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Apr. 23, 2013 10:30 am

Smartphone Physical: These apps let you give yourself an Electrocardiogram

The Smartphone Physical project, which uses a set of devices that connect to an iPhone, allows doctors and patients to conduct a comprehensive physical examination. The devices can collect both quantitative and qualitative data, ranging from simple readings of weight and blood pressure to more complex readings such as heart rhythm analysis and visualization of the back of the eye. Here's why the project could change doctor's visits.

Penn med student Michael Hoaglin (right) screens a patient using a Smartphone Physical device.

This is guest post by Michael Hoaglin, a fourth year Penn medical student who cofounded "The Smartphone Physical" project with a Johns Hopkins medical student. The project was debuted at last week's TEDMED in Washington, D.C. These are notes from his presentation.

Physical exams are falling out of favor, but the Smartphone Physical project wants to change that.

The  project, which uses a set of devices that connect to an iPhone, allows doctors and patients to conduct a comprehensive physical examination. The devices can collect both quantitative and qualitative data, ranging from simple readings of weight and blood pressure to more complex readings such as heart rhythm analysis and visualization of the back of the eye.

Most of the devices are now widely available. The project hopes to create the best black bag of devices for the next generation of doctors and modernize medical education with mobile technology.

Here’s why the project matters:

  • The use of ‘small data” such as the smartphone-enabled devices and medical apps can enhance patient engagement. Being able to meaningfully trend blood pressure data at home with plug-and-play devices reduces the mundane by using the smartphone device as a repository for personal health information.
  • Patients can look at their own point-of-care images including middle ear and back of the eye. For 100 percent of patients I screened, this was the first time they’d seen their own eardrum. Most hadn’t seen their own retina.
  • Use of a smartphone Electrocardiogram (e.g. AliveCor) allows patients to connect symptoms to objective data. Often times patients experience chest pains or heart palpitations that land them in the ER. By the time the ambulance arrives and brings the patient to the ER, the patient may feel better and not have a findable medical issue. Now, patients can grab a smartphone-enabled ECG right when they’re having symptoms at home and beam results to a doctor who can help decide whether the patient needs immediate medical attention. This can be quite validating and reassuring for the patient
  • Baselining: collecting objective imaging, numerical and/or tracing data allows clinicians to create a patient’s baseline health so that future data can be compared to baseline for more personalized diagnosis
  • Some of these devices can be used at home, but others do not necessarily replace the physician. They make the physical exam more reliable and enhance its quality.

The Smartphone Physical can improve medical education by:

  • enhancing visual learning and the ability to deal with more data at the point of care to make better patient care decisions.
  • allowing students to see the optic disk/retina while learning how to do the exam in real time. I didn’t reliably see the optic disk until I started using the [Smartphone Physical] ophthalmoscope.

At TEDMED, where the Smartphone Physical launched:

  • Attendees received a copy of their data, including images. Some even opted to tweet photos of their retina as artwork.
  • Appointments for the week of TEDMED booked up on the first day, and people willingly waited sometimes over an hour to experience the physical.
  • Those experiencing our physical included TEDMED Delegates, Surgeon General Dr. Regina Benjamin, Richard Simmons and executives from Kaiser Permanente.
  • Some ailments such as atrial fibrillation were informally diagnosed and results were provided to attendees’ physicians.
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