It was 2.30 am. A patient with a serious injury had just been rushed to New Delhi’s Max Super Speciality Hospital. An urgent X-ray was taken, but there were no radiologists onsite during the small hours to interpret the scans. Luckily, Dr Debajyoti Chaudhuri – who was roused from his sleep – could access the image using an app called MphRx Connect on his BlackBerry at home. In seconds, he managed to spot a dangerous bleed, diagnose it, and alert the doctors at the hospital to save the patient’s life.
In another incident in January, Okari, a nurse practitioner at the Lwala Community Hospital in rural Kenya referred to a mobile app called Skyscape Medical Resources to read up on ‘how to perform a neonatal resuscitation’.
Okari feared that the child he would be delivering the next day could possibly suffer from breathing problems. And it was the procedures that he learnt on the app that helped him resuscitate the newborn after delivery.
Indeed, with the widespread proliferation of smartphones and tablets, health professionals are now relying on expert medical apps to help them make critical, split-second decisions.
In fact, doctors are even recommending certain apps to their patients and staff.
Laparoscopic surgeon Dr Dheeraj Mulchandani lets the nurses in his clinic in Colaba, Mumbai, use the Speed Anatomy app on his Android phone or iPad to quickly revise their knowledge of the basics. “It’s an educational utility that teaches people how to differentiate between organs like the liver, spleen, kidney and lungs,” he says. The 28-level “game” asks users to point to various organs on a graphical representation of the human body.
Indeed, browse through online stores and you will find apps similar to Speed Anatomy, and even tools that help people lead healthier lives, including basic utilities like How to Brush Your Teeth – an app that Hyderabad-based dentist Dr Chetan Bhawani recommends to his patients.
“The step-wise guide makes an important daily task like brushing easy and interesting.”
And then there’s nutritionist Himani Jariwala who admits that apps like Vitamins and Minerals on her phone come in handy while writing diet plans. “It lets me quickly find the food sources of specific vitamins and minerals,” she says.
A healthy market
In 2009, healthcare market research publisher Kalorama Information pegged the medical app market to be around $41 million. In 2010, a report by MobiHealthNews stated that the number of such apps available for the three major platforms of Apple iOS, BlackBerry, and Android, grew by 78%.
Today, some of the most popular apps being used by doctors are reference guides that give them important drug and clinical information on-the-go. Take Mumbai-based preventive medicine consultant Dr Ranjit Mankeshwar, for instance. “When prescribing drugs I look up drug-drug interactions on the app to avoid prescribing ones that react badly with each other,” he says, describing the Epocrates app, a mobile reference guide available on iOS, Android, Blackberry and Windows Mobile devices.
And making such medical reference apps is Skyscape Inc that licenses content from trusted medical publishers to create the app-versions of their books.
“A 50,000-page library of medical reference books and drug databases can be converted into apps that occupy about 1GB space on your mobile device,” says Makarand Karkare, MD, India Operations of Skyscape, whose apps include The 5-minute Clinical Consult, Harrison’s Manual of Medicine and DrDrugs: Drug Guide for Physicians.
While the US Food and Drug Administration (FDA) doesn’t see the need to regulate apps that are mere electronic copies of medical handbooks, it has expressed concern over certain types of software, including those that can transform a smartphone into a stethoscope, ECG machine, or a glucose meter.
British computer scientist Peter Bentley who developed the iStethoscope Pro for the iPhone says that his software is intended to be used for entertainment purposes and as a demonstration of technology.
“We are working to develop fully certified iPhone apps that may be used as medical devices in the future,” reads a post on his site.
Closer to home
Interestingly, officials at India’s Central Drugs Standard Control Organization said they haven’t received any instructions from the Health Ministry to regulate mobile medical applications as yet.
At the same time, US’ FDA has already started clearing such software.
The first such app to be cleared was Mobile MIM, which turns an iPhone or the iPad into a diagnostic medical instrument that allows physicians to view computed tomography (CT), magnetic resonance imaging (MRI) scans to make diagnoses on the go.
Like MIM, remote monitoring app eTRAQ has been designed to help specialists and visiting doctors at hospitals monitor real-time patient data, including ECG, heart rate, and ultrasound images while the patient is at home, or the doctor is away from the patient’s bedside.
“Previously, the only mode of finding out how the patient was doing was through a telephone call which is reactive. This technology lets doctors be proactive,” says Arindam Sen, CEO, Advanced Micronic Devices Ltd – a company which is pilot-testing the app viewable on a Blackberry Playbook in five hospitals across the country.
But while app technology is advancing and a large number of healthcare professionals are using them not all Indian doctors are open to the idea. According to a study by market research firm Tavess only 15% of Indian physicians perceive smartphones to be essential for their profession.
“Doctors in rural hospitals and those belonging to the older generation are yet to adopt medical apps,” says Dr Ruchi Dass, a physician tracking healthcare IT.
Dr Dass herself uses MyDays (a period and ovulation calculator) and PurpleTalk’s My Health Records (a health information tracker that lets users save lab reports, prescriptions, and family health history on their mobiles). Similar to the My Health Records tracker are fitness tracker apps like Calorie Counter: MyFitnessPal, one of Dr Bhawani’s favourite apps in the Android market.
“You simply have to key in the name of the food item and the app will find its calorie count for you from its database of over 1,200,000 food items. It also lets you use your phone to scan barcodes on food packages to give you the calorie count of the item,” says Bhawani, one of the few Indian doctors who blogs about technology and medicine.
Still, physicians caution lay users. “These apps should not be considered as an alternative to a doctor’s advice,” says Dr Mankeshwar “And in the matters of health, such decisions are best left to the professionals.”