(SOURCE: John Bennett MD: www.internetmedicine.com)
December 15, 2012

The creation and widespread use of the iPhone has impacted many industries, and now has affected Medicine profoundly, and in many ways.  In many cases the iPhone enpowers and enhances the power of the device to which it is attached by its optic or  computing power.

(See these Top Ten in VIDEO, at the DocVid Video Classroom)

We will examine the Top Ten Medical Uses that we feel has, and will have, a deep, continuing impact on the practice of healthcare.

1. The iPhone as  Otoscope

The Otoscope using the iPhone is also called the Remotoscope, and sometimes Cellscope.  The versatile ole iPhone is used to, not only view the inner ear with magnification, but also take pictures, to send to doctors, or specialists, from home or remote areas.  It is approved by the FDA.  This is yet another use of the iPhone as a periperal device useful in Internet Medicine.

Here’s a video which illustrates its utility:

2. AliveCor as Portable EKG

 

WEBSITE

Just recently approved by the FDA (December 2012) the iPhone ECG is a single-lead electrocardiogram reader that attaches to the back of an iPhone and displays heart rate info via an app. (An Android version is in the works.) The creator, Dr. David Albert, is an Oklahoma Cardiologist, who likes to be called an “Inventor”.  Son of former Speaker of the House, Carl Albert, David believes the iPhone ECG could be used in intensive care units and used by EMTs.   His team is recently compiled data in June 2012, after which his company received more funding  from the powerful Qualcomm, a big company in the wireless industry.
 

Basically, a peripheral device, projected to be around $100, is attatched to any Smartphone, and a real time, a high quality one lead EKG can be done. This EKG can be done anywhere a Smartphone goes, and allows for rapid, quick assessment of some cardiac problems in the field, including rhythm disturbances. To truly diagnose a full MI, however, the AliveCor is not able, since it does not give a total picture of many leads. A full EKG is indicated as Dr. Albert maintains to truly diagnose an myocardial infarction.
Additionally, its’ low cost also allows for mass screening in developing countries.

And like any wireless device, one is allowed to transmit any questionable EKG to any other Smartphone, which allows for in-the-field consultations with cardiologists, which are relatively scare in developing countries.

The thrust of this well-funded company is global. The company has moved to San Francisco.

AliveCor’s ECG device basically enables medical professionals and regular consumers to monitor a person heart health. Its cardiac monitoring technology is designed to work with the iPhone, iPad and Android devices.

Here’s a video of  Dr. Albert demonstrating this wonderful global technology

 

3) The iPhone as a Microscope

 

One has to stop thinking of the iPhone, Android, Blackberry as a phone, when dealing with its place in Internet Medicine.  It, rather, should be thought of as a powerful mini-computer, with a state-of-the-art photo equipment.  Yes, that little thing.  It can be converted to a powerful, picture-taking camera, to act as a supremely useful  peripheral device.

Of course, this would not be needed in most labs, but in rural area, in underdeveloped countries, it would  have unlimited potential.  No phone connection is needed, simply the peripheral and the smartphone without an internet connection.  Of course, a connection would be needed if the image is sent to other parts of the world to be interpreted.  The device will prove to be invaluable in underdeveloped countries where cost and distance are now problems to diagnose the common infectious disease in the Third World.

Here’s a comparison of microscope photos taken with a high-resolution camera, and one with the smartphone:

(SOURCE)

Basically, there is a combination of finding the right economical lens, and developing software to work with the image. The aim in underdeveloped countries is the diagnosis of infectious diseases, TB, malaria, and other microbes.

(SOURCE)

Above , in the top row, are images of pollen seen under a normal microscope.  Below are Smartphone images.  This is included, not only for teaching purposes, but because it is beautiful and colorful, and it might break the page up a bit.

The miraculous thing about smartphones and the use of the microphone, is that is shows the unlimited, fantastic potential of using portable computers for use in the field, in uses which will be tremendously exiciting, and useful in the healthcare field throughout the world, and will undoubtedly find niches heretherefore unreached.  Whew, I love using that word “heretherefore”.

 

4) The iPhone as a GLUCOMETER : IBGStar


What is called a “Killer App” will be the creation of a non-invasive way to measure serum glucose.  That day has not arrived yet, at least none has been approved by the FDA, but that day will soon come, and ALTAPURE says they will be the first.

 Until then, we have peripheral devices as on this page.

IBGStar is a blood glucose meter plug-in for the iPhone   There is a  an iBGStar Diabetes Manager App that tracks blood glucose, carbohydrate intake, and insulin dose.
The benefit of this peripheral is to manage your regimen of care of the diabetes, by posting alerts, keeping log, etc.

Finger sticks with the lancet are still required. There are other devices on the horizon of the digital revolution that will avoid being stuck to check glucose.


5) iPhone as a Skin Scanner: THE  DERMATOSCOPE

dermatoscope

 

From Germany, we have the development of the “Handyscope”, or Dermatoscope, which is a case that fits snugly over an iPhone, and takes up top 20x magnification. It also has accompanying polarized light to better show the skin lesion.

easily save the picture, send it to a collegue by email, or send it to the desktop.

