Abstract
Several years ago, perhaps even longer, we were in attendance at a telemedicine-oriented meeting, and many colleagues were eagerly walking about using both their cell phone—some type of flip phone like a Star Trek communicator such as the Motorola StarTac—and a Palm Pilot personal digital assistant. We posited a question to vendors in attendance about why these two devices were not in fact integrated, making it easier to carry and manage one device instead of two. The response was, well, one of perplexing dumfoundedness and a flat-out “that's not possible at this time.” Well, nearly 15 years later, the smartphone is the fastest growing mobile device, and in fact there have been more mobile phones manufactured and sold in the past 12–18 months than all televisions ever made and sold in human history! Clearly the integration of a telecommunication device and computing device into one, user-friendly, system has been a tremendous beneficial step in changing the way we work and play.
So, what does the smartphone do for us? Well, plenty. We are all very familiar with the ever-changing iPhone and the Android phones, and even the BlackBerry. While the latter may survive under a new management, the other two are in a galactic battle for consumer market supremacy! Individuals from a variety of backgrounds and age are developing applications, or “apps” as they are affectionately called. There are apps for almost everything—news, sports, entertainment, games, travel, finance, leisure, and, most important to us, health.
Health apps run the gamut. Both Google Play and the iTunes Store carry thousands of apps for a wide variety of medical disciplines for clinicians and patients alike. In fact, download of all apps from both of these sources measures in excess of 75 billion. The statement “there's an app for that” rings true across the landscape of medicine. But are they of any true value? Research in U.S. academic institutions and from various sites around the world demonstrates the utility of mobile phone and associated apps. 1 –4 There are reports from the Pew Research Center on Mobile Health and Health Online that discuss the utility and market penetration of the health apps. The U.S. Departments of Defense and Veterans Affairs have invested significantly in the development of apps for soldiers and Veterans. 4 They have seen firsthand how the mobile phone has been a great tool for the soldier. You will see more peer-reviewed original research articles in the pages of this journal in the coming months.
Mobile phones are relatively inexpensive, are easy to use, and are widely available. In his newest book, The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Healthcare, Dr. Eric Topol of the Scripps Transnational Science Institute comments on mobility and apps for the individual and its impact on healthcare. Clearly the use of these devices is changing business functions like banking and Web searches for information, and, as Dr. Topol recently demonstrated on a recent segment of the “Colbert Report with Stephen Colbert,” various inexpensive sensors for monitoring such things as blood pressure, pulse oximetery, electrocardiogram, etc., integrated into a plug-and-play mode, provide powerful tools to the consumer and healthcare industry.
New releases of smartphones are equipped with powerful cameras (10, 12, and even 15+ megapixels). If you can take high-quality photographs with your cell phone, what does that do for the marketplace of very expensive cameras that do the same thing? What if the camera now is integrated with a dermatology app? You now have a very inexpensive tool to support healthcare. This will drive the development of new delivery models and new business models.
The challenge with all of these apps is that they are so rapidly developed that they may or may not meet anyone's needs or expectations. Some are free, and some cost a few dollars. Some are developed literally overnight and may only exist online for a few months. The U.S. Food and Drug Administration (FDA) has provided final guidance for health apps used on mobile phones. The Web sites
In the coming months we will provide additional information and commentary on this rapidly emerging segment of healthcare. There is no doubt research must be conducted and published with regard to smartphones and apps for healthcare. As Dr. Topol and many others have commented, mobile health is transformational. Mobile phone integration into healthcare makes it much more personal than ever before. It provides useful tools that can help patients manage their health in new ways. The mobile phone is a tether to healthcare that is not obtrusive or inconvenient.
The smartphone market and the associated apps are only at the very beginning of a transition in medicine. As the computing power, image quality, and bandwidth continue to improve, we will see rapid growth in apps and a paradigm shift in the practice of medicine. There really is an app for that; just check out what your phone can do for you!
This issue of the journal provides you with several articles on how mobile phones are used, for example, in China for medical examination 5 and in Finland for medication reminders for Parkinson's disease patients. 6 In addition, an article on the utilization and impact of the American Telemedicine Association's clinical practice guidelines 7 is offered for your review and use.