White Coat, Black Art·Blog

This app could save your life!

This smart phone app could prevent a stroke by detecting an abnormal heartbeat. That's patient power.
This smart phone app could prevent a stroke by detecting an abnormal heartbeat. That's patient power. (Getty Images)

Approximately 350,000 Canadians have atrial fibrillation, but a lot of them don't know it. The irregular heart rhythm puts older people at increased risk of stroke, heart failure and death. The trouble is, atrial fibrillation typically has no symptoms. 

Some doctors have called for mass screening programs to check every Canadian for atrial fibrillation. Smart phone apps and a handheld heart monitor would make screening a lot easier and far less expensive. A recent study shows just how it would work. What's more, it could have great potential when it comes to Patient Power - if people could actually use it to diagnose themselves.

Researchers in Hong Kong recruited more than 13,000 adults into a community-screening program. Health-care workers got them to open a smart-phone app and place fingers of both hands on a small hand-held wireless monitor for thirty seconds.

The device detected the patient's heart rhythm and sent it wirelessly to the smart phone app. The device detected 101 cases of atrial fibrillation that had not been detected before. In two thirds of these cases, the patient had no symptoms. 

To reduce the risk of stroke, doctors prescribe pills that thin the blood and cut the risk of a stroke by up to 70%. Doctors said all of the adults who tested positive were eligible to receive blood thinners to reduce the risk of stroke.

The people in this study didn't actually diagnose themselves -- they were doing it under the supervision of health care providers. So where does patient power fit in? You don't need a physician to diagnose atrial fibrillation. Intelligent software put into an app can do that and more. Sixty-six per cent of Canadians own a smartphone, and 49% use tablets.  Most Canadians know how to download and use apps. The wireless heart monitor is dead simple to use.  To me, this is an app that was made for patients to use.  

The list of apps used by patients to monitor their health is growing. Bant is an app for people with diabetes. The app enables you to take finger-prick blood sugar readings on a glucose monitor - with the results sent wirelessly to your smartphone.  The app analyzes and stores blood sugar readings, and alerts you when your blood sugar is too high or too low. A study found that teens do 50% more monitoring of their blood sugar when they use Bant.

An app invented by a dad takes digital photos of the eyes, and can help catch the early onset of leukocoria - which means 'white pupil'. The condition occurs when the pupil is white rather than the usual black. Causes of leukocoria include cataract, and a tumor that occurs in infants and children called retinoblastoma.  

A new National Health Service (NHS) program in the UK will have patients diagnosing their own ailments using smart phones. They will also be able to register for a GP, download medical records and order prescriptions.

Not too far down the road, patients with heart disease will be able to use an app to diagnose their own heart attack and summon paramedics for emergency treatment.

Not surprisingly, the idea of patient power has its share of critics.  A lot of my colleagues doubt smart phones and apps will entice patients to diagnose themselves. Others may be threatened by patients who self-diagnose accurately.  

You don't need every patient to use apps for the idea to be a success. Given the lack of timely access to a doctor, I think they hold the promise of bridging a big gap in health care.  If health apps make at least some patients better informed and more motivated, I'm all for it.


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