgraded to the Palm Tungsten, then the Treo phone and now, after a succession of Blackberries I have an iPhone 4s.

I remember downloading the 5-Minute Clinical Consult app from Skyscape on my Treo, and it had a very interesting feature where you could check the signs and symptoms of a particular patient and then it would come up with a list of diagnoses that matched with that group of symptoms, arranging it by those diseases that matched the most number of symptoms first. I was determined to test it, and as a matter of fate, I was watching an episode of House, MD and decided to mark down all the symptoms that our favorite TV doctor wrote on his whiteboard. At first, I thought that the result was very off target, but we all know how House never disappoint us and comes up with the most bizarre diagnosis after trying some wacky tests; to my surprise it was the exact diagnosis that my Treo came up in the first place (way to go Treo, MD!).

Maybe not this mean…

I have always thought of an idea where patients could download an app that worked like this symptoms checklist and after coming up with a list of possible diagnoses, it would direct them to the right source of information. I believed that this could reduce the huge misinformation that the internet provides. It is not uncommon to find patients coming into your practice auto-diagnosed with “the most horrible of cancers” and asking you to do something because they are “dying.” The amount of information in the internet is filling the heads of patients with ideas that are not always true or pertinent. This type of apps will also empower patients to take actions towards their own health by guiding them towards the right direction. I have come across a couple of apps on my iPhone that include this symptoms checklists. The most promising is the one found on the WebMD iPhone app. It includes a figure of a human body and one can touch the specific body part that has the problem, it then sorts all possible symptoms that affect that particular area and the user can choose one and add it to his complaints list. After adding all the symptoms, the app comes up with a list of possible diagnoses. I am not sure if this final diagnosis list is ordered by most common diagnosis for a particular age, gender, place, lifestyle, etc. or if it is arranged by the ones that matched the most symptoms. It would be interesting to develop algorithms that include all this variables and assign a weight to each one (e.g. it is more common for a soccer player to have a torn ACL than a swimmer). The technology is there, we just need to know how to apply it.

There is a very interesting take on algorithms for healthcare in a recent article on TechChrunch. The author argues about pros and cons and also gives his particular view on how the near future would be in healthcare when these algorithms are introduced. I believe this is an inevitable process, the question is how are you going to react? Are you going to reject it and fight against it? Good luck… Instead of just accepting it, I’d rather be one of the people making the changes and pushing healthcare forward with innovation.

The ball is on your side of the court – What do you think is the best use of current technology in the benefit of patients?