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Practicing Medicine in a Mobile Powered World

Apple changed the world when they launched the iPod.  When the iPhone came out, a new standard for smart phones was set, healthcare apps appeared, and the devices were quickly adopted by physicians (here is a great list of apps for physicians and medical students).  So, given Apple's track record,could the Apple iPad help revolutionize healthcare?  It may be wishful thinking, but I believe mobile technology has and will continue to change the way medicine is practiced. 

64% of U.S. physicians own smartphones and this number is expected to increase to 81% by 2012, according to Manhattan Research.  There are some significant advantages to today's mobile platforms, and for many physicians, our mobile device has become essential to our practice.  Consider a typical patient encounter…

A 66 year old patient of mine comes to the office with symptoms of depression.  She has a complicated medical history with heart failure, atrial fibrillation, high blood pressure, diabetes and high cholesterol (believe it or not, there is nothing rare about this type of patient, they make up 10-20% of a typical panel and a much larger portion of the medicare population.)  Here she is, with a relatively straightforward problem (depression), confounded by multiple medical issues and the host of medications that come with them.  In addition to the seven (7) medications she is currently taking, I need to add an antidepressant to treat the mood. Yet, with all of these medications I am concerned about drug-drug interactions and wonder if there is an optimal drug to use.  Today, I use Epocrates on my iPhone to see that there are a few I want to avoid.  In less than 2 minutes I figure out the best option with the least potential interactions – 10 years ago I had to check multiple sources for the same information – a process that took me 10-20 minutes.  With the time I save, I can move on to help another patient.

The reality for physicians is that we not only have a need to save time, but we also want to make the most of the time we do have.  Why waste minutes searching for information when we don't have to?  Part of the reason we have difficulty maximizing our time comes from having multiple sources for good information.  I may use a drug lookup tool on my handheld, then go to a desktop to review more detailed clinical research, then get on the phone with a colleague or ask a member of Ozmosis to help me interpret the results, then go back to my chart – or EMR to complete the visit.  Imagine how much more efficient my workflow would be, and the time saved, if everything was available in one place, interconnected and available to me no matter where I was physically located.

Remember our same 66 year old who is in the office?  I still need to capture her complicated history, figure out her diagnosis, and choose a medication...this part isn't going to change.  However, imagine if, while I am looking up drug-drug interactions on my handheld, I get a targeted alert that a new study has come out that shows drug A is superior to drug B for the treatment of her condition.   In a matter of seconds, I am reading the article summary, and also seeing that 5 of my colleagues - who I know and trust - have all read the same article and not only shared their thoughts and commentary on the data, but also endorsed it's findings.  While I'm still on my mobile device, I can then check the patient's formulary for their insurance, write and send the prescription to the pharmacy, and if available, even order samples for my office for the next time a patient needs it.

This is one example of one workflow, and there are countless others - including the potential for real-time, mobile consultations with videos, images, and other patient data.  The future of medicine includes a world full of mobile devices, innovative wireless applications, access to crowdsourced knowledge, and improved clinical workflows. 

I'll be speaking more on this topic at the ePharma Summit, February 10th in Philadelphia.

Jason Bhan, MD
Co-Founder, Ozmosis

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