From the 25 January posting at Eye on FDA
Patients are changing. They are accessing medical information differently, they are storing it differently and they are consuming it more voraciously. This access to medical information and tools means that many patients are more medically conversant and knowledgeable than the patient of just five years ago. Medical literacy is likely on the rise.
It also changes the way physician and patient communicate. Five years ago, I never would have considered the need for email between my physician and myself, thinking it impractical. Today, I think a physician needs to have some portal of access for the exchange of data and information. Here are my readings – blood pressure, blood sugar, whatever… – for the week. The medical record will reflect information not just gathered at an exam in the office, but that gathered by my apps when I am not in the office. And when I’m diagnosed with a new condition, I fully expect either the physician or someone in his or her office to not only prescribe some medication, but to pull out an i-Pad to steer me to some good resources, including apps. If the condition is one where there are few treatment options and I’m expected to consider a clinical trial, the i-Pad should have a clinical trials app that lets us look at what’s available together….
- eHealth: patients are changing, but not (yet) the Physicians (scienceintelligence.wordpress.com)
- From Pinterest and Septris to the Patient of the Future (Science Blog)
“Are ePatients self diagnosing too much ? Too many people are not going to see their doctors on a regular basis and they need to be educated on why that is a bad idea. No printed or interactive forum can replace a trained medical professional. The Patient of the Future Like many “self-quanters,” Smarr wears a Fitbit to count his every step, a Zeo to track his sleep patterns, and a Polar WearLink that lets him regulate his maximum heart rate during exercise. Stanford University’s Septris app …”
A Critique by Scientific Experts, Physicians and Oncologists
In its unsigned commentary on September 3, 2011, “Worrying about Wireless”, The Economistmakes a number of technical errors and misleading statements about microwave radiation that we write to correct. The governments of more than a dozen nations have issued precautionary advice and policies about wireless devices, including restricting cellphone use by children in France, India and Israel (See Worldwide Advisories at http://www.saferphonezone.com). The Economist would do well to consult with experts in these and other tech-savvy nations to learn the science behind these countries’ decisions so that it can provide accurate reporting on wireless safety and health matters.
The Economist states:
“Let it be said, once and for all, that no matter how powerful a radio transmitter–whether an over-the-horizon radar station or a microwave tower–radio waves simply cannot produce ionising radiation. The only possible effect they can have on human tissue is to raise its temperature slightly.”
This is a red herring. Of course microwave radiation is non-ionizing radiation. It has insufficient energy to directly break chemical bonds including mutating DNA. Independent studies show that microwave radiation from cellphones can damage genetic material and disrupt DNA repair without inducing heat. Microwave radiation from cellphones can also increase the production of damaging free radicals, which can also indirectly damage DNA. [1a,b,c]
In 2000 the cellphone companies T-Mobil and DeTeMobil Deutsche Telekom Mobilnet commissioned the ECOLOG report. This report acknowledged that microwave radiation damages genes, living cells, and the immune system. Since then, the evidence base suggesting that prolonged cellphone use can harm human health has grown substantially. In May 2011, after a rigorous review of the evidence, the World Health Organization’s (WHO) International Agency for Research on Cancer (IARC) classified radiation emitted by wireless devices including cellphones as “possibly carcinogenic.”
In addition, scientific studies carried out in Russia in the 1950s and 1960s and corroborated by European researchers more recently show that microwave radiation affects the heart, brain and liver, as well as the production of hormones and male human and animal fertility….
Read the entire article (medium long)
- Cellphone And Wireless Risks – Experts Criticize The Economist’s Coverage (medicalnewstoday.com)
- Mobile phones – latest alert (after-cancer.com)
- Does WiFi pose health risks? (macleans.ca)
- Cellphones and health: How Canada’s precautions compare (cbc.ca)
Hopes, ideas, and hundreds of apps, are floating in the hallways during the third annual mHealth [Mobile Health] Summit***, marking the beginnings of a field that is still in its infancy and carries with it more questions than answers.
The federal government is pushing mHealth, launching programs like theHealthy Apps Challenge, which Dr. Regina Benjamin, the U.S. Surgeon General, introduced in her keynote speech. Health and Human Services Secretary Kathleen Sebelius, introduced the SmokeFreeTXT program, a text messaging service that helps teens quit smoking. Ms. Sebelius has also established theText4Health Task Force last year to look at other uses of texting in promoting healthy behavior.
“As our phones get more powerful, they are becoming our primary tools for doing everything from getting directions to deciding where to eat, Ms. Sebelius said during her keynote speech on Monday. “And increasingly, that includes using our phones to track, manage, and improve our health. In the iTunes store alone, there are nearly 12,000 different apps related to health – a number that will probably have gone up by the time I finish speaking.”…
…we sometimes come away from a conference, such as this week’smHealth Summit, with the feeling that the only ones making a living with mHealth are conference organizers. Maybe it was the format…That being said, however, the mHealth Summit, now in its third year, is the best conference one can attend in the US if one wants to get the global pulse on all things mHealth.
