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(SOURCE: John Bennett MD: http://www.internetmedicine.com)
December 15, 2012
The creation and widespread use of the iPhone has impacted many industries, and now has affected Medicine in many ways. In manycases the iPhone applifies the power of the device to which it is attached by its computing power. In some, it uses it powerful photographic and optic powers to affect change.
We will examine the Top Ten Medical Uses that we feel has, and will have, a deep impact on the practice of healthcare.
The Otoscope using the iPhone is also called the Remotoscope, and sometimes Cellscope. The versatile ole iPhone is used to, not only view the inner ear with magnification, but also take pictures, to send to doctors, or specialists, from home or remote areas. It is approved by the FDA. This is yet another use of the iPhone as a periperal device useful in Internet Medicine.
Just recently approved by the FDA (December 2012) the iPhone ECG is a single-lead electrocardiogram reader that attaches to the back of an iPhone and displays heart rate info via an app. (An Android version is in the works.) The creator, Dr. David Albert, is an Oklahoma Cardiologist, who likes to be called an “Inventor”. Son of former Speaker of the House, Carl Albert, David believes the iPhone ECG could be used in intensive care units and used by EMTs. His team is recently compiled data in June 2012, after which his company received more funding from the powerful Qualcomm, a big company in the wireless industry.
Basically, a peripheral device, projected to be around $100, is attatched to any Smartphone, and a real time, a high quality one lead EKG can be done. This EKG can be done anywhere a Smartphone goes, and allows for rapid, quick assessment of some cardiac problems in the field, including rhythm disturbances. To truly diagnose a full MI, however, the AliveCor is not able, since it does not give a total picture of many leads. A full EKG is indicated as Dr. Albert maintains to truly diagnose an myocardial infarction.
Additionally, its’ low cost also allows for mass screening in developing countries.
And like any wireless device, one is allowed to transmit any questionable EKG to any other Smartphone, which allows for in-the-field consultations with cardiologists, which are relatively scare in developing countries.
The thrust of this well-funded company is global. The company has moved to San Francisco.
AliveCor’s ECG device basically enables medical professionals and regular consumers to monitor a person heart health. Its cardiac monitoring technology is designed to work with the iPhone, iPad and Android devices.
3) The iPhone as a Microscope
One has to stop thinking of the iPhone, Android, Blackberry as a phone, when dealing with its place in Internet Medicine. It, rather, should be thought of as a powerful mini-computer, with a state-of-the-art photo equipment. Yes, that little thing. It can be converted to a powerful, picture-taking camera, to act as a supremely useful peripheral device.
Of course, this would not be neeedd in most labs, but in rural area, in underdeveloped countries, it would have unlimited potential. No phone connection is needed, simply the peripheral and the smartphone without an internet connection. Of course, a connection would be needed if the image is sent to other parts of the world to be interpreted. The device will prove to be invaluable in underdeveloped countries where cost and distance are now problems to diagnose the common infectious disease in the Third World.
Here’s a comparison of microscope photos taken with a high-resolution camera, and one with the smartphone:
Basically, there is a combination of finding the right economical lens, and developing software to work with the image. The aim in underdeveloped countries is the diagnosis of infectious diseases, TB, malaria, and other microbes.
Above , in the top row, are images of pollen seen under a normal microscope. Below are Smartphone images. This is included, not only for teaching purposes, but because it is beautiful and colorful, and it might break the page up a bit.
The miraculous thing about smartphones and the use of the microphone, is that is shows the unlimited, fantastic potential of using portable computers for use in the field, in uses which will be tremendously exiciting, and useful in the healthcare field throughout the world, and will undoubtedly find niches heretherefore unreached. Whew, I love using that word “heretherefore”.
4) The iPhone as a GLUCOMETER : IBGStar
What is called a “Killer App” will be the creation of a non-invasive way to measure serum glucose. That day has not arrived yet, at least none has been approved by the FDA, but that day will soon come, andALTAPURE says they will be the first.
Until then, we have peripheral devices as on this page.
IBGStar is a blood glucose meter plug-in for the iPhone There is a an iBGStar Diabetes Manager App that tracks blood glucose, carbohydrate intake, and insulin dose.The benefit of this peripheral is to manage your regimen of care of the diabetes, by posting alerts, keeping log, etc.
Finger sticks with the lancet are still required. There are other devices on the horizon of the digital revolution that will avoid being stuck to check glucose.
5) iPhone as a Skin Scanner: THE DERMATOSCOPE
From Germany, we have the development of the “Handyscope”, or Dermatoscope, which is a case that fits snugly over an iPhone, and takes up top 20x magnification. It also has accompanying polarized light to better show the skin lesion.
easily save the picture, send it to a collegue by email, or send it to the desktop.
