Dr. iPhone: How Will the Smartphone Physical Change Healthcare?

One of the much-hyped features of this year’s TEDMED conference ws the “Smartphone Physical” — a physical assessment conducted entirely through mobile health applications. Here’s the video, courtesy of Medgadget:

My first interaction with a cellphone app was in 1999; it was the snake game on a non-color, low-res flip phone. I laugh to think that, at the time, it mesmerized me as much as this does now. In 15 years, we’ve transformed the mobile phone from a mere communication device to a 24/7 interface that lends context, connectivity, and quantification to our every action.

Mobile health applications represent the next stage of patient empowerment. 30 years ago, patients received information and procedures from their physicians, often without instruction. Now, the smartphone physical empowers patients to identify, understand, and manage their own health on a completely new level. This offers critical implications for the future of medicine:

1. Patient Engagement: It’s probable that the physical act of regularly checking blood pressure or measuring blood sugar levels can make a patient more conscious about their health. It’s also hopeful that such self-tracking can inspire self-education and positive behavior change. This is difficult to measure experimentally (have you ever noticed that the most avid quantified self-ers are the fittest and healthiest people?) but it offers reason to be optimistic about mHealth.

2. Remote Care: A critical challenge of hospital readmissions is that, once the patient walks out the door, it’s no easy endeavor to reconnect with them. If physicians could remotely monitor patients, it’s possible they could identify early signs of a complication and intervene. As a readmissions researcher, I’ve spoken with patients who waited for three weeks of not being able to eat before returning to the hospital 30 pounds lighter. The smartphone physical could have flagged that—and someday, it will.

3. The Doctor’s Role:¬†This is the big question, and it’s a loaded one. How will physicians interpret and process the information overload that follows such complete self-quantification? How will electronic health records and/or personal health records adapt to meaningfully consolidate, analyze, and present all this data? How does the patient’s ability to self-educate, self-diagnose, and (perhaps eventually) self-treat change the purpose and significance of the doctor-patient relationship? At Millennial Medicine, Dr. Eric Topol presented these mHealth innovations and said, "With this, why would you want to go to the hospital?" Good question — Will¬†patients still want, or need, to interact with their doctors?

These are ambitious goals, but with the advances I’ve seen in this video as well as other seminal achievements made in mHealth and digital medicine recently, I’m optimistic that they are all entirely doable. I’m also conscious of how often I’ve used the word “possible” in this reflection and how scarcely I’ve said “proven.” It simply speaks to the fact that we’re faced with inspiring technical capabilities that offer tremendous hope; the challenge now falls to tomorrow’s physicians and scholars to innovate, research, and troubleshoot to bring these ambitions to realization.