Thursday, February 10, 2011

Epocrates Pulse: Innovation

I wanted to share this editorial from the February Epocrates Pulse newsletter on the topic of Innovation:
by Anne Meneghetti, MD
Director, Clinical Communications, Epocrates

2011: Innovating the Tools of our Trade

Stethescopes, oto/ophthalmoscopes, reflex hammers. These extensions of our eyes, ears and hands have changed little over the decades. I grew up watching the original Star Trek™ television series in the 1960s. Here it is 2011, and I am still waiting for a real medical tricorder, the handy diagnostic scanner device used by Starfleet physicians. Still, innovations in medical tools and gadgets are emerging rapidly, especially in the telecommunications and diagnostics spaces.

Do you remember beepers? Aptly named, they did little else other than beep or squawk out a message audible to everyone in your vicinity. Finally, along came displays with a few lines of text, about as much as a 19th century telegraph. Now, our mobile devices are phone, calendar, plus medical reference all in one.

A laptop, an iPad™, and a smartphone all found their way into my cabin luggage for a recent cross-country plane flight. If devices are so much smarter these days, so multi-functional, then why do I still need so many of them? The form factor of tablets is great for viewing, but not for phoning home. Newer tablets like Xoom™, Galaxy™, and Streak™ might be right-sized for slipping into a white coat pocket, but they do not replace my computer. Laptops are great for documents and programs, but lack the apps I rely on for work and fun. And even with all these devices at my fingertips – I would still rather time a patient's pulse by an analog watch or wall clock.

Medgadget's Best of 2010 list included a one pound, 3 x 5.3 inch-long pocket-sized ultrasound. If only I could make sense of ultrasound images, I could probably imagine many great uses for it. Other notable inventions included real-time moving MRI, a microbial array that scans for 2000 viruses and 900 bacteria in 24 hours, and a radiofrequency device that treats resistant hypertension by eliminating sympathetic innervation to the renal arteries.

This year's Consumer Electronic Show's honorees included mobile device software to assist in cognitive rehab after traumatic brain injury. For patients with complex medication regimens, a home medication machine dispenses pills on time, almost like a vending machine, and offers audiovisual medication and health reminders. It also alerts caregivers when patients are non-adherent.

One of my grandfathers was a farmer, the other a railroad engineer by trade. They understood how their tools worked, could take them apart and reassemble them. Physicians today are not likely to say the same; most of us rely on hardware and software whose inner workings are a mystery. One thing I know for sure is this: A clinician's good judgment is still among the most important tools used in practice today.
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