How are they being used?

Smartphones – part one of three

By Neil Versel

A study published in the January 29, 2009, New England Journal of Medicine found that following the 19-item World Health Organization Surgical Safety Checklist reduced the incidence of death by nearly half and cut the rate of inpatient complications from 11 percent to 7 percent at eight hospitals worldwide.

Following publication of that paper, Australia and New Zealand standardized on the WHO checklist to confirm the patient’s identity, proper surgical site and the number of instruments, needles and sponges, as well as to assure that the patient has been introduced to the entire surgical team before the procedure begins.

“It’s great, but who’s going to have this piece of paper lying around?” wonders Vancouver nephrologist Dr. Daniel Schwartz. It would be much easier to have an electronic version of the checklist-preferably on a handheld device. So he built one for the iPhone.

Of course, not everyone has the programming prowess of Schwartz, who co-founded QxMD, a developer of medical reference applications for personal digital assistants (PDA) and smartphones. But physicians everywhere are finding smartphones indispensable in the practice of medicine and in the management of their lives. Smartphones combine the features of pagers, mobile phones, web browsers, PDAs and, often, music players. The newest models support a huge variety of third-party applications.

Physicians for the most part are not technophobic; they just want technology that’s easy to use, saves them time and above all, enhances their ability to practice medicine. Electronic health records (EHR) don’t always do that. Smartphones, for the most part, do.

“We know that physicians are looking to consolidate paging, telephone service and mobile computing in a single device. They don’t want to carry around two pagers, a mobile phone and a PDA anymore. Apps are a key part of that,” says Fraser Edward (pictured), manager of market development for healthcare at Research In Motion (RIM), the Waterloo, Ont.-based maker of the BlackBerry.

Edward believes physicians are looking for four things from smartphones. “Two are consumer-focused (as part of physician-patient interaction), and two are more institutional, hospital-focused,” he says. “On the consumer side are medical reference and dictation. Then they use their devices for alerting or as pager replacements and for collaboration tools and messaging.”

The mHealth Initiative, a Boston-based research group that superseded the Medical Records Institute in February 2009, estimates that about 2,000 of the more than100,000 iPhone apps available in the Apple App Store are related to healthcare. There are more than 3,000 healthcare apps for other smartphone platforms, including BlackBerry, Windows Mobile, Palm OS and Google’s Android, and some have huge followings.
Popular electronic drug database Epocrates, which celebrated its 10th anniversary in October, claims 900,000 users worldwide, including more than 100,000 on the iPhone in the year and a half since that version was released.

While PDAs are essentially reference tools, smartphones are true communication devices. We’ll explore this topic further with Dr. Peter Rossos, director of medical informatics at University Health Network (UHN) in Toronto, in part two of this three-part series. (Please see the March 18 issue.)

Posted March 4, 2010