That is not to say they are no advances occurring here in the US. One of the keynote speakers, cardiologist Eric Topol, gave several live demos during his talk of the mHealth tools he is already using including stating that he has not used a stethoscope in two years, instead preferring to use mobisante’s ultrasound wand and iPhone App. Then there was our conversation with WellDoc’s CTO who informed us that they are currently being deployed at a number of institutions and hope to have a host of CPT codes that doctors can bill against in late 2012. And there was the small start-up we spoke with who has done the hard work of first identifying what the value proposition is for all stakeholders in a community (payers, providers and consumers) and then developed an extremely compelling solution (think analytics & automated quality reporting, tied to reimbursement, tied to consumer engagement) that has a lot of promise in a market where physicians’ pay will increasingly be based on outcomes and ability to meet pre-defined quality metrics…
For a slightly different take, check out the post by VC firm Psilos’ Managing Partner Lisa Suennen’s. Well worth the read.
- mHealth: Closing the Gap Between Promise and Adoption (iHealthBeat- Reporting Technology’s Impact on Health Care)
- mHealth Summit 2011 – Videos Available (International Medical Association News)
- HIMSS: Most hospitals still developing mobile policies (MobileHealth News)
- Physicians in Scotland use iPhone 4 and Skype to remotely manage lung and pleural ultrasound (iMedical Apps, Dec 2011)
- UK patients able to get health advice via free iPhone medical app, review of NHS Direct app (iMedical Apps, Dec 2011)
Get Mobilized! An introduction to mobile resources and tools in health sciences libraries (Medical Library Association)
Archived 2011 online class including “lecture notes”, resources, class discussions, and related slides/videos
- Health Apps (in Health and Medical News and Resources selected by Janice Flahiff)
a short list of information and tracking apps derived from the above Get Mobilized class
- mHealth: Seemingly Stuck in Neutral (chilmarkresearch.com)
- Importance of mHealth for Peacebuilding (/technologyforpeace.wordpress.com/)
- Physicians aren’t taking mobile health seriously (KevinMD.com)”Although I realize that many actively practicing physicians cannot attend all technology meetings, I would consider mHealth Summit to be that one meeting a year that an ambitious physician mobile health entrepreneur would take the time to attend. Therefore, I am assuming that this correlates with a low number of physician entrepreneurs in the marketplace. Although large numbers of physicians are certainly using smartphones, there is still a notable lag in the incorporation of mobile health within the traditional medical practice.
For example, case examples of physicians recommending health apps to their patients and then measuring changes in medication adherence or health outcomes are not common. Additionally, mobile phone sensors as a dominant outpatient diagnostic tool is also uncommon although cardiologist Dr. Eric Topol mentioned that his mobile phone vscan ultrasonic sensor has now replaced his stethoscope in his outpatient clinic. Exchanges on twitter such as the one listed below may mirror the fact that perhaps physicians aren’t taking mobile health seriously:”
- Mobile health and the globalization of medicine (kevinmd.com)
- mHealth Moving Fast, Raising Hope, And Questions (jflahiff.wordpress.com)
- Mobile health: Hallelujah or bah humbug? (finance.fortune.cnn.com)
- mHealth Summit 2011 – Videos Available (imianews.wordpress.com)
- mHealth Moving Fast, Raising Hope, And Questions (egmnblog.wordpress.com)
- Sensei, Inc. Presenting at mHealth Summit (prweb.com)
- Zeo Sleep Monitor CEO at the 2011 mHealth Summit (medgadget.com)
- Physicians Play Important Role in mHealth Integration (egmnblog.wordpress.com)
- 10 startups from mHealth 2011: Meddik (medcitynews.com)
- Converging Ideas at the 2011 mHealth Summit (rwjfblogs.typepad.com)
- Mobile health: Hallelujah or bah humbug? (finance.fortune.cnn.com)
***”The largest event of its kind, the 3rd annual mHealth Summit brings together leaders in government, the private sector, industry, academia, providers and not-for-profit organizations from across the mHealth ecosystem to advance collaboration in the use of wireless technology to improve health outcomes in the United States and abroad.”
I interviewed about 150 medical leaders just a few years ago for my book The Future of Medicine – Megatrends in Healthcare. Not one mentioned wireless devices as a coming megatrend. How fast the world changes! Nowadays everyone has a cell phone and we rarely stop to think that just two decades ago almost no one had them. We have a laptop or tablet computer that can access information from the web at very high rates of speed; again it is hard to remember when this wasn’t so. And those with smart phones have numerous “apps” – to check traffic conditions, find the nearest Starbucks, or play games. But these and other devices that use wireless technology will lead to major changes in the delivery of health care in the coming years. This is another of those coming medical megatrends.
Read the rest of Wireless devices will dramatically change how medicine is practiced on KevinMD.com.
- Unintended consequences of patient portals (kevinmd.com)
- Invasion of the Body Hackers? Wireless Medical Devices Susceptible to Attacks (tjantunen.com)
- Mobile Security Requires More Than Secure Wireless Devices (aviatnetworks.com)