Yet another use for the iPhone – treating patients

Among the 200,000 iPhone apps that include Hello Cow (emits a variety of mooing sounds), Hang Time (calculates the precise amount of time the device spends falling to the ground), or Haircaster (predicts what kind of hair day it will be), the UBC Faculty of Medicine has added one more – with a somewhat less catchy name, but a decidedly more useful purpose.

The BC Guidelines app enables health professionals to get information about diagnoses and treatments without ever having to leave the examining room. Exploiting the iPhone’s seductive interface, its list of ailments can be easily scrolled and its images enlarged with a swipe of the fingers. (The program is available at the iTunes store, at http://itunes.apple.com/)

The guidelines, developed by the British Columbia Medical Association and the Ministry of Health Services, give health professionals advice about 30 conditions, including ankle injury, cataracts, mammography, methadone maintenance and rheumatoid arthritis.

“We’re providing the latest evidence, vetted by medical experts in B.C., on demand,” says Kendall Ho, Director of the eHealth Strategy Office in the Faculty of Medicine and an associate professor of Emergency Medicine. “Would you trust your health professional to remember all of the latest information? Wouldn’t you want a health professional who wants to check out the latest evidence when treating you?”

Contrary to the unrealistic expectations of many patients, physicians and nurses aren’t walking medical libraries; they need refreshers, especially when it comes to numbers. Among the nuggets of information available from BC Guidelines: medication dosages for asthma patients; the recommended body mass index and waist size for a patient diagnosed with hypertension; how to interpret test results when screening a patient for kidney disease.

The software grew out of a project funded by the Ministry of Health Services and aimed at helping physicians keep track of their diabetes patients’ conditions using the Palm, the original mobile computer. Physicians weren’t so taken with the monitoring part – entering patients’ weight and glucose levels and viewing the resulting graphs on a tiny screen wasn’t a big hit, especially when they had to track down the information from a nurse. But they really liked having treatment guidelines so readily available.

The eHealth Strategy Office, which was created under Dr. Ho last year, obtained additional funding from the Ministry and the British Columbia Medical Association to adapt all of BC’s Clinical Practice Guidelines for the Palm and Windows Mobile devices. In late 2009, it launched a BlackBerry version.

But the iPhone version, which took eight months to develop, gave the project a turbo boost of popularity. One thousand copies of the program were downloaded within the first two weeks of its release last month.

“It’s blowing my mind,” says Noreen Kamal, Assistant Director of Technology and Innovation in the eHealth Strategy Office. She believes that physicians, most of whom are independent, are more likely to carry iPhones than BlackBerrys, which tend to be used by organizations. Plus, the iPhone’s touch screen makes the guidelines so much easier to use.

“It actually becomes a fun and enjoyable experience,” Kamal says. “I think it’s a function of having highly intelligent people who want to absorb a bunch of information and get back to whatever they’re doing.”

“I use it to make sure I’m following the proper management protocols – that I’ve checked what I need to check, that I’ve ordered the right blood work, things like that,” says Sara Mitchell-Banks, a chronic disease nurse in Powell River who is studying to become a nurse practitioner. “I’m sure most clinicians have not memorized most things that need to be known.”

BC Guidelines is intended for the province’s health professionals, so the eHealth Strategy Office provides technical support only to people in that category. But anyone, anywhere can download the software and use it as a handy reference tool.

“It’s quite unique that the province and the BCMA chose to do this, and continues to support it,” Kamal says. “It shows that, working together, British Columbia is a leader in using technology to disseminate medical knowledge.”

The iPhone app, however, is just one small step in Dr. Ho’s vision of integrating electronic tools into the arsenal of tools used by health professionals. While he considers himself an early adopter of new technology, he says younger physicians are even faster to embrace the latest tools.

“Five years ago, my son, who was 11 at the time, challenged me: Why can’t people make appointments with doctors online?” Dr. Ho says. “We do that with airplanes, we do that with hotels. That’s a wonderful vision.”

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