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technology for tomorrow

For a lot of consumers and business people, using smartphones to their fullest has become second nature. But when it comes to health care … not so much.

While there are mobile applications that will lead you to the best burrito shop in some unknown town at 3 o'clock in the morning, finding a mobile app that might help combat ballooning health care costs, extended wait times and finding enough manpower to service and treat an aging population is another thing.

But they are coming.

Sure there are those glitzy smartphone ads showing a brain scan onscreen, but realistically speaking, it would hardly be large or detailed enough for a physician to make an informed diagnosis in today's world. And yes, there are a lot of forward-thinking health care facilities that have been working with wireless applications for specific applications such as paging, entering patient data and enabling collaboration with remote practitioners. But those on the development side say that's just the tip of the iceberg.

"One of the biggest technology challenges for health care to date has been around wireless," notes Rob Lalonde, CEO of AnyWare Group, a Toronto-based developer of remote-access portal solutions for health care. "One issue has been [secure]access, but I think that's been resolved."

Another is application availability, he adds. "Applications that practitioners need haven't been accessible and available through wireless devices. The difference today is that web-enabled access is making it easier to get to them."

Rob Moffat, president of Wallace Wireless in Toronto, developers of alerting solutions for the BlackBerry, agrees that the web component is an important breakthrough. "There are a lot of applications now being developed for health care because it seems that the market has gone full bore toward the web browser interface. That's allowing health care facilities to pull information together to look at it on a handheld. While health care may have been behind, it now has the opportunity to skip a whole generation of wireless advancement in the near term."

Once the conversion to electronic health records (EHR) comes to fruition, all the groundwork will mesh together nicely so that information - including diagnostic images - will travel in real-time, get updated in a central repository and be accessible from just about anywhere. Patients for their part will be equally nimble in tracking their vital signs, educating themselves on their condition, reporting to their doctor, and keeping up to speed on dietary and exercise regimens without having to visit a clinic.

As wireless in health care comes of age, developers are turning their collective efforts to bringing all sorts of new health-related functionality to the small screen - from electronic patient record presentment and recording and monitoring of vital signs, to ordering food or downloading a picture of a pill to make sure it's the right one.

Once these hit the mainstream, the impact on the health care system in future will be significant, Mr. Lalonde says. "Health care represents about 40 per cent of provincial budgets right now, which have gone up 50 per cent in the last 10 years. The figures are astronomical. There isn't the money to deal with patients using traditional methods. So you need to find ways to treat more patients at lower cost."

"As chronic illness increases with the aging population, it will be very important to have as many tools as possible at our disposal," says Janice Campbell, primary health care consultant of the New Brunswick Department of Health in Fredericton. The province is already laying its portal strategy in place to manage patient care in the province.

"We've got the foundation [with the web-based portal access]" Ms. Campbell says. "Although we're not quite at the point of using handhelds, it's what we're dreaming about."

Quinte Health Care in Ottawa has been using laptops on mobile carts and tablet PCs for a number of bedside tracking applications. Handheld devices are also used for inventory control and equipment tracking. Now, says director of information services J.R. Dick, "We're looking at some new smaller form factor handheld technologies to tie to our telephone systems. Our goal is to take voice recognition to the next level so devices will respond to voice commands."

Fraser Edward, manager, market development for health care for RIM in Waterloo, notes that in the months to come, handhelds in health care will evolve on two fronts. There's the "patient companion" side, where applications will allow them to monitor their health, create programs or research medical information.

"Then there's the enterprise side. That's where health care workers can use a highly secure device for looking up patient information and making the best decisions possible. Both are relevant to how the future of health care will change."

As a co-managing partner for BlackBerry Partners Fund, a Toronto-based smart phone application-focused venture fund, Kevin Talbot has a head start on what he sees coming down the pike in health care applications. Many of these are already in the early stages of adoption, but he expects that several will become mainstream in the foreseeable future. "This is not science fiction. These are real possibilities."

On the monitoring side, "Smart sensors and smart bandages will monitor patient health and communicate with smart phone health management applications that transmit data to health care professionals," Mr. Talbot explains. "Patients will also have a health dashboard that shows them (and their doctors) relevant indicators and warnings."

In field management applications, GPS-enabled smartphones will help health care professionals route patient calls, send field reports and billing.

Drug/medication management smart phone applications will track prescriptions all the way from doctor to pharmacist to patient, while smart packaging will communicate with smartphones to track dosing. "Social networking and user-generated content will also meet mobile as the smart phone becomes a health care reference device," Mr. Talbot says. "And the smart phone will be the medical professional resource of choice for reference materials."

While it's all piecemeal at the moment, Fraser expects everything will be integrated into one highly efficient whole in a few years. "Right now information is a bit fragmented and not quite synchronized, but in time it will all be seamless. Then smartphones will truly break the barriers between hospitals and home care. The next couple of years will be about gluing it all together."

"This is the time for mobile applications because there is enough market momentum," says Mr. Moffat. "It might take a few years for most of this stuff to happen because we need to see the appropriate groups of Gen X's and later generation doctors and users who will come to expect it. But when it does, it will be a huge change."

Mr. Talbot, for his part, believes that the ability to lower health costs through smartphones is still nascent. "When we're at the point when everybody has got a smart phone or computer in hand, the types of applications that will be able to improve our lives will be virtually limitless."

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