Iphone and Tablet Apps for Doctors: Who is Making The Diagnosis?

Medcalc, and other Iphone and Ipad apps are quickly becoming widely used among physicians these days.  In fact, digital technology, born initially from high speed convenience, is beginning to take over at alarming speeds in the medical fields.  Take, for example, a weary on- call doctor who needs to calculate the precise volume and concentration of a saline infusion for a patient.  The doc is too tired to think.  He has worked two shifts and has been on his feet for 23 hours.  He knows that any miscalculation of saline may lead to unwanted reactions in his patient, such as swelling or even seizures or death.  What’s a guy to do?  Well, he just whips out his trusty Iphone, opens his MedCalc app and plugs in the information that the app requires to do the thinking for him.

There are many medical applications for download available.  Airstrip Cardiology is an app that allows doctors to view EKGs taken of their patients while they are at home before deciding whether to rush back to the hospital to see a patient personally.  A nurse takes the EKG and pushes the information to the doctor’s phone or tablet.   Skeleton System Pro II is popular among both doctors and attorneys.  This application allows the user to view the human bone system from various angles with a single tap.    (Attorneys are even using it in the courtroom to demonstrate to their juries where an alleged injury occurred.)

All this technology is a dream come true for doctors because it saves both time and money.  They can now spend more time evaluating scans, x-rays and EKGs rather than driving back and forth to the hospital.  Is anybody worried about potential bad outcomes if this new technology is too heavily relied on?  What is the possible detriment to the patient?

A doctor who is tired and on a third shift who uses an Iphone app to decide a medicine dosage for his patient is essentially relying on the computer programmers that designed the application.  If this doctor doesn’t stop to think about the app’s suggestion – if he doesn’t evaluate it for himself- who should the patient pay for medical treatment- The doctor or the software designer?  Notwithstanding the general assumption I make that the app designer likely hired many medical experts to oversee the design, that software creator ultimately  needed to check the accuracy of it all.  (And here is another nightmare:  I also worry about the “bug fixes” on the app – hopefully it won’t be the one thing that causes a patient’s death.)

A medical doctor, ultimately, is responsible for all the decisions he makes about his patient and needs to consider his risk of malpractice from relying heavily on an app meant to make his job easier.

For more information on the subject, see:  Redefining Medicine with Apps for Iphone and Ipads at http://www.nytimes.com/2012/10/09/science/redefining-medicine-with-apps-and-ipads-the-digital-doctor.html?_r=0

For Apple’s top 5 medical apps, see:  http://www.imedicalapps.com/2011/12/apple-top-iphone-ipad-medical-apps-2011/

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One thought on “Iphone and Tablet Apps for Doctors: Who is Making The Diagnosis?

  1. I can see your argument. It is the same one my high school algebra teacher made when we asked to use a calculator in class. He told us it was too easy to rely on technology and we needed to know how to do it ourselves and then reverse the calculation to make sure we factored the numbers correctly.

    While I disagreed with the teacher at the time (I was 16 and disagreed with everyone older than me at the time) I agree with you now. The risk is too high and telephone app technology is not perfect. There needs to be a way to double check the answers before a patient is treated.

    In your hypothetical, the doctor should take a nap.

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