Digital Health is a broad term which encompasses overlapping technology sectors across healthcare—as evidenced by our Venn diagram representing the Digital Health Landscape. In this “Digital Health in Action” series, we’re focusing on specific examples from each domain to show what an impact the digital health movement is making on healthcare across the world. Here, we take a look at an example in mhealth—the use of smartphones in point-of-care diagnostics.

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Intelligently-designed algorithms and microelectronics found in sensors and wearables are expanding the mhealth applications of smartphones on the Digital Health Landscape by effectively turning them into point-of-care diagnostic tools. Lab-on-a-chip technology, which integrates many medical laboratory functions on devices the size of a few square millimeters to square centimeters, has led to the development of numerous clip-on sensors that can be attached to smartphones.

Point-of-Care testing is nothing new.

The healthcare community has always welcomed point-of-care testing capabilities which enable remote diagnostics. This provides added convenience and optimized efficiency—supporting timely decision-making for clinical management. Point-of-care testing technologies—like glucometers that let diabetics monitor their blood sugar levels—also empower consumers by providing clinical information that increases awareness and aids in chronic disease management.

Smartphones make point-of-care testing more widely available—and more affordable.

When point-of-care diagnostic capabilities are embedded or added onto smartphones using clip-on sensors, the ubiquitous presence of mobile phones vastly expands the reach of health services. Patients in remote areas that were previously difficult to reach using traditional healthcare delivery models are provided much greater access to care than ever before.

In addition, smartphones are cheaper than many specialized medical diagnostic devices. Certainly, it then makes economic sense to use them as enabling platforms to which many diagnostic capabilities can be added.

Smartphones are now diagnostic tools around the world.

Thanks to advances in lab-on-a-chip technology, smartphones can be used to detect diseases and as mobile laboratory tools. Here are just a few examples of how that’s being done around the world:

  • Malaria – The Lifelens Project smartphone app needs just a drop of blood on a specialized slide to use its detection algorithm to assess for abnormal red blood cells containing malaria. When results are uploaded to the web, GPS coordinates also help healthcare workers to identify outbreak areas—and use mapping technology to spot global trends.
  • Asthma – Researchers in Jamaica are using embedded sensors in smartphones to detect early symptoms of exercise-induced asthma—eliminating the need for external monitoring sensors attached to the body. Results can be sent to other mobile devices worn by caregivers and physicians.
  • HIV Co-morbidities – A global team of researchers have developed NeuroScreen, a smartphone app to screen for HIV-related neurocognitive impairment. The easy-to-use interface incorporates ten automated neuropsychological tests to identify this often undiagnosed disorder.
  • Thyroid Disorders  - Thyrometrix USA and Holomic LLC have created the Holomic Rapid Diagnostic Reader for smartphones which diagnoses thyroid disorders with a drop of blood on a test card. The card is then inserted into the HRDR-200, which is attached to the smartphone’s camera unit, providing immediate results.
  • Parkinson’s disease  - Using machine learning, a team of researchers led by Dr. Max Little at Aston University have developed software that uses the smartphone’s microphone and motion detector to assess for signs of Parkinson’s disease. Using a variety of factors—such as voice, motion and behavioral patterns—the team’s diagnostic algorithm helps identify and track disease progression.
  • Portable Laboratory – A team at the University of Cambridge has created an app which is touted as “turning any smartphone into a portable medical diagnostic device,” with a goal of fighting diseases such as HIV, tuberculosis and malaria in the developing world. The Colorimetrix test reader turns a smartphone into a portable spectrophotometer, making use of a mathematical algorithm to obtain results that can be sent from any setting directly to health professionals.
  • Oral Cancer – Oral cancer is easily detected during a dental examination, but in many parts of the world, dental care is difficult to access—such as India. There, some rural areas have as little as one dentist per 250,000 residents—and oral cancer is the cause of more than 40 percent of all cancer-related deaths. A team of scientists at Stanford has developed OScan, which is a screening device that attaches to a smartphone. Workers in remote areas can take pictures of a patient’s mouth and send them digitally for expert analysis.
  • Dermatology - Students from the Indian Institute of Technology, Kharagpur, have developed a smartphone app called ClipOCam-Derma that can assist clinicians to diagnose skin cancers and related ailments faster and with better accuracy. ClipOCam-Derma consists of an add-on device with a high resolution lens that can be attached to a smartphone, and an app that provides and analyses clinical information. The device is simple to operate and can be used even by semi-skilled healthcare workers to diagnose a variety of disorders.
  • Urinalysis - A mobile urinalysis system developed by Biosense Technologies, uCheck consists of test strips which change color in close correlation with the change in concentrations of various compounds in the urine. The system’s application then uses the smartphone as a sensor to analyse the strip, providing results that have similar or higher accuracy levels than traditional laboratory diagnostic systems. It is a multi-test analysis system that can be used to screen for numerous components in the urine.
  • Ophthalmology - Early this year, Stanford University researchers turned smartphones into ophthalmoscopes using simple, low-cost iPhone adapters enabling healthcare professionals to diagnose for eye diseases such as glaucoma, papilledema, and retinal detachment. This minimalist system consists of a low-cost macrolens, 3D-printed indirect lens, LED light and a universal mounting system. With it, all smartphones can take clinical-quality images of various parts of the eye.
  • More Ophthalmology - Another team of scientists from Stanford University and Bar-Ilan University developed a new eye implant that can constantly monitor intraocular pressure. The user can then use a smartphone to take a picture of the implant and its readings—which are then interpreted by the interfacing smartphone app to calculate intraocular pressure.

The trend continues to grow.

In recent months, various organizations have been focusing their research and development efforts on developing lab-on-a-chip technologies that can be deployed on mHealth platforms so as to diagnose and treat diseases faster, cheaper and on a larger scale.

The US National Science Foundation awarded a five-year $3 million grant to Cornell University researchers to develop smartphone apps and accessories that can be used as point-of-care diagnostic tools. The program, which is divided into three parts, seeks to develop a Nutri-Phone for nutritional awareness, Stress-Phone for stress management and Hema-Phone for monitoring viral loading in HIV-positive patients using smartphones apps and add-ons.

Smartphone-based mHealth programs can be a tremendous help in delivering healthcare services in rural and remote areas to low-income and at-risk populations who have limited access to healthcare professionals. This new trend of using the smartphone as a point-of-care diagnostic tool has the potential to improve healthcare outcomes by increasing affordable access for rapid diagnosis, decision-making, and intervention—supporting optimal use of healthcare resources across the world.