The iPhone, Apps, & Medical Technology    

The Computers Club Mac SIG

March 17th, 2014

Presented by:

Rebecca Nelson, RN and

Nancy Collins

Please  note  this  presenta.on  is  informa.onal  only.    

 

Informa(on   provided   during   this   presenta(on   is  general  informa(on  for  entertainment  and  educa(onal  purposes  only.  Any  informa(on  given  either  printed  or  verbal  is  not  designed  to  and  does  not  provide  medical  advice,   professional   diagnosis,   opinion,   treatment   or  services  to  any   individual.  The   informa(on  provided   is  not  a  subs(tute  for  medical  or  professional  care.  If  you  believe   that   you   have   a   medical   emergency   or   any  other  health  problems  or  concerns  you  need  to  contact  911  or  your  primary  physician.    

Can  Telemedicine  Save  You  a  Trip  to  the  Doctor?  by  Chris(na  DesMarais  on  February  05,  2014    

TeleCare  In  telecare,  modern  technology  allows  caregivers    to  remotely  monitor  people  with  chronic  issues.    

TeleMedicine  Basic  telemedicine,  a  type  of  telemedicine  that's  been  going  on  for  decades,  uses  video  conferencing  or  telephone  calls  to  connect  pa(ents  with  one  or  more  consul(ng  physicians.    

TeleCoaching  Telecoaching  is  an  interac.ve  online  pa.ent  educa.on  experience.  “…..  it’s  a  real  educa(on-­‐  and  training-­‐intensive  thing  to  get  a  new  pa(ent  trained  so  they  can  stay  on  top  of  their  own  condi(on  and  do  a  really  good  job  of  self-­‐management…”    

Telehealth  …..quality  care  outside  of  tradi.onal  medical  sePngs    …..  remote  care  and  disease  management…..  

Ø  The  doctor  used  to  come  to  my  house.    Ø  Then  I  used  to  go  see  him  in  his  office.    Ø  Then  I  went  to  a  medical  office  to  see  one  of  many  doctors.    Ø  Soon  I  won’t  “see”  a  doctor  at  all  except  REMOTELY!  

But  when  it  comes  to  health,  good  service  and  convenience  can  make  all  of  the  difference.  There  is  a  lot  of  innova(on  in  this  area,  none  more  so  than  new  virtual  medicine  apps  where  people  can  get  medical  advice  from  doctors  using  their  smartphones.    Doctor  on  Demand  connects  people  with  physicians  via  smartphone  video  conference.  Within  seconds  of  downloading  the  app  you  can  be  talking  to  a  cer(fied  doctor,  rather  than  dealing  with  the  hassle  of  booking  appointments  and  wai(ng  to  see  a  GP.      You  can  ask  the  doctors  for  diagnoses,  basic  prescrip(on  medica(ons  and  other  non-­‐emergency  medical  advice.  They’ve  even  been  offering  free  consulta.on  for  the  past  few  weeks  during  flu  season.  It’s  a  great  example  of  using  technology  to  simplify  an  oYen  difficult  process  and  improve  people’s  lives.”  

Virgin  Airlines  CEO  Richard  Branson:    

“One  of  the  things  people  care  most  about  is  gePng  great  customer  service,  regardless  of  what  part  of  their  life  it  applies  to.  

Medicine  with  a  smile!  

“…..the  future  of  medicine  may  involve  a  virtual  consult  with  your  physician  via  a  Skype-­‐like  or  Google  Glass  connec(on,  followed  an  hour  later  by  an  Amazon  drone  delivery  of  your  drugs  or  tes(ng  equipment.”  The  Coming  Medical  Revolu.on:  Drones  and  Telemedicine?    hJp://www.fool.com/inves.ng/general/2014/02/08/the-­‐coming-­‐medical-­‐revolu.on-­‐drones-­‐and-­‐telemedic.aspx  

Amazon  to  

you!!  

Guess  which  free  Medical  App  was  #1  this  week?  

March  1,  2014  

Neurologist  consulta(on  in  the  hospital  to  diagnose  and  treat  a  stroke  

 

A  computer  monitor  with  a  camera  is  plugged  in  at  the  foot  of  the  bed.  The  doctor  and  pa(ent  can  see  each  other  while  a  nurse  works  with  the  pa(ent  as  the  doctor  observes  the  pa(ent’s  movements.  

