I must admit I have a little knowledge about SMS. While gallivanting in our neighbor country Canada (Go Blue Jays Toronto…not. Go San Francisco Giants), I was able to explore “Mobile World Live”(MBL). It is an awesome mobile SMS with a fine health part (mHealth). Even philanthropic Bill Gates was featured in MBL talking about mHealth and vaccines.
As per MBL, there are about 500 million people to use mobile health apps by 2015, an mHealth study. Most of these health campaigns are mostly preventative but just few are dealing with diagnosing and treating any illnesses. Maybe it is useful in some developing countries wherein malpractice lawsuits are not that rampant. Due to their financial restraint, people in developing countries will be happy with the free services provided to them.
My personal experience in mobile texting with pictures saved me from going back and forth to the hospital and sometimes saving some parents to go to ER. I have some examples. First, a new graduate RN called me in the middle of the night and she was so frantic because of generalized rash in a newborn baby. Doctor, you need to come in the hospital now. The baby might need a spinal tap and start antibiotics. Can you describe the rash (sleepy voice)? It’s red, bumpy, and generalized. I’m not comfortable with this rash. Relax!! Do you have an iPhone? Yes, doctor. Take some pictures of the rash and text it to me. She send this picture through mobile phone.
Ok….miss RN, it’s a baby rash called erythema toxicum. It’s a benign baby rash and doesn’t need antibiotics. It will disappear after a couple of days. Good night and thank you miss RN. Click and I went back to bed.
My second example: an overzealous mom called me at about 7 pm Sunday and mentioned that her baby’s skin is not perfect anymore since she has a rash over his face. Should I go to ER? Just pm me the picture of your baby’s face.
Mom, just stay home and enjoy your baby. You don’t want to expose your baby to other sick people in ER. It’s just baby acne.
The last example is more of a life and death situation. A term baby with no risk factors was being resuscitated. Miss RN called me and said: Doc, we’ve been bagging this baby for 5 minutes and oxygen content in not coming up. It happened that the x-ray technician was here so we did a chest x-ray. I’ll send it to you. Holy cow….do not bag and mask the infant. Intubate (inserting a small tube through the mouth then to the lungs) the baby right away. It was a surprised and undiagnosed case of congenital diaphragmatic hernia (a hole in the diaphragm that allow passage of abdominal viscera into chest cavity).
I made an experiment and texted the picture below to my friends who are practicing pediatrics, internal medicine, and family practice (n=14).
Some of the doctors don’t have any form of social medias/networking. I was amazed by some of their answers: 1. Inraductal papilloma (a form of breast cancer) 2. Fungal infection (initially my answer too) 3. Furuncle 4. Photoshopped lotus seed pod in a breast (most number of answers). My point here is that a picture can be read or misinterpreted differently unless you see it personally. This will make a difference with a doctor’s diagnosis and consequently the management.
It could have been so convenient for everybody to mobile text your doctor or send a picture or a video of a rash or your tonsils then your doctor upon reviewing the picture can just call the pharmacy for appropriate treatment or just some medical advise. If a doctor is sick, he or she can just work at home just by mobile texting or just even face time.
Are we ready for diagnosing and treating illnesses through mobile phone? I would say that yes probably in some field of medicine like dermatology and radiology. This probably is suited only in common illnesses. In more complicated cases, a thorough physical examination is a must aside from extensive history taking. Personal touch will be lost if we use mobile phone in diagnosing and treating illnesses. Also, there is always a risk of being sued and it will be the target of Health Insurance Portability and Accountability Act (HIPAA). Is this can be an option under Obama care or am I just being skeptical or unrealistic? I might have just opened a can of worms.