During the coronavirus pandemic, our smartphones have become a lifeline, keeping us connected, informed, sane, employed, and socially distant. But they are also emerging as necessary tools to keep us safe and healthy. Smartphones’ cameras and sensors are increasingly turning them into fast, accurate, and low-cost devices for medical diagnosis—without their users ever needing to leave home.
So far, the novel coronavirus has killed thousands of people worldwide and infected hundreds of thousands more. Health experts are straightforward: Stay home or you risk contracting and spreading the disease. Particularly the high-at-risk among us, such as the elderly, diabetics, and immunosuppressed people, must remain home. At the same time, these vulnerable populations still have health needs—and increasingly they can turn to their smartphones to monitor symptoms and even administer tests.
A number of diagnostic tools harness the power of the smartphone, such as ResApp, which uses the sound of a cough to diagnose respiratory diseases. The primary care app K lets you input your symptoms and gives you a potential diagnosis via artificial intelligence. The startup Diagnoz.me is building a disposable smartphone add-on that turns your camera into a microscope that can analyze bacteria in your bodily fluids. Tel Aviv-based Healthy.io has developed urine screening tests that use your phone’s camera.
Sridhar Tayur, a professor at Carnegie Mellon University’s Tepper School of Business who studies healthcare operations, says these technologies are becoming increasingly important as COVID-19 spreads around the world.
“These apps are crucial, and it is good that we are not inventing something new or telling people to do something different, as they have reached a certain amount of comfort and capability among users,” Tayur says.
According to Katherine Ward, Healthy.io’s chief commercial officer, the company’s diagnostic apps have been successfully used by 99.5% of people, ranging from 18-year-olds to 80-year-olds. “We’ve even had patients of 90 years and more using our tests,” Ward says.
Healthy.io’s urine screening tests are particularly helpful for some at-risk groups. Some governments, including that of the U.K., have declared that pregnant women, along with people over 70 and people with underlying health conditions, are at an increased risk of severe illness from coronavirus. Pregnant women, however, need to do a urine test regularly to test for excess protein—a symptom of preeclampsia, a complication of pregnancy characterized by elevated blood pressure and signs of damage usually to the liver and kidneys.
During the pandemic, pregnant women will likely want to avoid visits to the hospital as much as possible. That’s where home-based testing comes in. Instead of requiring you to go into the hospital, an obstetrician or a midwife can give you Healthy.io’s Dip.io, a home urine screening kit for preeclampsia. The kit includes a small plastic cup and a dipstick—a paper or plastic ribbon that’s divided into 10 small colorful pads that correspond to the 10 compounds the app aims to test. When these pads are immersed in urine, they change color based on how much of each compound is present.
After downloading the company’s app, you follow the instructions of a chatbot nurse named Emily. You fill the container with your urine, dunk the dipstick, and then take a picture of the resurfaced dipstick against a color board, which provides a point of comparison for the company’s algorithms. The app relays the image to a cloud-based platform, which uses colorimetric analysis to compare the dipstick to the colors on the board and determine the levels of protein, glucose, and other compounds in the urine. In less than a minute, the result shows up in your smartphone app and is sent to your electronic medical record. Dip.io is currently available in the U.K. and has received FDA clearance in the U.S.
This kind of at-home testing can give a physician clinical-grade information about the state of your health. There’s no need for exposure to an environment where a deadly virus lurks. Nor do you need to burden an already strained healthcare system that is reeling from the impact of the pandemic. All this is possible without reinventing the underlying technology.
“It is the same dipstick that’s used millions of times around the world,” Ward says. “We are essentially taking what hospitals have been doing for many years and making it more accessible to the patient, more accurate, and more automated.”
Accelerating the pace of change
The large number of people that must self-isolate these days could benefit from using their smartphones to monitor their health. But despite the relatively low cost of these technologies—Healthy.io’s product that detects urinary tract infections retails for just $12—Tayur says these apps have yet to explode in popularity.
The spread of COVID-19 in Italy, the country with the most deaths, shows just how important it is for people who can avoid the hospital to stay home right now. Italy’s patient zero was a 38-year-old man who went twice to a hospital in Codogno, a small town in hard-hit Lombardy, infecting hundreds of individuals in his path. He later tested positive for the virus.
How many of those people in the hospital were high-risk and were at the hospital for routine urinary screenings or bacterial infections? Though we may never learn the answer to this question, Tayur believes that if telemedicine were more widespread, deaths would have been fewer. “Granted, of course, that the government had given information correctly and folks had stayed home,” he says.
For a long time, the medical establishment has been notoriously slow to change. Case in point: It took more than 200 years for the thermometer to become standard medical equipment. “There’s a general saying that it takes 17 years for a new innovation in healthcare to actually be used often on the ground,” Ward says. “And that’s a combination of entrenched ways of working and of people who are too busy to be able to put their heads up and do something new.”
Katherine Ward, Healthy.io
There’ll be both a push from the bottom up . . . to say to clinicians, ‘Look, we know you can do this more easily now.’”
But Ward believes the current global pandemic will force the medical industry to adapt much faster. “There’ll be both a push from the bottom up, from users, from patients, to say to clinicians, ‘Look, we know you can do this more easily now,'” she says. “But also clinicians will feel confident that things have been done safely and the results have been great too.”
She thinks that COVID-19 will push people away from a model of medicine where the doctor is the sole authority handing down rulings that patients are expected to blindly obey. Instead, she believes that more people will embrace the internet, with the wealth of choices it enables, such as telemedicine and at-home testing. This is what Tayur calls the “retailization” of the healthcare industry—where companies provide healthcare services more directly to consumers, similar to how retail goods and services have long been available without any mediator.
Tayur uses his students’ rapid adjustment to e-learning as an analogy for how COVID-19 will help more people accept smartphone-based medicine. Over the past few days, Carnegie Mellon’s business school has moved most of its courses online. As Tayur reports, students who were forced to switch to distance education have come to love the flexibility, comfort, and even privacy of e-learning.
Similarly, Tayur believes the coronavirus will convince those who need healthcare to consider the vast possibilities of their smartphone as a medical diagnostic tool.
“Like the internet that came to replace physical newspapers,” Tayur says, “we should be expecting the interaction between the consumer and the healthcare system to move in this direction—now with coronavirus more than ever.”