Wednesday, June 6, 2012

Pagers, Silver Water and the Future of Mobile Health

Small advances please me greatly. I learned on NPR this morning that NYU’s Langhorne Medical Center is phasing out the iconic pager that has been tied to doctor’s waists for almost sixty years to be replaced by the smartphone. Privacy concerns and cost slowed down this transition. Lethargy might have played a part.  I’ve had two successful operations at Langhorne and know doctors there who think pagers remain the perfectly appropriate technology not likely to end up inside a patient.

But it was time. When a technology becomes a butt of jokes and parody, such as in 30 Rock with its pager salesman and in the sci-fi series Dark Angel, it’s time to retire the beast. Presumably the Langhorne Medical Center has figured out how to improve frequent weak cell phone coverage inside the hospital corridors.

I think the health and fitness fields offer tremendous opportunities for advanced mobile technologies. But, as we know, every development has a shadow side and for the medical field the shadow is in the testing.  Recently I went to a new doctor for my annual physical. In addition to the blood work and the like, he ordered a stress test and an EKG for me, though I had given him a detailed history of my running, cycling, and endurance training.  I told him my history with Bicycling Magazine, Runner’s World, Scuba Diving, Men’s Health and Prevention to emphasize that I had been monitoring my health and the field for thirty years. I had no family history of heart disease and no symptoms.

As luck would have it, my May 2012 issue of the AARP Bulletin arrived with an article entitled, “7 Medical Procedures You Don’t Need.”  Leading the list were EKGs and stress tests for people without symptoms. The other six include (with some editing): bone scans for men under 65; antibiotics for mild/moderate sinus infections; Advil and Motrin for those with high blood pressure or kidney disease; CT scans for uncomplicated headaches; dubious diagnostic tests for suspected allergies; and CT scan, X-Ray, and MRI for lower back pain.  This data comes from a study by the American Board of Internal Medicine and forms the basis of their Choosing Wisely Campaign. Full details can be found at

I assume good will on the part of most physicians and understand they are protecting themselves from malpractice. But I had a hard time swallowing advice from a New York physician who suggested I flush my sinus cavities with silver water. And the advice from a New York allergist, well-known to television audiences in the area, who pressed me to take monthly immunoglobulin  shots for allergies even when tests showed I had no antibody deficiencies. I finally found a physician who provided a low-cost, low-tech cure.

Few media companies of consequence don’t have a doctor on board to parse the unrelenting barrage of medical advice we receive from an array of journals, universities and trade associations. Consumers need help. The recent suggestion that men should not routinely be given the PSA test for prostate cancer has caused confusion and alarm.   

There appears to be an app for every pain and body part.  PriceWaterhouseCoopers estimates that there are more than 10,000 medical, fitness and health-related apps available for download. Jokes about pager use aside, we know that 95% of doctors with smart phones are using apps to assist in their work. Given the growing shortage of primary care physicians, it seems that the healthcare industry will inevitably make better use of mobile phone technology.  In India, a pilot project involving 50,000 consumers who get medical checkups over mobile devices shows promise.
The medical field does not lack information; we are inundated. What the field lacks is integration and particularly wireless integration. 
Qualcomm Life, a wholly owned subsidiary of Qualcomm Inc., is offering some tantalizing possibilities. (Full disclosure: I have consulted for Qualcomm QMT in the past).

Qualcomm Life is building a vast wireless ecosystem—in effect a platform that will include devices and apps, gateways, cloud-based connectivity, and access for patients, healthcare professionals, and payors. The platform is designed to meet HIPAA requirements and data security standards developed by the payment card industry.

Given Qualcomm’s knowledge of device manufacturers, carriers, and network development, the company will have something to say about the future of mobile health with the consumer as much a partner as patient. 

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