USA - Smartphones join stethoscopes in the doctor’s first aid kit

For Ross Mitchell, powerful medical apps that live in your iPhone are just one part of a larger revolution. Dr. Mitchell recently moved from the University of Calgary to the Mayo Clinic in Scottsdale, Ariz., to become a senior associate consultant in diagnostic radiology.

Canada’s loss is the U.S.A.’s gain. In Calgary, as head of the university’s Imaging Informatics Laboratory, Dr. Mitchell led the development of ResolutionMD Mobile, the world’s first smartphone radiology product to win regulatory approval for primary diagnostic use. With this server-based app, which runs on the iPhone and iPad, a physician can make a diagnosis by viewing patient images and medical documents stored anywhere.

For two years, the Mayo Clinic has been using the original desktop version of ResolutionMD to help stroke victims in rural Arizona. As such web-enabled technology comes into wider use, it will change medicine, Dr. Mitchell predicts. Pooling data online will allow physicians to access it cheaply, wherever and whenever they need it – and colleagues on different continents will be able to discuss the same image on their screens.

“You could bring advanced medicine to rural parts of Africa or Asia,” Dr. Mitchell says. “And this is where the power comes. It’s not just in the mobility; it’s in the ability to link this up and get a network effect.”

Dr. Mitchell believes his invention has big commercial potential. Calgary Scientific Inc. (CSI), a company he co-founded, already sells the ResolutionMD products. After Health Canada gave his mobile app the nod early last year, the U.S. Food and Drug Administration – which approved the desktop software back in 2006 – followed this September. CSI has partnerships with several firms, including Siemens Healthcare and U.S. radiology outsourcer Virtual Radiologic.

Increasingly, medical professionals are turning to smartphones and other mobile devices to help them diagnose diseases, manage patient care and make hospitals run better. In addition to saving lives, mobile health (m-health) could take pressure off the system by reducing hospitalizations.

“The last five or six years have seen an explosion in the use of the smartphone in health care within the hospital setting,” says Joseph Cafazzo, leader of the Centre for Global eHealth Innovation at the University Health Network in Toronto. By bringing in smartphones, Dr. Cafazzo explains, hospitals are trying to address problems with communication – a major cause of medical errors.

Many physicians still pack an alphanumeric pager, which is very reliable but doesn’t allow for quick response to calls. As smartphones grow more popular, doctors mostly use them for e-mail and a few apps such as reference tools and medical calculators, Dr. Cafazzo says.

The biggest barrier to adoption of smartphones and tablets? Medical software developers haven’t imported their products on to platforms such as BlackBerry and iPad, Dr. Cafazzo explains. In response, he says, The Ottawa Hospital and other institutions are creating their own software for mobile devices.

Although Dr. Cafazzo does plenty of work with smartphones within hospitals, he has a greater interest in deploying them outside hospital walls. For example, he and his team conducted a trial involving about 100 at-home patients with heart failure, some of whom received handheld electrocardiogram devices that fed data to their smartphone. That data got sent to the hospital, where an algorithm monitored it and alerted a cardiologist if necessary.

By using smartphones to catch problems at home early, Dr. Cafazzo says, physicians can avoid drastic and costly interventions such as rushing someone to hospital for a long stay. At the same time, patients get involved in their own care because the system reminds them to take readings. “We’re looking at ways of giving patients the ability to do more at home, rather than being more dependent on the health system,” he says.

At The Ottawa Hospital, chief information officer (CIO) Dale Potter has made tablets and smartphones an essential tool.

Mr. Potter joined the hospital in 2008 from the private sector, where he had worked in Europe as CIO of Alcan Engineered Products and Bombardier Transportation. Since last year, he’s bought about 3,000 iPads for staff physicians and other clinical professionals.

Part of Mr. Potter’s motivation was to get physicians to deliver care at patients’ bedsides. But first, he had to deal with the fact the medical software vendors didn’t cater to the iPad. So Mr. Potter built a 70-member software development team that has created mobile apps for everything from viewing diagnostic images to assessing pain levels.

Mr. Potter, who’s equipped physicians and some nurses with iPhones too, says mobile devices quickly became indispensable. In a pleasant side effect, the iPad has also made patients feel more engaged.

“The physician will sit at the end of the bed and show a family of a patient, ‘Here’s your mother’s hip when she fractured it, and here was the fracture. Now we take another X-ray after we repaired the hip,’” Mr. Potter says. “It’s not the physician using big words over the back of a manila envelope.”

The high-tech tablet could also revive a more integrated way of practising medicine. Twenty-five years ago, Mr. Potter observes, everything that doctors and nurses needed to know about a patient was in a folder at the end of the bed.

“When we introduced technology, we broke their natural workflow,” he says. “They had one foot in the paper world and one foot in the electronic world. That hasn’t resolved itself effectively, and I think mobility is helping.”

NICK ROCKEL

Special to Globe and Mail Update

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