Science Fiction or Modern Medicine?

In the popular television series Star Trek, Captain Jean-Luc Picard’s “away team” often used a handheld device to assess the health of alien life forms they encountered on whatever planet they happened to be visiting.

A device like the tricorder is highly sought after right now, and in fact, 10 teams are currently participating in a $10 million Qualcomm Tricorder XPRIZE to actually develop such an item. 

While the race to develop the first real-life tricorder is on, assessing and managing a patient’s health using a range of technologies is already, in fact, in full swing.

The FDA recently launched an app that is designed to quickly notify clinicians of drug shortages. According to a recently-published report from Medical Economics, “the remote patient monitoring sector is growing so quickly it could reach sales of $8 billion in just three years,” and research on these monitoring systems is being conducted all over the world. 

Take for instance research like that being done by Robert Jamison, PhD. Jamison, who is a professor of anesthesia and psychiatry at Harvard Medical School and pain psychologist with Brigham and Women’s Hospital, and his colleagues are using smart phones and tablets to track pain in their patients from a distance.

At the 33^rd American Pain Society Annual Scientific Meeting, Jamison and colleagues presented the design of their ongoing research, which involves 60 patients with chronic cancer and noncancer pain who used a pain management smartphone app.

A key feature of the pain management app is daily pain tracking in which patients are asked several questions about their pain, including: activity interference, sleep, mood, and overall status on a sliding scale of 1 to 10, and compare these with baseline ratings. Should pain ratings significantly increase from baseline or reach 9 or 10, the patient gets an immediate response that the pain specialist has been contacted.

Jamison noted from the literature that the average response rate to text messages to pain patients was 70% to 90% and that high responders demonstrated improved pain levels.

“The patients enjoyed the instant feedback,” Jamison said in an interview with Clinical Pain Advisor.  

As a result, Jamison and colleagues are currently in the process of recruiting for a second phase of the study, where participants, using two-way messaging on their app, will either get feedback and support from a clinician, or a standard message each time that just confirms receipt of a pain report from the patient.

The theory, Jamison said, is that if “people feel they are being paid attention to, they will be more inclined to track their symptoms, successes and problems.”

Some free mobile apps that are currently available to track patient’s pain include: CatchMyPain, Manage My Pain, and WebMd’s Pain Coach. All of these can be downloaded via iTunes.

Then there is research like that being done by Stefan J. Friedrichsdorf, MD.

Friedrichsdorf, who is medical director of the Kiran Stordalen and Horst Rechelbacher Pediatric Pain, Palliative and Integrative Medicine Clinic at Children’s in Minneapolis,  and colleagues are using smartphone technology in another way – in part, to ease pediatric patients’ acute pain through distraction.

In his blog, Friedrichsdorf lists a number of apps that he uses in his own office and shares with his patients. He said these technological distractions can ease patients’ pain stemming from everything from vaccine to anesthesia administration.

In a recent interview with Clinical Pain Advisor, Friedrichsdorf said that increasing the use of technology in clinical practices is “nonnegotiable.”

“We must do these types of things,” Friedrichsdorf said. “We know that 25% of adults are needlephobic, because someone did something to them when were children like holding them down while they screamed (about getting vaccinated). Those same people are so afraid of hospitals they may end up forgoing medical care later on, and this can be catastrophic. It’s an upstream effect. Get them comfortable … make sure they don’t become needlephobic using technology they already know, so they are not afraid (later).”

Friedrichsdorf said that incorporating technology is just one pearl he has learned in helping to treat pediatric patients.

“(The distraction) needs to be age appropriate. (For younger patients) 3-13 months, you want to incorporate rocking, skin to skin contact, holding the baby, singing, this is all very  helpful,” Friedrichsdorf said. “As they get older, you incorporate bubble and pinwheel blowing, biofeedback, and, as the children get older, hooking up the computer.”

Some common apps that Friedrichsdorf suggests on his blog, that he introduces patients to, include Talking Tom, which features an animated cat that repeats what the child says in a funny voice; drums, which allows children to play a drum set; The Healing Buddies Comfort Kit, which offers an interactive, virtual way for children to learn and immediately benefit from self-care techniques to manage common symptoms like pain, worries, nausea, fatigue and trouble sleeping. His favorite, he said, is Balloonimals, because it allows children to “blow up” balloon animals when the child blows into the microphone of an IPhone or an IPad.

With technological innovations like these available today, can the medical tricorder be that far off tomorrow?

References

1.      Jamison R. American Pain Society’s 33^rd Annual Scientific Meeting.

2.      Verdon DR, et al. Medical Economics.  2014. 

Dr. Friedrichsdorf notes that his hospital’s program, led by Maura Fitzgerald, NP, developed The Healing Buddies Comfort Kit.