When Dr. Paul Abramson treats patients, he has the usual assortment of medical tools, tests and protocols. And then there’s the patient-gathered data he reserves for his most confounding cases.
Using an iPhone app, Abramson will have a patient with, say, mystifying migraines or seemingly inexplicable stomachaches self-track data such as how much sleep they’re getting or what they’re eating.
That information is eventually fed back to Abramson as potential clues to whatever medical mystery he’s trying to solve. The result is a more complete picture of his patients that in turn makes it much easier for him to figure out what’s going on.
“I am getting immeasurably more info about a patient than I could have gotten on my own,” Abramson said. “Patients who have been my patients for years I’m finding out are completely different people than I thought they were.”
Abramson is on the vanguard of the emerging digital revolution in medicine. Beyond consumer-driven apps that count calories or encourage exercise, mobile technology is beginning to significantly change how doctors practice medicine.
“We’re at a very interesting intersection of technology impacting clinical care, which hasn’t really changed dramatically in 50 or 60 years,” said Dr. Michael Blum, director of the Center for Digital Health Innovation at UCSF. “When we look back in 10 years, we’re going to be amazed how far we’ve gone.”
An element of tech
The ubiquity of smartphones has already had an effect on clinical practice in numerous obvious ways. Doctors can speedily access important information such as drug dosage recommendations or disease profiles as well as a patient’s medical information. They can also more easily communicate about patients with specialists or other colleagues.
Abramson began experimenting with other uses for mobile medical technologies on himself. He was getting regular headaches, with little clue as to why. A geek of sorts who earned a master’s degree in electrical engineering from Stanford before heading to medical school, Abramson enjoys putting himself in the role of lab rat.
Using his phone, he started tracking everything from caffeine intake and mood to barometric pressure and light exposure.
This was possible, of course, because of the incredible number of gadgets all rolled into his iPhone. It turned out the headaches were related to sleep; if he got enough shut-eye, the headaches disappeared.
About a year ago, he debuted the Quant Coach program at his practice. The program’s roots stem from the tracking Abramson did on himself.
“I just didn’t feel like I had enough information coming back to me from patients,” he said.
The Mymee app
Patients are instructed to track varying sets of information, entering the data into an app called Mymee. That data is sent to Abramson’s office and compiled in an open-source data visualization software called FluxStream. What is called a “quant coach” in his office then pores over this data, summarizing it for Abramson.
He said the methodology has allowed him to solve some complex medical riddles – physical ailments, for example, that wound up related to less-than-obvious causes, such as environment. He can keep close tabs on his patients and amass a rich picture of all the factors that might be contributing to an illness.
The potential applications for smartphones in medicine are growing more sophisticated.
At the 2013 TEDMED conference in Washington, D.C., an exhibition introduced the notion of the “smartphone physical.” It featured a collection of gadgets that, when hooked into an smartphone, can gather a slew of clinically relevant information.
Tricked-out, the smartphone becomes something akin to a real-life realization of Star Trek’s medical tricorder. Plug in the corresponding device, and the phone can determine blood pressure, monitor glucose or perform an electrocardiogram. The NETRA-G is a small, plastic eye piece that, when hooked into a smart phone, can test visual acuity.
Fusing med and tech
As the home to companies such as Rock Health and Health 2.0 that fuse the power of Silicon Valley with medical expertise, the Bay Area has been at the forefront of digital health innovation. Such innovation, though, is still in the early stages.
For one, medicine has been relatively slow to embrace technologies already available. Several doctors referred to that pace as “sclerotic.”
“Physicians are still bound to archaic technologies like pagers and fax machines,” said Dr. Nate Gross, co-founder of Rock Health, a seed accelerator for mobile and web health startups. In one recent survey, fewer than half of attending physicians reported using smartphones for patient care.