From the very first day that the iPhone was mentioned, I pictured the writing on the wall. Palm would be knocked from its seat atop the medical apps world. Windows CE/Mobile would be a 3rd class citizen. I saw images of xrays, speech recognition software, e-readers with superior screens and that virtual keyboard, which seemed to beat graffiti, hands down overtaking anything that had ever preceded it.
However, from my perch, overlooking the sea of change, I perceived something else. It came to me last month when Steve Jobs debuted the iPhone SDK. One of the programs shown, running natively on the iPhone was EPOCRATES - My favorite medical app. Although I was happy to see EPOCRATES joining the sea of change, I began to have a slightly negative chill run through my veins this week.
One of the nice things about EPOCRATES is its seemless nature, jumping back and forth between applications and searches and updating itself almost automatically. However, herein lies the problem. PRIVACY !!!
For those of us who use EPOCRATES daily, we know that the company saves a list of the drug searches that are placed in the search box. If we use the online version, these searches are recorded. What becomes of these searches? Who views them? Are they open to scrutiny from drug companies etc ?
And who can forget the day when you bought your first PDA and it appeared robust, clean and snappy. Then you installed a few apps and suddenly you found your then large 64 mb memory turning to scraps and your brand new spiffy device beginning to crawl, falling victim to MEMORY HOGGING!
EPOCRATES is huge! It literally takes over your Palm device when you install it. It begs to be updated if you are 30 days out. It allows you to earn CME on your device by browsing over documents. Data, unknown to you, is sent back to Epocrates. What becomes of it? What else is being sent to EPOCRATES?
Don't get me wrong. I think EPOCRATES is fantastic. I have just signed up for another year to use them, but I use them as an example. There are a lot of companies competing to be a part of the Apple halo effect. There is pent up demand, akin to the early Palm days. But could we find ourselves in the same software bind that beckons us to leave Palm or Windows CE/Mobile? Will the new medical software take up 1/2 to 3/4 of the disk space, leaving what little space on the device useless, thus slowing the machine down to a dull roar? Will we be the subject of constant data mining, going on behind the scenes, with programs calling back to home (How would you like to be on vacation in another state, using your iPhone, not knowing that you are being tracked by one of the pieces of software that you have installed, because it calls home every time you turn on your device)?
We are all looking at the fantastic potential the iPhone and possibly other new devices have in store for us. But we must be careful not to let this fascination with advancement cloud our judgment, giving away our souls in the process. Medicine is an art and a science, but if we let others dictate what we should do, even surreptitiously, just to make life a little easier, we stand the chance of not living up to our maxim: Primum non nocere. As we embark upon this great future, we must DEMAND this of the software makers also.