The medical community is continually studying and evaluating new ways to use smartphones to help with patient monitoring. For example, according to studies published in NCBI, we can now fit shoes with sensors that communicate with the smartphone and follow the activity level of patients who have recently had a stroke. The smartphone’s accelerometer can be used to interpret the gait and balance of patients. Another study connected a single-lead ECG to a smartphone to diagnose and follow treatment with sleep apnea, providing a possible alternative to costly and labor-intensive polysomnography, which records brain waves, blood oxygen level, heart rate and breathing, as well as eye and leg movements.
There are already medical apps for smartphones in the market today. For example, according to NCBI, the app Diabeo collects information such as self-measured plasma glucose, carbohydrate counts, and planned physical activity prior to making insulin dosing recommendations. Similarly, ResAppDx designed by ResApp Health, diagnoses a wide range of respiratory illnesses by using the smartphones' microphone to detect cough sounds and analyze the data using machine learning. According to COPD News Today, this app has been successful in diagnosing both chronic obstructive pulmonary disease (COPD) and aggravations of COPD caused by infections, pneumonia, and acute asthma.
These advances in mobile technology are helping manage chronic diseases outside of the clinic by using a non-invasive clinical tool with much success. Patients can be enabled to have real-time access to their information on the diagnosis, management of their treatment and side effects. This is not only helpful for patients who may not be able to travel to a medical office for regular care, but also reduces their costs. The patients can interact with the medical staff to get day-to-day advice. They are empowering patients to get healthier and helping clinicians to become more effective and efficient.
There are some concerns though. According to VerywellHealth, many of these apps and connected devices have not been tested rigorously. There is a potential for errors which could lead to serious consequences. For example, an app or device designed to measure parameters such as blood glucose, blood pressure, physical activity, lung function, oxygen levels, cardiac rhythms, etc. could measure the parameter inaccurately, either by underestimation, overestimation, or misclassification and compromise patient safety. Some apps calculate a patient’s risk profile based on patient-specific data. For example, a cardiac risk calculator may use the patient’s age, gender, smoking status, blood pressure, cholesterol levels, and other information to estimate risk for cardiac events. Gross inaccuracies in such an app may tilt clinicians towards harmful or ineffectual treatment pathways.
There is a need for increasing the number of randomized controlled trials with large samples and long follow-ups to validate the apps and their underlying principles. Another approach when studying these apps may be to compare outcomes for patients using the apps with those receiving treatment in an outpatient setting.
Another important issue is the security of sensitive health information that is stored or accessed by this technology. Patients and clinicians are concerned about potential data breaches. The FDA regulates some types of mobile health apps, but others are considered low risk if they are not considered medical devices and not monitored.
The Health Insurance Portability and Accountability Act (HIPAA), was signed into law in 1996 by President Clinton. The law was created primarily to modernize the flow of healthcare information. According to the Department of Health and Human Services, “only you or your personal representative has the right to access your records”. And only “a healthcare provider or health plan may send copies of your records to another provider or health plan only as needed for treatment or payment or with your permission.”
HIPAA has been essential in laying the foundation for individual medical privacy, but recent developments have made some parts of it outdated. Medical Artificial Intelligence (A.I.) is one example.
A.I. has the power to completely transform healthcare. Through analyzing patient data from both doctors and their own devices, A.I. can finally make healthcare personal. We are all individuals with unique genetic makeups and behavior. We should be treated as such. But with the limited capacity doctors have, it is impossible for them to analyze each person’s health data and make personalized decisions. A.I. can be used to do exactly this, and act as a supplement or even advisor to doctors when making decisions.
Furthermore, A.I. can make accurate diagnoses and, better yet, accurate predictions about each individual's health. A.I. gives medical communities and professionals the ability to provide better preventative care by helping them predict potential outcomes.
A massive amount of healthcare data is being collected from disconnected sources. Yes, monitoring heart rate and blood sugar levels are important, but when isolated, those metrics do not give a full picture of the patient's health. Each of these data points must be integrated, and continuously updated, to truly unleash this new evolution of healthcare.
It is therefore imperative that the healthcare community be supported to usher in this next evolution in patient care. To do so, the data for each of these sources must be integrated into a form that both helps doctors and maintains the privacy of patients.
This next evolution of healthcare can lead to previously impossible treatments, and improve the efficiency and quality of care.