Training  future  medical  prac((oners  with  the  use  of  virtual  pa(ents  

 

By  asking  ques(ons  of  a  computer  digi(zed  virtual  “pa(ent”  and  observing  the  “pa(ent,”  nursing  students  learn  the  art  of  assessing  real  pa(ents  for  medical  condi(ons.    

The  iPhone  5S  introduces  two  key  features  relevant  for  doctors  Sep  11,  2013  by  David  Ahn,  MD    Conclusion:    “One-­‐touch  fingerprint    access  would  be  welcomed  with  open  arms  by  health  care  workers  who  are  juggling  various  logins  and  passwords  —  and  has  the  poten(al  to  help  us  treat  pa(ents  faster,  even  if  it’s  by  just  a  few  seconds.    With  the  M7  Ac(vity  Sensor,  we  have  a  new  method    to  track  pa(ent  data  and  health.    Along  with  checking    our  pa(ent’s  HbA1c,  we  might  be  checking  their  Nike+    app  as  well.”          

hip://www.imedicalapps.com/2013/09/apples-­‐september-­‐iphone-­‐event-­‐relevance-­‐medicine/    

Dr.  Eric  Topal,  the  Editor  in  Chief  of  Medscape  Medical  News  with  

Brian  Williams  of  NBC  hips://www.youtube.com/watch?v=uBhIgR-­‐W75I  Using  the  iPhone  to  capture  the  heart  bea(ng.  

hip://profitable-­‐prac(ce.soYwareadvice.com/5-­‐medical-­‐peripherals-­‐for-­‐the-­‐ipad-­‐or-­‐iphone-­‐1012612/  

hip://www.medgadget.com/2011/10/iphone-­‐transformed-­‐into-­‐microscope-­‐and-­‐spectrometer.html  

hip://internetmedicine.com/2012/12/14/top-­‐ten-­‐medical-­‐uses-­‐of-­‐the-­‐iphone/  

Another  use  of  the  iPhone  -­‐  used  with  a  peripheral  as  a    

breathalyzer,  to  detect  alcholol  levels,  from  your  expira(on.  

The  system  is  a  mobile,  wireless,  real-­‐(me  brain  scanner,  and  the  soYware  allows  for  wireless  transmission  to  the  Smartphone  program,  which  receives  the  EEG-­‐like  transmissions  from  the  various  electrodes  on  the  head,  and  like  anything  recorded  on  the  Smartphone,  can  be  sent  to  a  consul(ng  physician,  anywhere  in  the  world.  

CellScope  Otos  is  another  system  to  watch  for.  It’s  an  otoscope  for  the  iPhone  that  collects  high-­‐quality  images  of  the  ear  canal  and  eardrum  to  diagnose  ear  infec(ons  and  track  them  over  (me.  Currently  in  use  by  early  adopter  doctors,  it  will  soon  be  sold  to  clinician  users  for  around  $200.    A  CellScope  device  for  consumers  to  use  at  home  —  a  boon  for  parents  with  young  children  —  is  planned  for  launch  later  this  year.  The  idea  is  that  home  users  could  send  images  to  their  own  doctors  for  diagnosis  (or  get  connected  to  a  different  doctor  if  theirs  doesn’t  par(cipate  in  Cellscope’s  program).  The  company  says  it’s  also  working  on  soYware  tools  that  would  give  users  an  immediate  analysis  of  what’s  going  on  in  their  ears.  

Building  a  smartphone-­‐enabled  diagnos.c  toolkit  to  help  pa.ents  get  beJer  answers,  faster.  

hip://www.techlicious.com/blog/can-­‐telemedicine-­‐save-­‐you-­‐a-­‐trip-­‐to-­‐the-­‐doctor/  

Welch  Allyn  hip://www.welchallyn.com/promo(ons/iExaminer/index.html  

Check  out  this  video  from  this  Website:  hips://www.youtube.com/watch?feature=player_embedded&v=QxuaKc6drIc    

