Diagnosing Yourself via iPhone? Hmm…

Courtesy of the NYT: Do-It-Yourself Healthcare with Smartphones

I remember back in 2007 when I started hearing the term “electronic health records” (EHR) in office conversation. My familiarity with the technology at that time was minimal–I knew that George Washington University was integrating them into their healthcare system, but only because I had previously lived in Washington, D.C. at the start of that initiative. But then Google Health and Microsoft’s HealthVault–the names in personal health records (PHR)–came along, and they allowed people to securely store their medical information online to make it easier for medical professionals to access. Finally, in 2009 there was the founder of Athena Healthcare on cable news talking about getting funding from the new Obama Administration for development and launch of an electronic health records system that would be the first step in taking that technology mainstream in the medical profession.

Well, it’s 2011, we’ve moved over the EHR/PHR push, and we’re FINALLY talking about making mobile devices a part of actual healthcare. And I don’t mean the chatter about, “Oh! Look at my cool pharmacy app so I don’t give my patients the wrong meds!” I’m talking about the kind of apps–and peripherals–that will allow the individual to monitor and truly take ownership of their own health. So now, instead of relying upon the doctor to tell them that their blood pressure is too high, someone can actually hook up nifty little devices such as THIS to see how they’re doing. The nice piece to all of this is that people can take their health stats from these devices and apps and add them to their PHRs.

Now, if it goes into a PHR I can already hear the argument from some people: “Someone might deliberately lie to make it look as if they’re healthier than they are.” OK, yeah, maybe. But do you really think those people would have PHRs in the first place? The bottom line is, by giving the average person such a tool there is the side effect of people trying to self-diagnose and basically driving the physician batty trying to deal with that. However, think of what it can do in terms of providing the physician with an overview of the trends in someone’s health. Ideally, it can make the diagnosing easier, or at least present another piece of the puzzle that the physician needed to gain clarity into what they see with a patient.

That being said, depending upon the app or the peripheral, the actual value of the output to the physician will really depend upon the user’s level of sophistication. For instance, the NYT article I cite above mentions MyGlucoHealth and the benefits it can have for seniors:

“In February, Entra Health Systems announced a deal with the Swedish mobile phone company Doro to make its MyGlucoHealth service available on their senior-friendly cellphones. With a small device, blood glucose level readings can be sent by text message to a secure MyGlucoHealth portal, which provides instant advice to users on what to eat.”

That’s fine and dandy. Even more fine and dandy is the fact it’s going to appear on a senior-friendly cellphone. But, how senior-friendly is senior-friendly? At some point, the user will have to be adept enough with technology to actually interact with the device to successfully retrieve and act upon the text message. And since most human factors, ergonomics, and user experience people will tell you that no matter how easy an interface is to use there is always someone out there who will make mistakes using it or be unable to actually complete a task, I do worry about certain segments of the population being unable to use health apps and peripherals at all, or correctly, for that matter.

Anyway, the article ends on the note that integrating PHRs with EHRs will extend the benefits of integrated mobile health apps and peripherals’ information as it will allow for information from the PHR to automatically transfer into EHR files if people so choose. However, the data lacks a certain level of credibility–and utility–if it isn’t being entered by a medical professional (once again, harkening back to my earlier argument of the output is only as useful as the user is sophisticated enough to understand the device and its information).

In any event, I can see a nifty diary study of some of these healthcare apps. Of course, they’d have to be done in conjunction with medical professionals and medical institutions’ IRBs, but perhaps less sensitive data such as weight loss and dietary monitoring output could be done by those of us who don’t have access to IRBs and physicians?