Health Care

Will your smartphone be the next doctor’s office?

The same devices used to take selfies and type tweets are being repurposed and marketed for quick access to the information needed to monitor a patient’s health. A fingertip pressed against a phone’s camera lens can measure heart rate. The microphone, held next to the bed, can screen sleep apnea. The speaker is also tapped to monitor breathing using sonar technology.

In the best of this new world, data is transmitted remotely to a medical professional for the convenience and comfort of the patient or, in some cases, to support a physician without the need for expensive hardware.

But using smartphones as diagnostic tools is a work in progress, experts say. While physicians and their patients have seen some real-world success in using the telephone as a medical device, the overall potential remains unmet and uncertain.

Smartphones are equipped with sensors that can monitor a patient’s vital signs. They can help evaluate people for concussions, monitor atrial fibrillation, and conduct mental health wellness checkups, to name a few nascent applications.

Companies and researchers eager to find medical applications for smartphone technology are tapping into cameras and light sensors built into modern phones; microphones; accelerometers, which detect body movements; gyroscopes; and even speakers. The apps then use artificial intelligence software to analyze the collected images and sounds to create an easy connection between patients and doctors. Revenue potential and marketability are evidenced by the more than 350,000 digital health products available in app stores, according to a report by Grand View Research.

It’s very difficult to place the devices in a patient’s home or hospital, but everyone walks around with a cellphone that has a network connection, said Dr. Andrew Gostine, CEO of sensor networking company Artisight. The majority of Americans own a smartphone, including more than 60 percent of people ages 65 and older, an increase from just 13 percent a decade ago, according to the Pew Research Center. The covid-19 pandemic has also prompted people to become more comfortable with virtual care.

Some of these products have required FDA clearance to be marketed as medical devices. This way, if patients have to pay to use the software, health insurers are more likely to cover at least part of the cost. Other products are designated as exempt from this regulatory process, placed in the same clinical classification as a patch. But the way the agency handles artificial intelligence and machine learning-based medical devices is still being adjusted to reflect the adaptive nature of the software.

Ensuring accuracy and clinical validation is key to ensuring buy-in from healthcare professionals. And many tools still need to be perfected, said Dr. Eugene Yang, professor of medicine at the University of Washington. Currently, Yang is testing non-contact measurement of blood pressure, heart rate and oxygen saturation collected remotely via Zoom camera shots of a patient’s face.

Judging these new technologies is difficult because they rely on algorithms built from machine learning and artificial intelligence to gather data, rather than the physical tools typically used in hospitals. So the researchers can’t compare apples to apples by medical industry standards, Yang said. Failure to integrate those guarantees undermines the technology’s ultimate goals of reducing costs and access because a physician has yet to verify the results.

False positives and false negatives lead to more tests and higher costs for the health care system, he said.

Big tech companies like Google have invested heavily in researching this type of technology, targeting doctors and home health care providers as well as consumers. Currently, in the Google Fit app, users can check their heart rate by placing their finger on the rear camera lens or monitor their breathing rate using the front camera.

If you took the sensor off your phone and a clinical device, they’re probably one and the same, said Shwetak Patel, director of health technologies at Google and a professor of electrical and computer engineering at the University of Washington.

Google search uses machine learning and computer vision, a field within artificial intelligence that is based on information from visual inputs such as video or images. So instead of using a blood pressure cuff, for example, the algorithm can interpret subtle visual changes in the body that act as proxies and biosignals for a patient’s blood pressure, Patel said.

Google is also studying the effectiveness of the built-in microphone for detecting heartbeats and murmurs and using the camera to preserve vision by screening for diabetic eye disease, according to information the company released last year.

The tech giant recently bought Sound Life Sciences, a Seattle startup with an FDA-approved sonar technology app. It uses a smart device speaker to bounce inaudible pulses off a patient’s body to identify movement and monitor breathing.

Israel-based is another company that uses a smartphone’s camera to calculate vital signs. Its software examines the region around the eyes, where the skin is a little thinner, and analyzes the light reflected from blood vessels back to the lens. The company is completing a clinical trial in the United States and marketing its wellness app directly to insurers and other health care companies, company spokeswoman Mona Popilian-Yona said.

Applications also reach disciplines such as optometry and mental health:

  • With the microphone, Canary Speech uses the same core technology as Amazon’s Alexa to analyze patient voices for mental health conditions. The software can integrate with telehealth appointments and allow doctors to screen for anxiety and depression using a library of speech biomarkers and predictive analytics, said Henry O’Connell, the company’s CEO.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Along with Policy Analysis and Polling, KHN is one of the three major operational programs of the KFF (Kaiser Family Foundation). KFF is a gifted non-profit organization that provides information on health issues to the nation. NOTE: THIS TAGLINE MUST BE FIXED WITH THIS STORY

Originally published

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