iPhone ECG

It was exciting to hear the iPhone ECG was approved by the FDA early this month. This device has two electrodes that are built in a case for an iPhone, which can then record, display and also transmit ECG over a mobile network.

Mobile ECG or telephonic ECG are not new. There was a Nokia phone with ECG recording that was tested more than 10 years ago in a clinical study to see if EMR service can save time and improve outcome for heart attack. These studies later supported the current guideline from AHA that requires pre-hospital ECG for emergency services in patients with symptoms of heart attack. It makes sense when signs for ischemia can be identified from ECG, the information can save precious time in getting patients to a hospital that can provide treatment immediately.

I am more excited about the possibility of having an over-the-counter version of the iPhone ECG, which is not available now, but may become available next year. It is not immediately clear yet how the iPhone ECG will be used. Here are some thoughts …

I used to attend the international electrocardiography society conference when I was a graduate student in the late 90s. For several years, the theme for the conference has been “Was ECG still relevant?”. It was an irony for an ECG expert society to ask that question, but in reality, the ECG has become obsolete in most of cardiac services. Echocardiography, CT and MRI provide much more precise diagnostic information for treatment. I don’t expect the iPhone ECG to improve the diagnostic capability over the existing 12-lead ECG systems. That’s not the future.

The future of iPhone ECG is in its potential to provide services to empower us as a consumer for healthcare. In an early post, I argue that one of the reasons we cannot leave health care to a free market is because we are not equipped with enough knowledge to choose doctors or care providers freely. The health equipment shelf at Walgreen today has very few items, thermometer, glucose meter, blood pressure cuff, and none comes with a service. When we get sick today, there is very little choice but going to see a doctor. The trend of rising healthcare cost is not stopping. Recently, we have seen a new trend in the US for consolidation of large hospital systems that integrate diagnostics and treatment. That’s bad news for consumers.

iPhone ECG by itself will be limited to provide diagnostic value, but I see a future that a slew of health equipments that are available in consumer products. There will be independent diagnostic services that can help you become more knowledgeable about your conditions, and when you do decide to go to see a doctor, instead of waiting in the lobby for an hour, your doctor can't wait to see your iPhone.