Dr. Phone?

One of the topics that has come up frequently in hospital-wide meetings that I’ve attended lately is the role of phone apps in health care. We have been presented with the idea of care via phone, where someone essentially presses a button in an app and gets to video chat with a health care provider. I have some concerns about this. The first thing that strikes me as this becomes more widespread is that, to have availability of providers, there will have to be a lot of providers working for the app. To have on-demand providers available to the app, these providers may not have as much training as providers that would be available in person. Secondly, there are limitations to camera-based care. Obviously, an in-person provider will have access to as much information as a camera-based provider will. The in-person examination will likely be easier and better than the camera-based one. This is especially true in exam-heavy fields, where the exam gives a lot of good information, and fields in which special tools needed to perform the exam exclude the possibility of performing good exams via phone. Ophthalmology may be the exemplar of this. While eye care might not be the best candidate for app-based care, I am sure that app-based care will have a role in the future of medicine. Hopefully, we can shape those apps and use them judiciously so that everyone still gets the best care possible.