To Have and to Have Not – Is there an Emerging Digital Literati Divide in Medicine?

I was reminded as I tried to set up my new scale complete with WiFi that will feed into my iPad my weight, body mass index and with accompanying blood pressure cuff – my blood pressure.  The app in the iPad can then transmit the information to my physician.  Just two little problems.

First, my WiFi is out as I have no telephone service right now.  The company said it would be restored by last evening or I would get a text message otherwise.  Neither happened.

But second, my doctor still hand-writes my medical record.  Also, there is no email address provided to which I can send the information.  In fact, email use by physicians vis a vis patients has seen slow uptake.  So while I have advanced, my provider is somewhere in the past.

Both of these little problems raise two issues.  First, with the growing proliferation of medical apps out there – and some of them are fantastic – the truth is they are only as good as the systems upon which we rely to deliver the goods.  There are quite literally thousands of medical apps now available for both doctors and patients.  But what happens when our servers go down, our electricity is out, our bandwidth is too narrow, or our carriers just don’t carry?  In short, while great, there is some exposure when relying on a medical app.  In my situation, it is of course not life-threatening, but as medical apps progress they may be utilized for more clinically important circumstances.  In those cases, there need to be back up systems.

In the case of the second issue – as providers and healthcare systems gravitate to electronic medical record keeping – along with the myriad of security issues – there are questions about whether or not medical society is dividing into two camps of “haves” and “have nots”.  Some of that may be because a provider has not adjusted, but some of it may be a matter of access to band-width – of urban versus dial up.  Of 3G versus 4G.

Or is it like any other emerging technology platform?  Television was credited as being invented in the late 1920s, but it wasn’t until the 1950s that I Love Lucy was playing in everyone’s living room across America.

One thing is for certain.  The uptake of television took a generation.  While there are vulnerabilities associated with their use, the uptake of mobile apps for healthcare is taking about 15 minutes.  Systems – technical and medical – need to know that the change has already occurred and for whatever the reason, being one of the “have nots” may not be considered quaint as the “haves” march on.

Which enters a potential role for pharma.  As apps become of greater importance, pharma is presented with an opportunity to bridge the divide.  On the one hand, this can be done by creating or sponsoring third party organizations to develop good apps that patients can use while on the other hand, engaging in projects that help physicians bring them into their practice.  It would provide a much needed service for all stakeholders.

For more information on physicians and use of email to work with patients, see

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