Here is a video which explains how it works.

6)  The Smartphone Ultrasound

Inexpensive, Mobile, Wireless, Portable Ultrasound

This groundbaking mobile, wireless, portable ultrasound is sure to find widepread use in all medical settings across America, and the world. And it is inexpensive, which will lead to even wider use, especially in rural and third-world areas. This device will find widepread use in Emergency Rooms, and in the surgical and medical wards, as well as in office practice. Of course, there will be times when a higher grade ultrasound will be needed, but this Smartphone Ultrasound is a great start for diagnosing all types of medical problems, as a screening device., for medical conditions  such as vascular problems, gallstones, kidney stones, abdominal masses, and other problems.  This invention will be brought to areas that could not afford it, or live in inaccessible areas.

The above model is a Mobisante, which is the world’s first smartphone-based ultrasound imaging system, the MobiUS™ SP1 ultrasound system. This device has been approved by the FDA is made to order to reduce healthcare costs and improve diagnostics in areas that cannot access imaging centers..

In their words, .”….MobiUS fuses the power and wireless connectivity of a smartphone with the Internet into a game-changing diagnostic solution that is personal and accessible. Our patent pending intellectual property makes the system easy to use and to share information with remote providers.”

See a video on how this fantastic  portable ultrasound device works

7) The iPhone as a PETRI DISH

At Caltech, engineers have created a device, that aids in the process of identification of micro-organisms, with the Petri Dish process.  The iPhone is used, along with a Lego Frame, to read the Petri Dish in real time, after it is put into the incubator.

 

See the video on how, it is then placed in an incubator, and growth is allowed to be viewed in Real Time via remote computer!  This cuts down on labor, and handling the petri dish multiple times, and this system, more or less, automates it.

Now, this device just shows how a powerful mini-computer can make things more efficient, and save man-hours in the lab.  Most likely, a iPhone-like mini-computer will be specially made just for this purpose, and make not even look anything like the iPhone
Remember, computers double in power every 18 months!

8) The iPhone to Aid Slit Lamp:  Eyepiece Digital Adapter

The above shot from aniPhone is looking at the back of the eye, at the all-important retina, a frequent site of pathology, especially for diabetics.

Eyepiece adapter for the iPhone. You can plug in your iPhone 4 or 4s and take high definition pictures and video.  Equipped to adapt to most slit lamps on the market today. (to see some examples of pictures taken with the iPhone and the slit lamp adaptor, go HERE)

Again, one can take pictures of the images seen through the slit lamp, and send them anywhere there is internet, which one of the principles show by this device.  Minicomputers getting stronger, and more work-outsourced to patients, in the future.

9) iPhone to Measure BLOOD PRESSURE: Withings Blood Pressure Monitor

(Source)

This iPhone peripheral blood pressure cuff, does readings, and the app is programmed to record the readings, time of day, and keeps a log.  Also allows you to send your record to whereever you wish, including to your doctor.  This device allows a truer measure of blood pressure, avoiding “white-coat hypertension” or having falsely high readings at a doctor’s office.

The important part of a device such as this, is that allows for neat, easily retrievable records to be kept, made into graph forms by the software, and will make the patient more concious of the trends of the blood pressure.

There is also the option of using Microsoft® HealthVault™ , which keeps all your health records in one place.

 

10) iPhone as SPIROMETER andBREATHALYZER

SpiroSmart iPhone App

Accurately Estimates Lung Air Volume

iPhones will soon take the place of the spirometer.  At the University of Washington Medical Center, an iPhone App has been developed to make an algorithm with the audio portion of an expiration, and there is a 5% difference in studies performed, compared against the ole spirometer.

Researchers built the program, based on the audo, as seen in the following video:

This sprirometer is based on the same principles of work that is being done on the early detection of Parkinsonism, based on the sound waves generated by a persons voice on the phone.

iPhone Breathalyzer

Another use of the iPhone is used with a peripheral used as a breathalyzer, to detect alcholo levels, from your expiration.

“Most people keep their phones on them at all times (including when you’re drinking), which is why the iPega Alcohol Breathalyzer is so convenient. This portable breathalyzer plugs right into the bottom of the iOS device and displays the 2 digit BAC (blood alcohol content) on the LCD screen. No need to use blowpipe, just blow into the air hole.”

Could help with avoiding drunk driving.

See slideshow to see how it looks on the iPhone.

BONUS FOR AVID READERS

And, as a bonus for reading this far, we are presenting two more applications, both of them fascinating,, and potentially earth-shaking uses of the iPhone,.  The following peripheral is  early in its development in Denmark

11) SMARTPHONE AS A BRAIN SCANNER

At the University of Demark, research is being conducted on using the Smartphone, along with specially programmed software, and a specialized headset, to do portable, mobile brain scans.  Of course, it is just in the beta stage, but goes to show the potential of this powerful little computer, known as a Smartphone.

