Best tech for pediatrics: 2016
This has been an outstanding year for medical technology and innovation. Here is Dr Schuman’s review of the best tech products for your practice.
Improve ophthalmology exams
If we were to be honest with ourselves, pediatricians are not very proficient at using our ophthalmoscopes to exam the retina. Mostly, we use ophthalmoscopy to establish that young babies have an appropriate red reflex, young children have gaze symmetry, and rule out (with difficulty) retinal hemorrhages or papilledema when examining patients who have had a significant head trauma or worsening headaches. D-EYE (Pasadena, California) has improved upon the traditional ophthalmoscope by combining the computing power of the iPhone with an advanced lens attachment. The D-EYE system was invented by an Italian ophthalmologist, Andrea Russo, and is now being distributed worldwide.
Until I saw the system demonstrated for me at the AAP NCE exhibit hall, I was a bit apprehensive. There is a small learning curve to becoming facile with the instrument, but the videos on the site demonstrate the appropriate use of the system. A frame is attached to your iPhone and the lens system is magnetically attached to the smartphones lens. The application is activated, the patient’s identifiers are inputted, and you select a few diagnostic parameters. You then bring the device up to the patient’s forehead, roughly 1 cm from the pupil, and visualize the retina and optic disc. Next, you press a button on the screen to record a video of your examination. I have become proficient with the device and have been impressed by how it improves our ability to get a much better view of the retina, compared with a standard ophthalmoscope. It is worthwhile for a practice to buy some used or refurbished iPhones that can be dedicated to be used with the system (for as little as $115 from reselling sites such as glyde.com). The D-EYE system sells for $500.
Another “connected device” worth recommending to patients is the CliniCloud system (San Francisco, California). Parents can purchase a $150 kit consisting of a wireless thermometer and a surprisingly good stethoscope that connects to a smartphone. Parents can record their child’s temperature and record breath sounds at 4 locations on their child’s chest. These results can be transmitted via a portal to their physician who can review the auscultation and make decisions regarding what further needs to done.