How Mobile Technology Is Poised To Revolutionize Healthcare

It may also turn you into a hypochondriac.

Smartphones could play a major role in tomorrow's health services
Smartphones could play a major role in tomorrow's health services
Marc Gozlan

PARIS - It has a camera, a video camera, a microphone, a library, a photo and music album. The smartphone is a technological smorgasbord.

Add some apps and your smartphone turns into a GPS, a torchlight, a magnifying glass. Even better, connected to a wireless network, it allows you to surf the web, send texts, emails and of course, make phone calls.

What you may not know, is that its place at the center of today’s telecommunications, the smartphone could also play a major role in tomorrow’s health services.

“With wireless networks, Internet, connectivity, bandwidth capacities, the huge popularity of smartphones, cloud computing – capable of storing enormous volumes of data – we have a convergence of tools that can be applied to medicine,” explains Professor Eric Topol, a cardiologist specialized in genomics and director of the Scripps Transnational Science Institute in La Jolla, California. “We are in the middle of a digital revolution that will shake the world of medicine.”

Topol notes that there are six billion cell phones in the world. "That’s more than toothbrushes or toilets,” he says. The current one billion smartphones is expected to double before 2015.

Several innovative devices are already on the market in the United States. California-based company AliveCor has launched a mobile heart monitor that only requires an app and a smartphone case equipped with two electrodes. The patient presses two fingers on the electrodes, or lays the phone flat on his chest and the phone sends the electrocardiogram wirelessly to a cloud, where his doctor can access it remotely any time. The recording can last 30 seconds, from one to five minutes or be continuous.

This invention, which will cost $199, was approved by the FDA in Dec. 2012 and has also obtained European approval. AliveCor encourages physicians to prescribe this device to their cardiac patients, who could use it every time they feel faint or have palpitations and then send their electrocardiograms to them via email.

Will General Electric Healthcare’s pocketsize Vscan portable ultrasound scanner be able to replace a doctor with a good old stethoscope? No question, says Eric Topol, who headed the cardiovascular department at the Cleveland Clinic, in Ohio, for 14 years. He says he “hasn’t used a stethoscope for three years” – since ultraportable ultrasound scanners became available. The Vscan is specially adapted to abdominal, obstetric and cardiac imaging.

The device offers black and white imaging but it also includes a real-time color blood flow Doppler. It costs $7,900, as opposed to $30,000 for standard scanners.

A diagnosis tool or for health monitoring

Vscan's competitor is the ultrasound system developed by Mobisante, from Redmond, Washington. It costs $7,500 and was approved by the FDA early 2011. It has a probe that is linked wirelessly to a smartphone, which could prove handy in rural zones and developing countries.

In Aug. 2012, the FDA also approved Californian company Sotera Wireless’ ViSi Mobile system. The small device, which is attached to a patient’s wrist, measures a huge array of vital signs. This data is then transmitted to the physician’s tablet or smartphone. Whether he is in hospital or at home, the patient can be monitored as closely as if he was in intensive care.

CellScope is a mobile microscope start-up based in San Francisco, California. Its new invention turns smartphones into an otoscope – the device used by doctors to look inside your ears and throat. An otoscope attached to the phone’s camera makes it possible to examine the eardrum. Approved by the FDA, the mobile otoscope enables the parents to take photos of their children’s ears and send them to their pediatrician, reducing the number of consultations while enabling the long-distance diagnosis of ear infections.

The company also developed a cellphone microscope that enables health workers to test for tuberculosis in remote places.

LifeWatch V, the first mass-market healthcare smartphone was launched in Israel in July 2012. Just put your fingers on the sensors and the device measures your electro cardiogram, heart rate, glucose level and blood oxygen saturation. The device, which works on Android phones, can also measure body fat percentage and stress levels. It also uses an infrared sensor, to check your body temperature. It includes a whole array of features, some of which to monitor nutrition, or to remind people when to take their medicine.

The device is marketed to people working toward a healthier lifestyle or who suffer from chronic illnesses that require regular monitoring, like hypertension or diabetes. It has been approved in Europe and is awaiting FDA approval. Its price is $600 and it is available in Hebrew, Arabic and English.

Smartphones can also be used to test saliva for the flu or streptococcus or as a microscope to help diagnose HIV, malaria, tuberculosis and anemia.

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How Thailand's Lèse-Majesté Law Is Used To Stifle All Protest

Once meant to protect the royal family, the century-old law has become a tool for the military-led government in Bangkok to stamp out all dissent. A new report outlines the abuses.