Inexpensive, Mobile, Wireless, Portable Ultrasound
This groundbaking mobile, wireless, portable ultrasound is sure to find widepread use in all medical settings across America, and the world. And it is inexpensive, which will lead to even wider use, especially in rural and third-world areas. This device will find widepread use in Emergency Rooms, and in the surgical and medical wards, as well as in office practice. Of course, there will be times when a higher grade ultrasound will be needed, but this Smartphone Ultrasound is a great start for diagnosing all types of medical problems, as a screening device., for medical conditions such as vascular problems, gallstones, kidney stones, abdominal masses, and other problems. This invention will be brought to areas that could not afford it, or live in inaccessible areas.
The above model is a Mobisante, which is the world’s first smartphone-based ultrasound imaging system, the MobiUS™ SP1 ultrasound system. This device has been approved by the FDA is made to order to reduce healthcare costs and improve diagnostics in areas that cannot access imaging centers..
In their words, .”….MobiUS fuses the power and wireless connectivity of a smartphone with the Internet into a game-changing diagnostic solution that is personal and accessible. Our patent pending intellectual property makes the system easy to use and to share information with remote providers.”
At Caltech, engineers have created a device, that aids in the process of identification of micro-organisms, with the Petri Dish process. The iPhone is used, along with a Lego Frame, to read the Petri Dish in real time, after it is put into the incubator.
8) The iPhone to Aid Slit Lamp: Eyepiece Digital Adapter
Eyepiece adapter for the iPhone. You can plug in your iPhone 4 or 4s and take high definition pictures and video. Equipped to adapt to most slit lamps on the market today. (to see some examples of pictures taken with the iPhone and the slit lamp adaptor, go HERE)
Again, one can take pictures of the images seen through the slit lamp, and send them anywhere there is internet, which one of the principles show by this device. Minicomputers getting stronger, and more work-outsourced to patients, in the future.
9) iPhone to Measure BLOOD PRESSURE: Withings Blood Pressure Monitor
This iPhone peripheral blood pressure cuff, does readings, and the app is programmed to record the readings, time of day, and keeps a log. Also allows you to send your record to whereever you wish, including to your doctor. This device allows a truer measure of blood pressure, avoiding “white-coat hypertension” or having falsely high readings at a doctor’s office.
The important part of a device such as this, is that allows for neat, easily retrievable records to be kept, made into graph forms by the software, and will make the patient more concious of the trends of the blood pressure.
There is also the option of using Microsoft® HealthVault™ , which keeps all your health records in one place.
10) iPhone as SPIROMETER andBREATHALYZER
Accurately Estimates Lung Air Volume
iPhones will soon take the place of the spirometer. At the University of Washington Medical Center, an iPhone App has been developed to make an algorithm with the audio portion of an expiration, and there is a 5% difference in studies performed, compared against the ole spirometer.
This sprirometer is based on the same principles of work that is being done on the early detection of Parkinsonism, based on the sound waves generated by a persons voice on the phone.
Another use of the iPhone is used with a peripheral used as a breathalyzer, to detect alcholo levels, from your expiration.
“Most people keep their phones on them at all times (including when you’re drinking), which is why the iPega Alcohol Breathalyzer is so convenient. This portable breathalyzer plugs right into the bottom of the iOS device and displays the 2 digit BAC (blood alcohol content) on the LCD screen. No need to use blowpipe, just blow into the air hole.”
Could help with avoiding drunk driving.
See slideshow to see how it looks on the iPhone.
BONUS FOR AVID READER
And, as a bonus for reading this far, we are presenting one of the most fascinating, and potentially earth-shaking uses of the iPhone, early in its development in Denmark
(SOURCE: milab, at University of Denmark)
At the University of Demark, research is being conducted on using the Smartphone, along with specially programmed software, and a specialized headset, to do portable, mobile brain scans. Of course, it is just in the beta stage, but goes to show the potential of this powerful little computer, known as a Smartphone.
The system is a mobile, wireless, real-time brain scanner, and the software allows for wireless transmission to the Smartphone program, which receives the EEG-like transmissions from the various electrodes on the head, and like anything recored on the Smartphone, can be sent to a consulting physician, anywhere in the world. In their words:
“Our system provides a fully portable EEG based real-time functional brain scanner including stimulus delivery, data acquisition, logging, brain state decoding and 3D activity visualization. The software is realized in Qt. The raw EEG data is obtained from a wireless Emotiv 14 channel Neuroheadset with a sampling rate of 128Hz and electrodes positioned at AF3, F7, F3, FC5, T7, P7, O1, O2, P8, T8, FC6, F4, F8, AF4 (the international 10-20 system). The headset transmits the EEG data to a receiver module connected to a Nokia N900 phone. The binary data is decrypted directly on the phone, filtered and passed to the source reconstruction module that outputs the colors of model vertices for the visualization. The source reconstruction is performed over number of samples (default over 16 samples resulting in 8Hz visualization). The delay between the signal appearing in the headset and being visualized on the screen depends on the used source reconstruction window and is between 130 and 150 msec for 8Hz visualization. The framerate of the visualization (realized in OpenGL) is around 30fps.”