In this feature of Tech Talk, Dr Neil Polwart, Novarum founder and BBI Group head of mobile discusses how pharmaceutical manufacturers can go digital using only their smartphones.
mobile manufacturing
One of the simplest mHealth offerings that pharmaceutical manufacturers can implement is an automated drug dose calculator. These feed in simple metrics like height, weight, age and gender to perform relatively straightforward calculations that deliver a dose recommendation.
Such tools are very useful to clinicians but could play a valuable role in increasing understanding of patient demographics. They could also enable a more direct communication channel to clinicians –alerting them to a potential product risk or to new data supporting the use of a particular drug in a wider range of applications.
True innovation is likely to go beyond simple calculators or trackers to incorporate sensors or hardware devices. This moves the typical pharma company out of its comfort zone and into the domain of “medtech”. Partnership may well be the order of the day – as trying to manage that level of change through a large organisation can often be too difficult.
However, before deciding to try and develop partnerships with hardware providers, it's worth considering if the phone in your pocket already has some or even all the capabilities you might need.
Take the stethoscope, probably one of the most fundamental tools of clinical diagnosis which has evolved little since the 1940s. There are several stethoscope apps available for download, most for “entertainment purposes only” but some do have clear clinical potential. We may never see the traditional stethoscope being replaced by a smartphone but imagine the advantages of a patient in a remote area being able to send their chest sounds ‘over the phone’ to their doctor.
Doctors could even share the ‘sound wave’ to the junior doctors following the registrar on their ward rounds from an educational perspective. More so, machine learning algorithms could be implemented to alert doctors to a potentially missed heart murmur. What if it could be compared to the sound from the same patient recorded last week, or last year, to measure if a condition has improved or progressed?
It’s clear to see why a new generation of “digital” stethoscope is emerging and it will be interesting to see how and if they’re adopted.
It can be tempting to follow the route of building a hardware product as you can specify and control every component and have a physical product to sell at the end. Certainly, there will be medtech applications where it’s simply not possible to devise a suitable solution that achieves the desired performance using the phone itself.
However, consider measuring Bilirubin levels in new-borns – that is a procedure which classically is performed with a laboratory blood test, but can also be measured using a non-invasive optical instrument. Researchers at University of Washington have demonstrated that you can achieve similar results just using the camera on a smartphone, with a coloured reference frame in the image.[1]
That brings us closer to my day-to-day work helping diagnostics companies read point of care devices using smartphone cameras. There is a huge temptation to over-specify the performance requirements, forgetting that the clinician is often only really interested in normal or abnormal results or general measurement trends. If something is wrong, they may be referred for more precise testing, but just as important is to quickly screen out healthy patients so time is best spent on those who need support the most.
Why then create the complication, cost and storage headache of smartphone add-ons, or laptop-sized instruments if the phone can achieve adequate performance on its own? Especially in a world where phone sizes and standards are constantly changing.
As smartwatches gradually become more prevalent, the array of sensors will only continue to grow and they are likely, either directly or in combination, to make monitoring patient outcomes easier without having to build whole new dedicated devices.
References
De Greef, Lilian, et al. "Bilicam: using mobile phones to monitor newborn jaundice." Proceedings of the 2014 ACM International Joint Conference on Pervasive and Ubiquitous Computing. ACM, 2014.