See the following video to see how it works:

 

SYSTEM

The system is a mobile, wireless, real-time brain scanner, and the software allows for wireless transmission to the Smartphone program, which receives the EEG-like transmissions from the various electrodes on the head, and like anything recorded on the Smartphone, can be sent to a consulting physician, anywhere in the world.  In their words:

 

“Our system provides a fully portable EEG based real-time functional brain scanner including stimulus delivery, data acquisition, logging, brain state decoding and 3D activity visualization. The software is realized in Qt. The raw EEG data is obtained from a wireless Emotiv 14 channel Neuroheadset with a sampling rate of 128Hz and electrodes positioned at AF3, F7, F3, FC5, T7, P7, O1, O2, P8, T8, FC6, F4, F8, AF4 (the international 10-20 system). The headset transmits the EEG data to a receiver module connected to a Nokia N900 phone. The binary data is decrypted directly on the phone, filtered and passed to the source reconstruction module that outputs the colors of model vertices for the visualization. The source reconstruction is performed over number of samples (default over 16 samples resulting in 8Hz visualization). The delay between the signal appearing in the headset and being visualized on the screen depends on the used source reconstruction window and is between 130 and 150 msec for 8Hz visualization. The framerate of the visualization (realized in OpenGL) is around 30fps.”

Video

“The video demonstrates the smartphone brain scanner with the Emotiv 14-channel EEG headset worn by a subject and a real-time 3D brain reconstruction and activity visualization on the N900 smartphone.”

Source code and additional information is available on the smartphonebrainscanner2 project website.

(From milab, at University of Denmark. Milab is a laboratory at the Cognitive Systems Section at DTU Informatics offering an environment for research and teaching in the areas of mobile context awareness, media modeling, and user experiences.)

12) SPECTROMETER

Smartphone Spectrometer Can Measure Oxygen and Diagnose Disease

smartphone spectrometer

Optics is a science of light that is finding an increasingly bigger role in medicine, because of digitalization, and the use of the camera system of the powerful little computer, known as a smartphone.

Not only is optics giving primary physicians handheld tools to closely examine diseased ears, and the state of the retina, but the powerful camera of the iPhone is being used to fashion an inexpensive portable spectrometer.

Spectrometers use measurements of the wavelengths of light to distinguish objects, because of the ability of different molecules to absorb different wavelengths of light.  In this fashion, different moleculte can be identified by their characteristic wavelength fingerprint.  Currently in medicine today,the spectrometer is used to measure  blood sugar and pulse oximetry, as well as to measure drug levels in blood, and in forensics, measuring chemicals as well.

Besides application in science class, there are innumerable applications in medicine, for a portable, cheap, wireless, mobile device to identify substances in blood, and other bodily fluids.  A team of researchers from the University of California, Davis has done much work in this niche of optic medical diagnosis via a smartphone, which is sure to grow, since the technology is so cheap,  portable, and wireless.  It would certainly be useful in rural areas as well as third-world countries.

And, since it will be more likely to be explored as a tool to identify substances, because of the low cost, the technology will be more fully explored, and many uses for diseasse detection are sure to occur.

spectrometry wavelength

(SOURCE)

(For further info on the SmartPhone used as a Spectrometer, go HERE)

iPhone being researched as Spirometer to invetigate Lung Function

 

13) The “BioAssembler System”

iPhone  Measures Drug Toxicity, and Speeds up Culture Growth

biosystem

A company from Houston, Texas, n3D Biosciences,  is harnessing both the computing power of the iPhone, as well as its powerful optical properties to, essentially, record and interpret the movement of cell cultures, when exposed to various drug toxic environments, thereby testing drug potency, or toxicity.  By utilizing  a device called a “Bio-Assembler” they utilize magnetic levitation to speed the process of cell movement, in a more realistic 3d environment than the 2D Petri dish.  The iPhone takes time sequence  photos, and the company’s program interprets the movement data.  There is a much faster growth of cell (hrs versus weeks).

For a detailed explanation of the n3D system pictured below, go HERE.

n3dock.jpeg

(iPhone App and n3D system)

See also their website for more info.  Overall, the company hopes to use the iPhone to “….to apply this breakthrough technology in the fields of toxicology screening, drug discovery, and regenerative medicine: and,  specifically,  to apply the technology for cancer and stem cell research…”.  As we contend in other parts of this website, cancers days are numbered!  Between fantastic devices like this as well as advances in microscopy, and radiology, cancer cells can be more accurately isolated, manipulated, and evaluated.

See the following short video that helps explain this exciting technology

15) The iPhone as an Eye Clinic

16)  iPhone app and Smartphone Get detect toxins, proteins, bacteria, viruses, and other molecules.

An iPhone, a cradle enhanced with optics, and a companion app combine to make a handheld biosensor capable of performing tests previously the domain of dedicated labs. (Image courtesy of Brian T. Cunningham)
 
 

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