Could smartphones play a role in treating and preventing disease?
A team of researchers from Worcester Polytechnic Institute thinks so. They designed an app that uses the camera and flash of a Motorola Droid smartphone to measure vital signs through blood pulsing inside the fingertip.
There are apps on the market that use the phone's camera or microphone to measure a person's heart rate, but even though the WPI app won't be available for sale to the public in the near future, the school sees the app's ability to measure a number of vital signs as a potentially transformative technology with high market potential.
Led by Ki Chon, head of biomedical engineering at WPI, the team designed the app using Chon's algorithms to sense pulsing blood in the finger as well as subtle shifts in color of the reflected light from the flash.
Those inputs alone allow the app to detect heart rate, heart rhythm, respiration rate and blood oxygen saturation. Currently, doctors must use several devices to measure those vital signs, including EKG machines, pulse oximeters, chest band sensors and heart rate monitors.
Chon's team wrote in a recently published bioengineering paper that the app measures vital signs as accurately as hospital medical monitors do.
"To make a medical decision you need many different vital signs," Chon said during an interview in his Gateway Park office on Prescott Street. "I think that's what distinguishes our approach from the others."
WPI is hoping the app's value will go beyond consumer curiosity. Some of the research has been funded by a $750,000 grant from the U.S. Office of Naval Research to develop related algorithms to better monitor a diver's vital signs. WPI has also invested $100,000 in venture funding.
Chon is preparing a prototype of the app for the iPhone to be used in a study that will be conducted at the University of Massachusetts Medical School under Dr. David McManus.
McManus' study will focus on atrial fibrillation (AF) patients, who suffer from abnormal heart rhythm. The condition can often be difficult to diagnose because the symptoms come and go and may be missed during a visit to the doctor.
McManus will provide 45 AF patients with iPhones to monitor their vital signs both before and after cardioversion, a medical treatment. McManus plans to test the app on a broader population of patients after the AF study.
McManus said the app has the potential to better treat patients and lower health care costs by catching health conditions early and eliminating the need for some trips to the doctor.
The app could also be useful for helping patients with heart palpitations monitor themselves, he added.
"Our algorithm would provide such a patient with a way of looking at their heart rhythm during a symptomatic period," McManus wrote.
Why did Chon choose the iPhone after developing the app on his Droid? He was attracted to Apple's tight control over its technology compared to the more open-source Droid."They're harder to hack," Chon said of iPhones.
Chon's app fits into the trend of increased use of technology by medical providers to improve patient care.
Fast-improving mobile phone technology has caught the eye of the U.S. Food and Drug Administration, which is responsible for approving medical devices for market use. The FDA said this summer it intends to create regulations for some mobile medical apps, and Chon's could be included.
The FDA plans to regulate any app that's used as an accessory to a regulated medical device or that transforms a mobile platform into a regulated medical device.
In February, the agency approved a radiology application that allows doctors to view medical images on the iPhone or iPad. It was one of the first mobile medical apps to receive FDA approval.
Michael B. Manning, associate provost for research at WPI, said it's too early to tell what impact the FDA could have on the future of Chon's app.
"The idea, of course, is that this is something that is used outside of the strict clinical hospital setting," Manning said. "This is a device that can aid."
He said WPI is focused for now on its study with UMass Medical School, which aims to validate the app's capabilities.
McManus said incorporating smart-phone technology into medical care is going to be a learning curve both for doctors and the FDA. Doctors tend to be cynical about new technologies unless they are proven to be effective, he said. That's the goal of his study.
"We hope that our app fills a niche not heretofore occupied, thus distinguishing it from 'me-too' consumer technologies that might be redundant or annoying to doctors," he said.