Mobile Technology in Medicine

The following was written by Risha Bera, a member of the 2014 Medicine X Student Leadership Program. Risha is currently a medical student at University of California at Irvine.

For the last three years, University of California, Irvine has studied how iPads have improved the quality of education throughout the four years of medical school. Most notably, increasing use of the iPad program in the first and second years was linked to substantial increases in USMLE Step 1 exam scores. Third and fourth year students also learn to use their iPads to explain medical conditions to patients using drawing applications and publicly accessible resources on the Internet.

As a 2nd year UCI medical student and iPad recipient myself, it was exciting to see what lay in store for me in the following years. While trying to visualize myself actually using an iPad with a patient in an exam room, I thought, “But what are the contexts in which using an iPad in the exam is not culturally appropriate? Could using an iPad deter fostering a healthy patient-physician relationship?”

In places like Orange County and San Francisco where smartphone ownership is prevalent, I can see myself as a physician who can use a tablet or smartphone without having to explain the 2-dimensionality, or the limitations of the device because my patient will likely already understand how to translate information from the screen into “real life”. The patient might appreciate that the physician used a familiar device to convey understanding to the patient.

However, in areas where there is low ownership of smartphone devices, I worry that using luxury devices (after all, a luxury is something that everyone doesn’t have, right?) can deter a healthy relationship between physician and patients. For example, a patient who doesn’t have a smartphone might associate an iPad with expense that the patient cannot afford. As a result, the patient sees the physician as holding the information in a way that only physician has access to, thus creating a more traditional and paternalistic relationship between provider and patient.

The UCI iPad program addresses this concern by training students to first ask patients if they can use an iPad in the exam room. In addition, students should keep in mind that patients who may not vocalize their objections may be unfamiliar with the technology, and be aware of body language that indicates discomfort with using the device. Students should also strive to translate medical content onto the screen for the patient’s understanding. Over the long run, it may be interesting to explore how direct patient interaction with the iPad may increase their engagement in building the patient-physician relationship.