Current Practice and Potential of Telemedicine

Galym Imanbayev
June 10, 2012

Submitted as coursework for PH250, Stanford University, Spring 2012

Introduction

Telemedicine is broadly defined as providing health services via the use of telecommunication technology. Within telemedicine, mobile health, known as mHealth, is the particular use of mobile devices in in the practice of medicine. [1] As mobile technology further develops, the capability of mobile phones will continue to grow and offer unique solutions to traditional medical problems, including telepsychiatry and diagnostics.

Telepsychiatry

With the advent of live video-sharing via smart-phones such as the iPhone, health care providers can now reach their patients miles away on the go. Using the Skype app on the iPhone, for example, patients can hold therapy sessions with their psychiatrists. While telepsychiatry has been around for decades, the increasing abilities of smart-phones are bridging the flexibility gap between patients and providers despite physical distances. The benefits of the expanding use of mobile phones as the medium of therapy sessions are primarily cost related. Both patients and providers not only save money on transportation costs, but also the general convenience brings down the hourly rates for patients. Finally, inclement weather will no longer be a cause to miss appointments.

However, telepsychiatry via mobile phones does introduce some challenges. First of all, many people believe nothing can replace the experience of meeting your therapist face to face. The tangible and intangible benefits of in-person therapy rule out the potential of telemedicine to certain healthcare providers. Furthermore, anonymity and privacy are opened to a host of potential internet-based threats. [2] While internet security remains a challenge, the notion that care provided via mobile phones is weaker than traditional in-person therapy is up to debate. In a study of 325 patients with depression published in the Journal of the American Medical Association found that both forms of therapy, in-person and over the phone, significantly reduced depression symptoms. While the effects of in-person therapy gained an advantage in the long-term component of the study, the efficacy of telemedicine was corroborated in the short-term and can only grow given that the study did not use advanced smart-phone video-chatting. [3]

Cell Phone as Diagnostic Tool

As cell phones have become technologically more advanced, the medical world has taken notice of the potential of cell phones as diagnostic tools. As of now, the cell phone's ability to take high quality images is at the fore-front of several studies trying to measure the possible uses of cell phones in medicine. A study at the George Washington University Medical Center's emergency room is comparing doctors' in-person diagnoses of flesh wounds to those diagnoses made via pictures acquired from cell phones. Dr. Neal Sikka, an emergency room physician leading the study, is optimistic about the results, claiming, "The trends are really positive and the numbers are really encouraging ... Doctors are really very accurate." The influx of photos can also provide other uses besides diagnostics. Photos can also educate patients and protect doctors from liabilities. Furthermore, photos can substantially cut costs for the whole healthcare industry in general by avoiding unneeded doctor visits when high quality photos can be shared electronically at the click of a button. However, as of now, many medical complications still require in-person visits to the doctor for diagnosis. [4]

While the previous studies focused on the existing technologies within the cell phone, Professor Aydogan Ozcan of UCLA was able to add a $50 dollar component to a typical Sony Ericsson phone to produce images that can detect "thousands of cells in a small fluid sample such as human blood." Calling the device LUCAS, which stands for lensless ultra-wide-field cell monitoring array platform, Ozcan introduced the concept of adding cheap yet effective medical equipment to cell phones ideally for use by medical field workers in rural areas which traditional diagnostic labs cannot reach. Ozcan is determined to continue improving and adding further diagnostic components to LUCAS. [5]

Conclusion

Telemedicine is poised to grow in both its technology and its prevalence. The ever-expanding role of the cell phone is an opportunity that can be exploited to expand health care services and cut down avoidable costs. In the developing world, the mobile phone penetration has dramatically increased and can enable the scarce medical labor force to serve rural populations. [6]

© Galym Imanbayev. The author grants permission to copy, distribute and display this work in unaltered form, with attribution to the author, for noncommercial purposes only. All other rights, including commercial rights, are reserved to the author.

References

[1] P. Cipresso, et al., "Is Your Phone So Smart to Affect Your States? An Exploratory Study based on Psychophysiological Measures," Neurocomputing 84, 23 (2012).

[2] J. Hoffman, "When Your Therapist Is Only a Click Away," New York Times, 25 Sep 11.

[3] L. Salahi, "Depression Therapy: Phone Sometimes as Good as in Person," ABC News, 5 Jun 12.

[4] K. Carollo, "Cell Phone Pictures May Be the Next Medical Diagnostic Tool," ABC News, 17 Sep 10.

[5] S. Almasy, "Invention Turns Cell Phone into Mobile Medical Lab," CNN, 3 Feb 09.

[6] E. Rios, "Telemedicine Critical for Latino Health," Fox News Latino, 17 May 12.