Proliferation of medical apps creates opportunity, caution
More patients than ever are communicating with their doctors through computer screens and smartphones, and health-care mobile apps for smartphones and tablets are helping doctors and patients with everything from record-keeping to diagnostics and monitoring.
The new technology is also helping health care facilities curb costs and enhance patient access, and allows patients take more control of their own health.
For doctors, apps range from access to databases about drugs and diseases to sophisticated monitors that read a person’s blood pressure, EKG’s, glucose levels or asthma symptoms remotely.
For patients, they can see a doctor or get a prescription without traveling to an office and sitting in a waiting room. Apps can keep track of their medical records, remind them to take their medications on time, record and send vital information to their doctor, and take their child’s temperature.
Further, wearable technology like sensors, and even sensor-embedded clothing, can monitor physical activity, collect data and deliver real-time feedback to healthcare professionals.
One of the most ubiquitous devices seen in health care facilities these days is the electronic health record (EHR), and the North Bay is no exception.
Dr. Brian Keeffe is a cardiologist at the Cardiovascular Center of Marin. He’s also a physician adviser in the on-going development of software maker Allscripts EHR. He’s testing and evaluating the application on Microsoft’s Surface Pro 3 tablet device, offering ideas for how to make the tablet as physician-user friendly as possible.
Keeffe says the tablet has streamlined his daily routine. Previously, he logged into individual computers depending on where he was in the hospital. Now everything is in his tablet, which he says can also switch over to being a very powerful computer. He uses it to access patient records, and says it’s vital for making diagnoses.
“I have everything I need at my fingertips,” he said.
Keeffe also has about 15 different medical apps on his iPhone. Among them is one for pharmacies, one for billing, and one networking with other doctors.
Keeffe has also adopted Alivecor into his practice, a portable heart monitor and app that produces electrocardiograms on a smartphone. Patients place their fingers over the monitor’s sensors, which communicate with the phone to produce the ECG. The patient can then send the results to their doctor.
While the technology allows a doctor to monitor a patient’s heart rate remotely, Keeffe says he worries about encouraging patients to use these devices.
For example, the device is not fully able to, and should not be expected to, detect when a heart attack is taking place.
“There is definitely a chance for misdiagnosis if the patient is trying to do it,” Keeffe said. “The readings need to be assessed quickly, and what if I’m not available? My concern is that we need to think through all the implications.”
Insurance does not cover the $75 device, so the Marin facility offers it to patients as a free service.
Keeffe is also aware that, for the patient, having a computer in the exam room can seem like an intrusive third party. He keeps the tablet in his lap while sitting side by side with a patient and never types in front of them. “I treat it like an old paper chart,” he said.
Elsewhere in the North Bay, healthcare apps and remote visits are also filling a gap.
“In Solano there are access issues and a tremendous need. Our clinics are full and there’s a huge need in the community for care,” said Aimee Brewer, president of ambulatory division at NorthBay Healthcare. “We’re asking ourselves how we can offer the highest quality care but more efficiently. We’ve got this remote capability and we need to think a little differently.”
NorthBay is working with companies such as San Francisco’s CellScope, which makes a case that fits over a mobile phone allowing the user to take a photo inside the ear. The user sends the information to a doctor who can send in a prescription if needed, saving a trip to the clinic.
“Face to face is best but for the mother who comes in six times a year for her child’s ear infections, it saves a lot of time. With additional technology we can focus on keeping our patients well and out of our office,” Brewer said.
Remote monitoring of the patients after they have been discharged from the hospital can also help identify complications - such as fever - so that they can be treated before it turns into a bigger problem and the patient has to be readmitted.
Patients at Sutter Health can meet with a physician via video through MDLIVE. Sutter is aligned with a national network so this service is available 24/7. The doctor you visit with is also able write prescriptions. Some insurances are accepted or the cost for the video visit is $49.
