No one sets out to design a new product that is intentionally complex and expensive and that requires advanced training to use—despite what you see in every new car commercial. In health care generally, and certainly in ophthalmology, that seems to describe many of the innovations that we report on nearly every month.
Now it seems that the reverse is happening: a movement away from adding features to technology in favor of stripping it down to the bare essentials to make it more convenient, cheaper and accessible to more people. This so-called “frugal innovation” was described in a Reuters article recently, but I was surprised when I realized that we have two examples of it—intentional or not, I can’t say—right in this issue.
Proponents say the health-care segment is late to the party on this one, but some have caught on. GE Healthcare is developing handheld mobile ultrasound and electrocardiogram scanners for use in regions where health clinics are few and far between, but the needs of the people are just as great. Seattle-based Mobisante is working on a smartphone ultrasound probe called the Mobius that works like a full-sized version but fits into your pocket like a mobile phone. It can be used for fetal ultrasounds and imaging of organs like kidneys, gall bladders, glands and soft tissue.
The device sends the image by mobile phone signal to a remote specialist to read, bringing the benefits of a full-blown scanning clinic to rural areas where there may be no expert in reading ultrasound scans—or even a steady electricity supply.
Our Technology Updatee this month describes a bit higher level but still not wildly complicated method of detecting presymptomatic diabetic macular edema ( p. 16); and a report in June's Ophthalmology ( Review News, p. 5) details a technique that uses a tonometer to detect patients at risk for stroke.
If anyone doubts the need for widespread availablity of accessible, inexpensive and non-professional user-friendly technology right here in this country, especially in the area of diagnostics, the “ Vision Problems in the U.S.” report, released in late June by Prevent Blindness America and the National Eye Institute, provides a sobering picture. Since 2000, AMD is up 25 percent; cataracts, up 19 percent; open-angle glaucoma, up 22 percent; and diabetic retinopathy, up 89 percent. These are not going to be solved by smartphones. But the need to connect patients, especially underserved American patients as well as those in Third-World contries, with doctors is dire and will only get worse. If simpler technology can connect more patients to medical care and expertise, then simplify, simplify, simplify.