Pro-Democracy protest at The Criminal Court in Bangkok, Thailand

Laura Valentina Cortés Sierra

"We need to reform the institution of the monarchy in Thailand. It is the root of the problem." Those words, from Thai student activist Juthatip Sirikan, are a clear expression of the growing youth-led movement that is challenging the legitimacy of the government and demanding deep political changes in the Southeast Asian nation. Yet those very same words could also send Sirikan to jail.

Thailand's Criminal Code 'Lèse-Majesté' Article 112 imposes jail terms for defaming, insulting, or threatening the monarchy, with sentences of three to 15 years. This law has been present in Thai politics since 1908, though applied sparingly, only when direct verbal or written attacks against members of the royal family.

But after the May 2014 military coup d'état, Thailand experienced the first wave of lèse-majesté arrests, prosecutions, and detentions of at least 127 individuals arrested in a much wider interpretation of the law.

The recent report 'Second Wave: The Return of Lèse-Majesté in Thailand', documents how the Thai government has "used and abused Article 112 of the Criminal Code to target pro-democracy activists and protesters in relation to their online political expression and participation in peaceful pro-democracy demonstrations."

Criticism of any 'royal project'

The investigation shows 124 individuals, including at least eight minors, have been charged with lèse-majesté between November 2020 and August 2021. Nineteen of them served jail time. The new wave of charges is cited as a response to the rising pro-democracy protests across Thailand over the past year.

Juthatip Sirikan explains that the law is now being applied in such a broad way that people are not allowed to question government budgets and expenditure if they have any relationship with the royal family, which stifles criticism of the most basic government decision-making since there are an estimated 5,000 ongoing "royal" projects. "Article 112 of lèse-majesté could be the key (factor) in Thailand's political problems" the young activist argues.

In 2020 the Move Forward opposition party questioned royal spending paid by government departments, including nearly 3 billion baht (89,874,174 USD) from the Defense Ministry and Thai police for royal security, and 7 billion baht budgeted for royal development projects, as well as 38 planes and helicopters for the monarchy. Previously, on June 16, 2018, it was revealed that Thailand's Crown Property Bureau transferred its entire portfolio to the new King Maha Vajiralongkorn.

photo of graffiti of 112 crossed out on sidewalk

Protestors In Bangkok Call For Political Prisoner Release

Peerapon Boonyakiat/SOPA Images via ZUMA Wire

Freedom of speech at stake

"Article 112 shuts down all freedom of speech in this country", says Sirikan. "Even the political parties fear to touch the subject, so it blocks most things. This country cannot move anywhere if we still have this law."

The student activist herself was charged with lèse-majesté in September 2020, after simply citing a list of public documents that refer to royal family expenditure. Sirikan comes from a family that has faced the consequences of decades of political repression. Her grandfather, Tiang Sirikhan was a journalist and politician who openly protested against Thailand's involvement in World War II. He was accused of being a Communist and abducted in 1952. According to Sirikhan's family, he was killed by the state.

The new report was conducted by The International Federation for Human Rights (FIDH), Thai Lawyer for Human Rights (TLHR), and Internet Law Reform Dialogue (iLaw). It accuses Thai authorities of an increasingly broad interpretation of Article 112, to the point of "absurdity," including charges against people for criticizing the government's COVID-19 vaccine management, wearing crop tops, insulting the previous monarch, or quoting a United Nations statement about Article 112.

Juthatip Sirikan speaks in front of democracy monument.

Shift to social media

While in the past the Article was only used against people who spoke about the royals, it's now being used as an alibi for more general political repression — which has also spurred more open campaigning to abolish it. Sirikan recounts recent cases of police charging people for spreading paint near the picture of the king during a protest, or even just for having a picture of the king as phone wallpaper.

The more than a century-old law is now largely playing out online, where much of today's protest takes place in Thailand. Sirikan says people are willing to go further on social media to expose information such as how the king intervenes in politics and the monarchy's accumulation of wealth, information the mainstream media rarely reports on them.

Not surprisingly, however, social media is heavily monitored and the military is involved in Intelligence operations and cyber attacks against human rights defenders and critics of any kind. In October 2020, Twitter took down 926 accounts, linked to the army and the government, which promoted themselves and attacked political opposition, and this June, Google removed two Maps with pictures, names, and addresses, of more than 400 people who were accused of insulting the Thai monarchy. "They are trying to control the internet as well," Sirikan says. "They are trying to censor every content that they find a threat".

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