Tech tools for rheumatologists are not new. We've been geeks for centuries! In fact, the stethoscope was probably the original tech tool in the rheumatology office. This was followed by the microscope, lab assays, the ophthalmoscope, and the fax machine.
In the 21st century, computers have changed how we practice medicine. Examples include the use of ultrasound and digital cameras for cutaneous diseases in the rheumatology clinic. Finally, thermal imaging is now being used with patients in the rheumatology clinic.
But, what's in our pocket? Our smartphone is a powerful microcomputer with a dedicated internet connection and an integrated camera. Did you know that the iPhone 7 benchmarks are equal to those of a 2015 MacBook Air?! So Healthcare + Smartphone = Health Tech Revolution. However, the challenges in implementing technology in the clinic include cost, time, usability, and impact on patient outcomes.
With that said, lets take a brief look at some hardware and software opportunities within the rheumatology clinic.
This is the most reliable way to distinguish between primary and secondary Raynaud's Phenomenon (RP). In clinical studies, 200X magnification is used and findings from these images have become part of the ACR/EULAR preliminary criteria. A cheaper version for nailfold capillaroscopy can include Olloclip Macro Pro Lens: This device clips to your iphone's camera and provides up to 21x optical magnification. You can use it to take still pictures and video. The cost is $79.99 compared with DERMLITE which costs $495.
Infrared imaging in RA has been shown to be useful to distinguish disease severity compared to normal controls. Traditional thermal cameras cost anywhere from $500 to $1000. The FLIR ONE Thermal Imaging Camera attaches to a smartphone or a tablet (both Apple and Android). This camera combines both a thermal image and a standard image to produce a composite dual image. The device can detect temperature differences as small as 0.1⁰C. The cost is $249. This device can be used in patients with Raynaud's Phenomenon and joint inflammation. Dr. Bhana showed examples of Raynaud's phenomenon, monoarthritis, and a difference in hand temperature in a patient with complete left subclavian stenosis due to Takayasu arthritis. After 2 months on steroids, there was a significant improvement in temperature.
Synovial microscopy is the gold standard to diagnose crystalline diseases. The Gosky Universal Cell phone Adapter Mount ($24.99 on Amazon.ca) is a hardware attachment that fits directly on your microscope. This can capture still images and video and utilize the phone's digital zoom.
3D4 Medical presents eD, real-time rendered, based on MRI and CT reconstruction. The cost ranges from $7.99 to $59.99. These are available as iPad apps.
This is a phone and tablet based video application where you can record videos and prescribe them to a patient. Videos can be played for patients in the office or viewed at home on their mobile device. Videos are shared through a private VidScrip channel.
Active Words (Windows) can work with Accuro in a Citrix shell to create universal macros for your clinic. Accuro also has a built-in macro feature.