Monday, June 6, 2005

Emerging Technologies

Cell phones may be good for your health

By Andrew Needleman

Back in 1983 when commercial cellular service was introduced, no one would have guessed that cell phones would eventually allow the average person to snap pictures, shoot videos, play games, or surf the web.

Now they may be used to help heal the sick.

At this moment some of the largest health care providers in Massachusetts, including Partners HealthCare, are testing a new kind of cell phone technology " one that integrates a cell phone's high-tech camera features with interactive web-based applications - to allow nurses, doctors, and medical specialists to speed a patient's recovery from miles away.

Once perfected, this new integration of cell phone-digital camera and web technology will give patients access to quality care in the comforts of their own homes, while helping overburdened, understaffed hospitals and health care providers deploy and manage precious medical resources more efficiently.

Digital imaging proves effective in wound treatment Three years ago, Partners Home Care and Partners Telemedicine began a pilot study to use standard digital cameras to increase the efficiency and quality of home leg wound care provided by their busy Enterostomal Therapy Nurses (ETNs are nurses who specialize in wound care), as well as to coordinate care provided by the ETNs and home health nurses.

Prior to the new program, ETNs were forced to use a home health nurse's description or drive to the patient's house themselves in order to develop treatment plans. ETNs found that the second-hand wound descriptions from home health nurses weren't always sufficient to treat the wounds properly and that driving to the patient's home wasted time they could spend treating patients at the hospital. Because of their differences in training (ETNs take up to 15 years to train), ETNs and home nurses often recommend different treatment plans, which affected the quality of patient care.

To solve the problem, digital cameras were given to the home health nurses. They took photos of the wounds and mailed the memory cards and wound care worksheets to a nurse, who then uploaded the pictures and entered the data into a web application. Then the ETNs downloaded the photos and noted their assessments of the wounds and their current treatment plan for each patient.

According to the pilot study published in the Dec. 7, 2004 issue of the Journal of Telemedicine and Telecare, the home health nurses and the ETNs generally agreed upon their wound assessments. This showed that the digital imaging was good enough to make accurate assessments of the wound. Each e-visit averaged about half the time it took to do a traditional home visit, which meant that patients could be seen more often by the ETNs.

Cell phone cameras become a patient's best friend Partners Telemedicine & Partners Home Care are now trying to make this process even more efficient with cell phone cameras. Their new pilot application provides home health nurses with Motorola MPX220 Smartphones, which have a digital camera built-in. Home nurses take pictures of the wounds and the phones automatically upload them directly to the web application. The ETN views the pictures and provides a treatment plan, which the home nurse is able to apply immediately. This eliminates the lag time between taking the picture, analyzing the wounds, and providing treatment, which is critical because proper healing is strongly determined by how fast the right treatment is provided.

The phone application is written on the Microsoft.NET framework and also uses Motorola's proprietary camera application. All communication is secured by SSL (the same technology used in E-commerce) to encrypt the communication between the cell phones and the web application to comply with strict privacy requirements.

Cell phones aren't just a toy anymore Questions remain about this particular application, such as whether the picture quality of the cell phone will be sufficient to diagnose wounds properly. However, with the development of much more processing power and simpler programming interfaces there's no doubt that cell phones are going to play a major role in application development for healthcare and other industries as well.

Cell phones are smaller, more portable, and less expensive devices than PCs, so they are attractive as a development platform for cost-sensitive industries. Plus, getting a cell phone online takes much less time and technical savvy than setting up a PC network and only needs to be done once.

With an aging population and increasing lack of medical professionals, the common cell phone could play a key role in keeping us healthy.

Andrew Needleman is a managing partner of Claricode (www.claricode.com), a Newton-based software development and consulting firm specializing in healthcare IT. He can be reached at 617-558-1444 x111, or andrew@claricode.com.