"Take two apps and call me in the morning" - Tucson News Now

"Take two apps and call me in the morning:" The future of medicine

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UA Professor of Surgery Dr. David Armstrong UA Professor of Surgery Dr. David Armstrong
TUCSON, AZ (Tucson News Now) -

You might not think something like your smartphone could someday save your life.

We're not talking about calling 911.

We're talking about the new science of merging consumer electronics and medical devices.

These unique combinations are being thought up, developed and tested right here in Tucson at the University of Arizona. In fact, it's the only place in the world where some of the greatest innovations are being developed.

The UA is considered the epicenter of the ongoing work to merge smart devices with medical devices. It's all leading to a whole new way of treating patients, and giving people the power to treat themselves.

Here's how one of those researchers, UA Professor of Surgery Dr. David Armstrong, sees the future.

"When someone comes into my clinic over the next few years, I think I'm going to be prescribing a lot more apps for them, than I am drugs."

Already, doctors might prescribe playing video games to improve balance and reduce the risk of falls, especially in older people.

The UA College of Medicine is unique in that you will find surgeons, such as Dr. Armstrong, working alongside engineers to develop devices to make us healthier and to even save our lives.

These scientists have been the first to find ways to use Google Glass in the operating room.

They've found several uses, including having a patient's vitals sent directly to the device that the surgeon wears on his head.

The doctor can read the data on the device's screen. Surgeons can even send information from the device during surgery. Dr. Armstrong puts the Google Glass on his face, and demonstrates how it can be used.

"I'm wearing it during surgery. And all I have to do now is look through it, look down at the surgical field at what I'm looking at and, literally, just wink my eye and there goes a photo. And I can now send that by asking it to text it or to email it to a colleague anywhere in the world,"

Dr. Armstrong is also the director of the Southern Arizona Limb Salvage Alliance, or SALSA. For years, he has devoted most of his work to preventing amputations in people with diabetes.

Armstrong says there are at least 26 million people with diabetes in the United States. He says half of them will lose, what he calls, the gift of pain.

They can't tell when they are wearing holes in the bottoms of their feet. Those ulcers can lead to gangrene and amputation.

Dr. Armstrong says among people who have an amputation, about half are dead within three years. He says intervention can make a difference. He shows us a boot that takes pressure off the healing foot as an ulcer heals. It's called a removable cast walker.

Armstrong calls it the gold standard of care, but says it's not golden when a patient doesn't wear it. Without the gift of pain, the patient doesn't feel the damage being caused by not wearing the boot as he should.

"They just want to take it off for a few steps. The trouble is a few steps turns into a few dozen and a few hundred and then, pretty soon, they're in the emergency room," Dr. Armstrong says.

So Armstrong and his colleagues are studying ways to get people to keep that boot on. In their study, they attach a sensor to the boot. It sends a warning message to the patient's smart phone or smart watch.

"These simple technologies that we're working on that can signal smart devices are going to keep people out of the emergency room, and are going to prevent gangrene and prevent amputation."

Another innovation to help people with diabetes is sensory substitution. Armstrong says special insoles replace that gift of pain by sensing when there's too much pressure on one part of the foot, pressure that could lead to a dangerous wound. Then the insoles send a warning, again to a smart device.

"Maybe we resolve the problem before it becomes a problem and we've kept another leg on another person's body."

Another innovative tool UA researchers are developing might be something no one will want to be without someday.

"Wouldn't it be great to be able to identify early warning signs a little bit better and maybe to intervene in our daily life before we have really deleterious episodes that could cause problems?" Dr. Armstrong asks.

UA researchers are working on that too. It's a sophisticated stress monitor.

They are making huge improvements to existing technology so a wearable sensor can identify changes in heart rate that come with stress. It's a reading that, until now, you could get only in a hospital or cardiac lab.

The sensor "sees" heart rate changes before the person wearing the device is aware of anything. The sensor then sends a signal to a smart device. The device warns the patient and even gives him a breathing exercise that calms him down and tells him when his heart rate is back to normal.

"We're giving basically the capacity of an ICU in some fashion to us as patients, and to our smart phones and to our smart watches," Armstrong says. "We've evaluated this device and now we're modifying it with colleagues throughout the University of Arizona to try to better identify when somebody's going to get stressed out and then they could just take a little exercise to try to chillax a little bit."

The UA is finding ways to use the heart rate sensor to determine when a patient might be frightened and need calming. Researchers are also using the sensor on surgeons in the operating room to try to identify stressful events during surgery.

Armstrong says that way scientists can better understand how stress affects outcomes and how surgeons can better prepare before surgery.

"Our bodies are giving off these cues all the time and it's just really hard for us to identify them all," he says. "But, the promise of some of this gadgetry is not that it's making our lives more complicated, but hopefully, that it makes our lives, in this case, maybe a little less stressful."

Dr. Armstrong says, "We've got to get smart if we're going to tackle all these terrible problems of our time, like diabetes, and all these other non-communicable diseases."

He says it's an exciting time in the science as devices give patients more information, allowing doctors to partner better with their patients.

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