This Doc's Prescription? Use This App, Twice Daily

Cardiologist Eric Topol, author of The Creative Destruction of Medicine and director of the Scripps Translational Science Institute, says smartphone apps and add-ons can now perform ultrasounds, electrocardiograms, and tests of blood pressure. He says the apps give him—and his patients—a better portrait of day-to-day health.

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Next up, if you like to meet a doctor - I'd like you to meet him - who prescribes not only medicine to his patients, but smartphone apps as well. And now there are apps that can measure your blood pressure, your glucose level. It can take and EKG or an ultrasound. It can even monitor your sleep. You need an add-on gadget to plug into your phone to do these things, but in many cases, it's a lot cheaper than getting the actual lab test done.

So what medical apps are out there? Dr. Eric Topol is the author of "The Creative Destruction of Medicine," also director of the Scripps Translational Science Institute in La Jolla, California. Welcome back to SCIENCE FRIDAY, Eric.

DR. ERIC TOPOL: Thanks very much, Ira. Great to be with you.

FLATOW: Give us an idea of what kind of apps that are out there for folks?

TOPOL: Well, it's quite a menu. You touch on a few, like being able to do your cardiogram through your phone, your blood pressure, your glucose. But it goes well beyond that. You can measure to find out if you have sleep apnea. You can get your eyes refracted. You can monitor your posture and how much you're sitting continuously. And then things are going forward with respect to depression, mood, stress, asthma, detection before an attack. So it's just an incredible burgeoning area.

FLATOW: All right. Well, now without endorsing any of them, I want to actually get into the names of some of these apps because people are going to go on to the App Store and have a look at them. So give me your top few picks for your favorite app?

TOPOL: Well, it's a tough one, Ira. Because I'm a cardiologist, obviously I like the cardiogram, and I get a lot of my patients to monitor when they think they're having a heart rhythm problem. So there's two that do that, AliveCor and ECG Check. And so they both have a case that fits on an iPhone, and I think they're both going to also work with Droid phones.

I also recommend to my patients those - almost all of them have high blood pressure. So there's two really good apps for that, iHealth and Withings that connect to either a wrist cuff or an arm cuff. And then you get your blood pressures all charted on a really nice single screen graph. I could go on. There's just so many choices.

FLATOW: Well, keep going. Go on. Let's talk about the - I'm fascinated by the glucose levels. So many people have diabetes and they're monitoring their glucose. This is something where you don't have to prick your finger for blood. You don't need a blood sample.

TOPOL: Not quite. Not yet.

FLATOW: Not quite? Not yet?

TOPOL: Well, they exist. But they're not yet through the FDA. They're kind of in the queue. So now, you still have to do a fingerstick, but instead of having a separate device to do that analysis, it actually can go right to the phone. There's an iBGStar device that you can get at Apple Stores or order it online, and that basically can get your glucose all charted and, you know, it's a very nice, convenient thing. But we do want to get rid of fingersticks.

FLATOW: What was the name? Yeah. What was of name of that?

TOPOL: It's called iBG. It stands for I Blood Glucose Star.

FLATOW: Mm-hmm. OK.

TOPOL: And that's - these are all add-ons, so they all are - all these things require an attachment to the smartphone.

FLATOW: Mm-hmm. What about an ultrasound app?

TOPOL: Well, that one's not quite an app. But there are a couple of handheld, high-resolution ultrasound devices that also function as a phone. So you can't turn your smartphone into an ultrasound device, but you can get an ultrasound device that functions as a smartphone and you can send your images wirelessly. And so there's two: one is called the Vscan, GE, and other one is Mobisante.

FLATOW: Mm-hmm. 1-800-989-8255 is our number, if you'd like to suggest an app or you have one that you think we should know about. Now everybody, sooner or later, looses sleep and we're all talking about sleepless nights. Is there an app to monitor your sleep?

TOPOL: Oh, there's about 50 of them.


TOPOL: The problem, Ira, is that they don't measure sleep that accurately. They basically are relying on movement during sleep, which, you know, it's not like actually measuring your brainwaves. And so that one - you get a loose sense about the quality of sleep and duration of sleep. But it isn't really a hard data, you know, not that accurate. But since you mentioned sleep, you know, one of the most important things out there is the sleep apnea that is stopping breathing.

And now you can get a smartphone connect to measure through your finger your oxygen throughout the night and your heart rate through the night. So you can get a really good screen for whether you have sleep apnea or not and whether the treatment for it is working.

FLATOW: And what's the name of that app?

