Children arriving at A&E are having their drug dosages calculated with a £1.59 iOS app which has not been certified and whose use is not monitored. It has been downloaded more than 500,000 times. This statistic was offered as an example of the development of "electronic health" technology at present at the Future World Symposium …
Well; apart from
some broken bones, and a partially barfed up heart, everybody seems to be ok..
beyond the fact that using devices that could, and probably have, been everywhere - and are practically impossible to sterilise, and the fact that just a little screwing about with an android app like this in particular could cause problems of epic proportions (for example, lets see what happens when you practically drench an 83 year old in adrenalin - aka Mad's horse turbocharger in Last Continent) is no one else worried that once theres an app for that - NHS miniondrones will slavishly use it and lose the will to think?
They're bad enough already - gave my gran morphine for a chest infection; gave me an anti-emetic after an accidental overdose, when the treatment primary revolves around the patient vomiting up, they gave me something designed to make sure that I DIDNT vomit.
I havent even started on the Apple Evil Empire(TM) thats doing its level best to own our schools and government - now they're after healthcare..
As Tony used to say...
Re: Well; apart from
NHS miniondrones will slavishly use it and lose the will to think?
Several assumptions there:
1) That they haven't already lost said will
2) That regardless of will, they still have the capability
terryifing. doctors are paid mega bucks to know this sort of stuff. they arnt paid mega bucks to check a 3rd party app. i could do that.
I'm sure they know the formula to calculate it. That however doesn't mean they have to sit calculating it by hand on an abacus when they can punch the numbers into a spreadsheet or an iPhone app which can do it much quicker.
Mike Brown, you are mistaken
in the belief that a doctor would use this application. You will not bee seen by a doctor, you will be seen by a nurse who, as he or she is guided by the NHS-App, had all of 4 month's worth of training and sold shoes before.
If you're lucky.
In future then, because it won't make such a big difference, you might just come to A&E and find a self-service iPad strapped to the locked door that issues a prescription online which will be delivered by Royal Mail within the next 3-5 working days.
I think I saw something about the app ages ago, it's a practical time/life saver. If they need to work out the correct dosage of medication X to give to a patient they need to work out the math based on their weight, size, age, whatever, with a quick input they get the maths done for them so they can get the medicine in to them quickly. They showed the maths needed to work it out so it was pretty good.
Sadly the reality is that the life of a child may depend on an iPhone app
It would be much safer to rely on doctor's mental arithmetic than trust an iPhone app.
After all doctors are infallible and there is no way that one would get milli and micro confused is there?
Re: Sadly the reality is that the life of a child may depend on an iPhone app
I wouldn't trust mental arithmetic.
I'm one of the last generation to have used a slide rule in exams. You need to know what you're doing, arithmetically, to use one of those. You have to at least estimate the order of magnitude. These days, everyone punches the buttons on a calculator, me included. And, while I am slower than I was, I can still stop dead, seeing an answer which screams "wrong", and wonder if I pressed the wrong button.
I would be very wary, myself, of an application doing this sort of thing which doesn't log every calculation. I don't expect it to get the arithmetic wrong. It's inevitable that data entry will be imperfect.
@Yet Another Anonymous coward
Looks like two downvoters completely missed the sarcasm.
Oh dog, what write?
"That was a call repeated by the other participants, and culminating in a call for the NHS Spine – a project to computerise all NHS health records – to be completed and placed until patient control."
Which will be available in 2030 or just after the triple-dip recession is over, whatever comes first.
"Sadly the reality is that the life of a child may depend on an iPhone app while millions of dollars is spent developing diagnostic gadgets aimed squarely at the very-rich-but-critically-ill demographic"
So I'm not quite sure whether this is a Good Thing or a Bad Thing or maybe an appeal to rely more on privatized healthcare instead of government-subsidized healthcare with the concomitant delirious waste of resources on services people don't actually need?
I think a few posters have missed the point. The article and the presentation weren't about not using technology, they were about making sure the software is certified, like the hardware, to work reliably in a medical environment. Which means it can be used reliably by stressed doctors and over-worked nurses, give consistent and reliable output, and can cope with a messy, distracting environment. Meanwhile it would be good if the hardware didn't transfer infections to everything it touches.
Re: Comprehension fail
Thats one of the problems with medical devices. Since this makes decisions which directly effect a patients treatment it would be class-A, at least for the FDA.
So the CPU, the ARM core, every line of iOS as well as the app's code would have to be certified by someone and the iPhone's HW would have to be shown to be electrically isolated to the voltage of a defibrillator - and the equivalent of a pocket calculator would cost 10grand.
The new Harold Shipman....
Be afraid, be VERY afraid..
Does everyone in hospital get an ECG, or only those with symptoms indicating an ECG, or only those with a medical history indicating an ECG, or only those with a medical history indicating an ECG and having done one of their own at home?
Well, in the case of ECG, there is a fair chance that the patient who has done one at home is still wearing their own wires when they get to the hospital, which potentially saves time if they are put in the right places.
It's really not simple
Apps have the potential to revolutionise health and care, but there are many issues. This is why a group of us have set up a new not-for-profit organisation for app developers in health and care in the UK
To pick up just two points from this thread.
We seem to expect doctors to practice memory based medicine. However, the volume of medical knowledge exceeded what the best and brightest might remember sometime in the 17th century. Doctors need tools to help them cope with exponentially growing knowledge so they can deliver safe and effective care.
The app described hear is probably illegal in Europe unless approved under the European Medical Device Directive MDD 93/42/EEC and the author and the user of this app are probably blissfully unaware of this fact..
If you want to develop apps in health and care come and join HANDI
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