I was recently asked to provide a blog for the new mHIMSS website focusing on mobile health, and will be sharing those entries here on InFocus as well. For your reading pleasure . . .
As this is the first entry in my role blogging for mHIMSS, you should know a little bit about me. I have been in the health IT industry for more years than I care to admit. Let’s just say that in my career I have hooked up lab instruments by making RS-232 cables from scratch, developed CPOE interfaces before there was HL7 and integration engines, and I have actually used punch cards. I spent the first half of my career working for an academic medical center, and the second half in consulting, primarily because I loved what I did at the hospital and wanted to do it more places.
I also look at the world through a few different lenses, including viewing healthcare through the eyes of all stakeholders – including patients. I also look through a lens that resembles a fun house mirror so that we all get to chuckle occasionally.
So with that in mind, and in recognition of the explosive growth of mobile health applications, I decided to start from a place close to home – my new iPhone 4S. My kids have played with it incessantly in the few weeks that I’ve had it, primarily testing the limits of Siri. I have been impressed with some of Siri’s capabilities, especially as she leverages the WolframAlpha computational knowledge engine. Yes, I referred to Siri as “she”. Even though Apple claims androgyny, she sounds female, as opposed to the male-sounding voice being used in France. I also find myself addressing her by name and politely as in, “Siri, what is the weather at my current location please?” I do that because deep down, I have a fear that, like her cousin the HAL 9000, she will set me adrift in space if I’m not careful.
We already know from Apple’s commercials that Siri can tell us the fastest way to Hartford Hospital. With increasing focus on the patient’s role in accountable care, particularly around management of chronic conditions, I decided to see how Siri could help a healthcare consumer in that regard. I came up with the following questions using a very scientific method that involved staring off into space for a few minutes, and list them along with Siri’s responses as well as my commentary.
Q: Am I too fat?
A: I can’t answer that Matthew
I could not detect if she activated the front-facing camera and perhaps chose a more politically correct response.
Q: How do I stay healthy?
A: Would you like to search the web for “How do I stay healthy”?
Okay, I’ll give her this one. Kind of an ambiguous question.
Q: What foods should I avoid if I have diabetes?
A: Sorry, I don’t understand “What foods should I avoid if I have diabetes”
This one I thought should have at least called up a web search request or reference to WolframAlpha.
Q: What is a personal health record?
A: OK . . . how about a search for “What is a personal health record”?
Clearly, if Apple had hopped on the bandwagon with Microsoft HealthVault and Google Health, there would have been a different response. I might have also expected a prompt to search the iTunes App Store.
Q: I’m feeling depressed.
A: Matthew, I don’t understand “I’m feeling depressed”.
Now this question I would have liked to generate references to local mental health providers, national associations, or maybe even a suicide hotline.
Q: How do I know if I have asthma?
A: WolframAlpha result showing “asthma – reason for patient visit” and listing what appears to be percentages of patients by gender presenting with cough and with high blood pressure.
Finally, WolframAlpha was engaged, but with limited usefulness of the information provided. I guess if I have a cough and am hypertensive, I might have asthma. Given how few people monitor their BP themselves, however, I would expect that the healthcare provider who identified the hypertensive condition would also pick up on the asthma.
Q: What are the symptoms of congestive heart failure?
A: WolframAlpha result showing “congestive heart failure – symptoms reported at visit.” One symptom – shortness of breath – was presented with percentages by gender, but then followed by a simple laundry list of 59 other possible symptoms.
Now, the pendulum had swung back in the other direction to information overload. Shortness of breath would, hopefully, prompt one to seek medical attention. But the list of those other symptoms was so long and diverse as to be useless. And what is a typical healthcare consumer to make of the fact that the list included the opposing forces of both diarrhea and constipation?
I am sure that the iPhone 4S has a lot to offer healthcare consumers in terms of tools to support health and wellness. And since the Siri function is supposedly self-aware and will learn over time, perhaps her responses will be more helpful in the future. For now, however, there are better sources than Siri for professional medical advice.
Siri? Hey Siri – why are you opening the pod bay doors?