“The  new  Welch  Allyn  iExaminer  turns  the  PanOp(c  Ophthalmoscope  into  a  mobile  digital  imaging  device  allowing  you  to  view  and  take  pictures  of  the  eye  like  you've  never  done  before.  The  adapter  aligns  the  op(cal  access  of  the  PanOp(c  Ophthalmoscope  to  the  visual  axis  of  the  iPhone  4  or  4S  camera  to  capture  high  resolu(on  (5/  8  megapixel*)  pictures  of  the  fundus  and  re(nal  nerve.  The  iExaminer  App  then  allows  you  to  store  the  pictures  to  a  pa(ent  file  or  email  and  print  them.  And,  because  the  PanOp(c  Ophthalmoscope  provides  a  5x  larger  view  of  the  fundus  than  a  standard  Welch  Allyn  ophthalmoscope  and  25°  field-­‐of-­‐view  without  having  to  dilate  the  pupil,  the  fundus  imaging  can  happen  any(me,  anywhere.  -­‐  See  more  at:  hip://www.welchallyn.com/promo(ons/iExaminer/index.html#sthash.DgNiWsvh.dpuf”  

To  get  medical  apps  for  your  device:    1.  Click  on  the  app  icon          3.  Click  on  Medical    2.  Click  on  Categories        4.  Paid/Free/Top  Grossing      

Even  MicrosoY  has  a  medical  app  for  the  iPhone!    

 “Medical”  and  other  apps    available  on  the  App  Store…..  

Some  of  our  Club  members  use  this  app  to  access  their  medical  informa(on  from  their  medical  facili(es  and  doctors.  

Disclaimer  on  one  app:  

There’s  even  one  for  Fido  and  Kiiy!  

Apps  for  emergencies  -­‐    

Five  signs  that  Apple  is    crea.ng  a  health  product  Malay  Gandhi    February  03,  2014  hip://rockhealth.com/2014/02/five-­‐signs-­‐apple-­‐crea(ng-­‐health-­‐product/      Over  the  past  year,  Apple  has  been  quietly  building  up  the  resources  necessary  to  release  a  health  product  of  their  own.  If  the  past  con(nues  to  repeat  itself,  the  digital  health  landscape  could  see  a  huge  shiY  as  the  standard  seier  works  to  create  a  product  that  consumers  love  and  use.  Culmina(ng  in  a  mee(ng  late  last  year  between  senior  Apple  execs  and  the  FDA,  here  are  five  signs  that  a  poten(ally  game-­‐changing  digital  health  product  is  on  the  horizon.      1.  “The  whole  sensor  field  is  going  to  explode.”  -­‐Apple  CEO  Tim  Cook      2.  The  M7  coprocessor  Apple  has  already  released  dedicated  hardware  for  tracking  health.  The  M7  coprocessor  is  included  in  every  iPhone  5s  designed  specifically  to  monitor  physical  ac.vity,    using  mo.on  data  from  the  phone’s  embedded  sensors.    The  chip  has  been  engineered  from  the  ground  up  to  sip  power,  extending  baiery  life  while  allowing  for  high  resolu(on  capture  of  ac(vity  data.    Leading  fitness  apps  including  Moves,  Nike+  Move  and  Fitbit’s  MobileTrack  feature  take  advantage  of  the  new  hardware.      

3.  They’re  hiring  medical  device  experts    •  Ravi  Narasimhan,  a  Stanford  PhD  with  exper(se  in  

“biomedical  algorithms,  data  analysis  and  wireless  technologies”  and  former  VP  of  R&D  in  Biosensor  Technologies  at  Vital  Connect  joined  Apple  in  December  2013  (LinkedIn).  

•  Nancy  Dougherty,  who  previously  worked  at  digital  health  sensor  startups  Proteus  and  Sano  Intelligence,  was  hired  in  December  (LinkedIn).  

•  Michael  O’Reilly,  the  former  CMO  of  Masimo,  developers  of  a  pulse  oximeter  for  the  iPhone,  joined  Apple  in  July  (LinkedIn).  

•  Dr.  Todd  Whitehurst,  a  self-­‐proclaimed  “medical  device  R&D  professional”  and  former  VP  of  Product  Development  of  Senseonics,  a  developer  of  glucose  sensors,  joined  Apple  8  months  ago  as  a  Director  of  Hardware  Development  (LinkedIn).  

