Smartphones are rapidly expanding their mobile healthcare footprint with new capabilities that are transforming them into serious point-of-care diagnostic tools.
Reports on the latest smartphone-as-diagnostic-tool are falling like snowflakes in Vermont. From the India Institute of Technology (ITT) comes the GE Edison Challenge first place-winning team Sinclair and its ClipOCam-Derma solution that attaches a high resolution lens and light to a smartphone to remotely diagnose skin abnormalities including melanoma, inflammation, ulcers, lipoma, psoriasis and keratinisation. The add-on device includes a lens attachment and a software application that provides clinical diagnostic and communications capability.
ClipOCam-Derma is targeted at remote areas where there is a scarcity of healthcare professionals. The device can be used by “semi-skilled” paramedics and allows for a rapid screening of patients.
[See also: Hospitals wringing big savings out of RFID, sensors.]
More than medical student researchers are seeking new ways to use a smartphone. On Dec. 24, 2013, Apple applied for patents for integrating a sensor to “detect a user’s cardiac activity” and a hover (rather than touch screen) technology that could be used to read EKGs.
As reported in AppleInsider, the patent for the heart monitor describes a device — the iPhone is not mentioned — that carries built-in sensors to measure cardiac signals.
Already commercially available is Stress Check by Azumio, which interprets stress levels by monitoring the changes in the heart rate of the subject, known as HRV, or heart rate variability. According to the company this can be used to determine the role various activities play in a person’s level of stress.
The device instructs users to place a finger lightly on the lens of the smartphone camera and hold still. HRV is determined through the camera and light features built into the phone and the Stress Check application.
Research labs worldwide are among the most-intensely focused on turning smartphones into point-of-care devices.
The Lab on a Chip Journal reports that researchers were able to use a smartphone to detect Salmonella, using what is known as “paper microfluidics.” After dipping specially treated paper into a solution suspected to contain salmonella and following instructions to position the smartphone at the correct angle and distance from the test paper, the images snapped are then evaluated by the application, with the results displayed on the smartphone screen.
The title of another paper reported on by Lab on a Chip reads, “Smartphone-based health accessory for colorimetric detection of biomarkers in sweat and saliva.” Another way of saying it might be “No Sweat,” because in this case the smartphone accessory and software reads the sodium concentration in sweat or saliva and indicates the “proper time to hydrate” as an individual exercises. 
And in an advance look by mHealth News at a paper to be published later in 2014, Lab on a Chip Journal will report on a smartphone accessory and application for patients monitoring their blood cholesterol level. While cholesterol monitoring devices are not new, they are costly and difficult to use. The discussed smartphone device measures total cholesterol by imaging the test strip.
There are also smartphone devices being developed to measure hyperthyroidism and another that detects Parkinson’s disease by placing the phone on the back of a patient’s hand and measuring the amount and frequency of tremors. Or, as reported in New Scientist, how about using a small droplet of saliva, urine or blood placed on a touch screen for analysis? This from Korea’s Advanced Institute for Science and Technology.
[See also: Telehealth provider launches 'Pay-with-a-Tweet' program.]
There’s no denying the amount of advanced technology and research built into today’s crop of smartphones. It’s also true that they offer patients many benefits, typically ease of access and use, and certainly smartphones are far less expensive than specialized devices. But the question one has to ask is how much can you retrofit a device essentially created as a communication tool and turn it into a serious diagnostic tool for patients?
For many years Microsoft faced a similar kind of dilemma when it felt duty-bound to keep Windows backward-compatible with older versions of its operating system. But at some point Microsoft’s software engineers understood that if they wanted to advance operating system technology they had to ultimately leave the previous iterations behind.
There may come a time when manufacturers designing hardware add-ons and applications for smartphones will have to sever those ties and go back to developing unique mobile diagnostic tools. And the deciding factor is bound to be price. Indeed, the cost for these unique tools will no longer be as expensive as they once were, due in great part to the ever-growing demand for point-of-care devices in an extremely health-aware and highly mobile aging population.
As powerful as the iPhone and the Samsung Galaxy may be, it remains unclear whether patients and their medical teams are actually getting the best tools for the job, particularly given the rapid technological advancement in diagnostic science taking place.
Ephraim Schwartz is a freelance writer based in Burlington, Vt. He is a recognized mobile expert and columnist, having spent 15 years as Editor-at-Large for InfoWorld, half of them covering the mobile space. Prior to that he was Editor-in-Chief of Laptop Magazine.
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