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July 25, 2013

Could a smartphone physical be in your future?

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WASHINGTON —

But what if these technologies not only make physicians' physical exams easier but also improve our interactions with patients? Smartphones can offer doctors a more reliable exam while increasing patient involvement in their care. Within the next decade, the smartphone physical might replace the traditional physical exam. Even now, the long-standing "routine physical" may no longer be so routine.

The traditional physical exam may be overrated when it comes to picking up diseases. A chest exam done as part of a physical, for instance, has been found to pick up only half of all pneumonias. A study found that stethoscopes wielded by young doctors correctly identified only one-fifth of previously diagnosed heart conditions.

So while the traditional physical exam may be hands-on, it's probably time to find ways to improve it; to me, smartphones offer that possibility.

Smartphone EKG

How can doctors wielding smartphones make a physical exam more effective? Technologies such as CellScope are often smaller and less unwieldy than otoscopes, stethoscopes and ultrasounds. "The Smartphone Physical" included a smartphone case that doubles as an EKG machine. Participants could get readings of their heart rhythms just by placing their fingertips on sensors located on the back of the smartphone case. By contrast, a standard single-lead EKG usually requires a technician to attach sensors to a patient's body in a clinic, doctor's office or, often, ambulance.

A study of the smartphone EKG presented at the 2012 American Heart Association annual meeting showed that its results were as accurate as a single-lead EKG at detecting atrial fibrillation and other arrhythmias. (Hospitals and emergency rooms use 12-lead EKGs to detect heart attacks and other conditions.)

Furthermore, the new device allows patients to participate in their own exam: The EKG readings can be transferred directly from iPhone to the Web, enabling a doctor to remotely look for specific heart wave abnormalities in real time - as opposed to having the patient go to an ER or doctor's office to be evaluated.

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