Peter Warren, our research manager in Chicago, sent me an instant message asking for my thoughts about non-dedicated medical devices. We had a little fun with the discussion. Here’s that IM string (apologies for the grammar):

PW: How often do you see iphones/pods in hospitals/clinics?

RT: Some, especially in ORs when surgeons crank up their music during surgery. Seen some used for basic medical record keeping tasks as well but mostly used like the avg person would. Why?

PW: Check out this link. ER doc talking about mobile devices and the medical industry. 

PW: The app provides audible/visual feedback when performing CPR to make sure you do it right.

RT: Hmmm.

RT: I’m not sure how I feel about the same device that the doctor was using to find a local restaurant last night is being used to try to keep me alive. I get it for medical records and admin/reference materials, but for life saving activities!? How much is that app?

PW: free

RT: Free! seriously? I’m not sure how I feel about that. In theory, you could use this for a lot of other medical applications as well.

PW: How about the idea that this approach lowers the cost of a medical device dramatically and can put medical applications into the hands of people who might not otherwise afford it?

RT: One of the reasons medical devices cost so much is they are designed to standards that other devices are not. Most are designed to be robust, failsafe. Tons of regulations, training

PW: Agreed but doesn’t finding lower cost medical solutions for people who wouldn’t be able to get it at all have benefit? Sort of a ‘better than nothing’ thing?

RT: Ok for fun let’s assume that the solution is robust and works. If I want to use an app now I have to press a button, slide the slider, flick over to the 3rd page of apps, press the app button, wait for it to load… time wasted in a medical situation.

PW: Yes, but imagine how equipped a dr can be with this ‘swiss army knife’. Prepared for lots more things.

RT: So you’re good with putting critical medical use cases into non-dedicated mobile devices?

PW: I think we need to embrace the mobility factor and the ability to have access to many different tools. But I also think it’s a mistake to try to make these mobile devices more robust, or similar in construction to established medical devices. They’ll never get there.

RT: How do drs feel about this?

PW: The ones I know with iphones love them, but so far they don’t see them as a medical device. Might not trust it. But what other applications might they want the help?

RT: Maybe it’s great for training? I just downloaded the free app. Brush up on my cpr skills.

PW: Maybe

RT: From a patient perspective…next time you go to the dr. and the nurse pulls up your sleeve to take your BP and she uses the iphone to do it, how do you feel? Trust it?

PW: iphone only? No other instruments?

RT: yes, just holding it up to your arm and it reads and records

PW: I’d feel a lot better if the iphone was used for recording the information and something else was taking the bp

RT: Lots to consider in this area.

PW: yep. Later.

Defining the use cases of medical applications for mobile devices is a tricky task, and there are a lot of questions that are unanswered, especially as personal mobile devices like the iPhone, iPod Touch and the upcoming iPad become ubiquitous in today’s society.With this new technology we have the potential to change the medical practice in a lot of interesting ways. What must be better understood is how to responsibly integrate different types of functionality in these personal devices to afford greater health care, without introducing further complications and risk. There is a huge amount of complexity associated with creating useful, appropriate medical devices from a use case, environment, regulatory and clinical standpoint that must be understood. Adding the mobility factor is another of those complexities.