•  Ueyn  Block  who  was  formerly  with  C8  MediSensors  developing  “non-­‐invasive  measurement  of  substances  in  the  human  body”  joined  10  months  ago  as  a  Technical  Lead  for  Op(cal  Sensing  (LinkedIn).  

•  Yuming  Liu,  who  previously  worked  at  O2MedTech  and  Accuvein,  was  hired  as  an  Analog  Engineer  (LinkedIn).  

•  Bob  Mansfield,  Apple’s  long(me  lead  for  hardware  engineering,  was  lured  out  of  re(rement  to  develop  unspecified  “future  products.”  The  New  York  Times  reports  that  Mansfield  has  been  exploring  sensor  technologies  for  health  and  is  directly  involved  with  the  future  smartwatch  project    

 

Five  signs  that  Apple  is  crea.ng  a  health  product  (con.nued)  Malay  Gandhi      4.  Intellectual  property.  In  2009,  Apple  filed  a  patent  for  a  “seamlessly  embedded  heart  rate  monitor”  and  was  ul(mately  awarded  the  patent  by  the  United  States  Patent  and  Trademark  Office  (USPTO)  in  late  2013.  The  patent  covers  the  use  of  embedded  sensors  to  measure  a  user’s  heartbeat,  heart  rate,  or  other  cardiac  signals.  The  patent  further  covers  loca(ng  the  leads  in  accessories,  such  as  headphones  (or  perhaps  a  wearable  device).  

Most  recently,  Patently  Apple  has  uncovered  a  patent  applica(on  for  a  medical  app  that  can  monitor  physiological  data  (e.g.,  arrhythmias),  and  either  store  it  on  a  device  like  an  iPhone  and/or  transmit  the  data  to  health  facili(es  via  a  communica(on  network.      5.  Check-­‐in  with  the  Food  and  Drug  Administra(on  (FDA).  Senior  Apple  execu.ves  met  with  FDA  leadership,  including  the  Director  of  the  Agency’s  Center  for  Devices  and  Radiological  Health,  which  has  oversight  of  medical  devices,  and  Bakul  Patel,  the  author  of  the  FDA’s  guidance  on  mobile  medical  applica(ons    

Some  ar(cles  and  Websites  to  check  out  from  other  members  of  our  Club  who  aiended  the  original  presenta(on:  

   hip://www.wired.com/business/2014/03/apple-­‐healthbook-­‐is-­‐just-­‐the-­‐beginning/?mbid=synd_yfinance  “Apple  is  poised  to  launch  a  body-­‐monitoring  app  known  as  Healthbook,  tracking  everything  from  sleep  to  nutri(on  to  exercise  to  vital  signs.”  Leeta  Mackey      hip://azlwi.org/its-­‐here-­‐introducing-­‐my-­‐ac(on-­‐planner-­‐for-­‐apple-­‐products.html  Arizona  Living  Well  Ins(tute  –  See  the  App  Store  for  My  Ac(on  Planner  (99¢),  “a  mobile  implementa(on  of  the  popular  Ac(on  Plans  in  the  Self-­‐Management  programs  developed  at  the  Stanford  Pa(ent  Educa(on  Research  Center….”  Reva  Lii,  MPH      hip://www.nih.gov  “The  Na(onal  Ins(tutes  of  Health  (NIH),  a  part  of  the  U.S.  Department  of  Health  and  Human  Services,  is  the  na(on’s  medical  research  agency—making  important  discoveries  that  improve  health  and  save  lives.”      hip://www.nlm.nih.gov/medlineplus/  “Health  informa(on  from  the  Na(onal  Library  of  Medicine.  Easy  access  to  Medline  and  Health  topics,  medical  dic(onaries,  directories  and  publica(ons.”      hip://pa(enteduca(on.stanford.edu/internet/healthyliving.html  “Beier  Choices,  Beier  Health™,  previously  named  Self-­‐Management  @  Stanford  Healthier  Living  with  Ongoing  Health  Problems,  is  an  online  workshop  given  on  the  Internet.  Groups  of  about  25  people  with  a  variety  of  ongoing  health  condi(ons  par(cipate  together.  Workshops  are  facilitated  by  two  trained  facilitators…”