TOPOL: Well, the one that I've used is Masimo, a Masimo app. That's the company that makes it. And it's - it really - it's a great screening tool. And it's - it can be reused. So if you have any other friends that have potential sleep apnea or your family, you can just pass it around.

FLATOW: Yeah. This is SCIENCE FRIDAY from NPR. I'm Ira Flatow, talking with Dr. Eric Topol, author of "The Creative Destruction of Medicine," about useful medical apps.

Do you - in your practice, do you - are there some patients who are just never going to get the hang of using an app and...

TOPOL: You know, you would have thought that as I did. But what I'm learning is because people are getting their own data about their body and their medical condition, it's amazing how they quickly become data driven. And this is the one reason that people will really get into smartphones because it's really preserving their health.

FLATOW: Mm-hmm. Let's go to the phones. Let's go to Chicago with - Mohammad(ph) is in Chicago. Welcome to SCIENCE FRIDAY.

MOHAMMAD: Hi. Thanks a lot for taking my call.


MOHAMMAD: I just wanted your guest to comment on people using these devices as a replacement for seeing the doctor because I can definitely see myself even on that slippery slope of jumping on Wikipedia, reading a few articles, not knowing all the information and coming to a conclusion that is, you know, at best fallacious, sometimes dangerous.

FLATOW: Good question, Mohammad. Thanks for calling. What about that, Eric?

TOPOL: Well, that's a really great point. And what a lot of these apps and add-ons do is essentially set up a bypass of the doctor so that algorithms are used. So, for example, there's one that you can convert the smartphone to an otoscope to look at a child's ear to see whether they have an infection. And that image, which is magnified, is sent to the cloud, algorithm interprets whether the child has an ear infection. Well, you don't even have to go to the doctor, for example, and you know whether there's a problem.

So the problem of all this is when is it right to bypass the doctor and when do you want to consult with the doctor. And that's a whole new look that we never had before in this era of unplugged medicine.

FLATOW: Mm-hmm. What was the name of that app, by the way?

TOPOL: That's CellScope.

FLATOW: CellScope. Are there any other ones that you know that normal doctor tools can be replaced with that we might use?

TOPOL: Yeah. Well, if you're trying to get your eyes refracted and you don't want to go to the optometrist, there's a $2 add-on from EyeNetra that you can get your eyes refracted and a text made to get your glasses. It's a text for your glasses to be made, and it's a pretty convenient way to get your eye exam.


TOPOL: There's, of course, the skin apps where you take a picture of a suspicious skin lesion. And there are algorithms that will tell you whether you should go to a dermatologist, have a biopsy or not. And some of those actually are quite well-validated, some are not. At one point...

FLATOW: Give me a well-validated one.

TOPOL: I think the skinScan and the University of Michigan skin app, which actually is - that's probably the best validate - those are probably the two that I'm most familiar with that I have confidence in.

FLATOW: Mm-hmm. What app do you want to see that doesn't exist?

TOPOL: Oh, gosh. Well, we want to have apps that will, for example, make asthma attacks a historical footnote because you can get lung function through the microphone of the smartphone, and you can put a band-aids on that would pick up air quality, pollution and all the other vital signs. So the whole idea would be not to ever get to the point where you're having wheezing, but you pick that up beforehand.

There are also some really nice collections of sensors for detecting mood and depression. And hopefully that could help some people who are really getting severely depressed and make sure that whatever treatment they are getting is adequate. We'd love to have a heart attack app that predicts a heart attack, of course, days or couple weeks ahead of time so that can be prevented.

FLATOW: Hmm. And, of course, these would also require an attachment, some sort of transducer of some sorts.

TOPOL: Yeah. I don't think you're going to get away with any of these except for the skin lesion that you can do a picture. But otherwise, you're talking about add-ons to the phone.

FLATOW: Do you see an app that could do DNA analysis at your home?

TOPOL: Absolutely. Oh, I'm glad you mentioned that, Ira. So that other big thing about smartphones is with this so-called lab on a chip add-on, microfluidics. You can make that into a laboratory. So you can do a DNA - you can't do a whole sequence now, but you could do a genotype for a drug interaction. And you can also do things like thyroid function test, liver function test, kidney function test. So there's so much you could do. It's not yet available for consumers, but it will be in the near future.

FLATOW: Yeah. We'll see that gene analysis coming real soon now also, I think so. Thank you, Eric, for taking time to be with us today.

TOPOL: Sure. Great to talk with you, Ira.

FLATOW: Good information. Eric Topol, author of "The Creative Destruction of Medicine," also director of the Scripps Translational Science Institute in La Jolla, California.

I'm Ira Flatow in New York.

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