Unusual utilisation of mobile technology in medicine

The popularity of mobile technology has grown rapidly over the last few years 1 and the integration of mHealth is transitioning from a curiosity to an accepted part of health-care delivery. With the growing number of mHealth applications, systematic reviews have highlighted limitations in evidence for their benefits 2 . Despite the paucity of highquality evidence, the unpublished and grey literature is littered with excellent examples of innovative applications and implementations of mHealth that may benefit patients and be of interest for future research. This has spurred interest from developers to think ‘‘outside the box’’ when trying to solve healthcare issues. We bring to the reader’s attention some of these ‘unusual’ applications and the exciting potential offered by new developments. With iPhone adoption being as high as 59% amongst anaesthetists 3 , it is a field that ripe for interesting applications of mobile technology. Like other specialties, there are an extensive number of apps and attachable peripherals for the device 35 . One particularly innovative use of the device involves the utility of the accelerometer built into the phone 6 . Reversal from neuromuscular blockade is best measured with a Train-of-four ratio technique, which requires a nerve stimulator and a measurement device for the force generated, such as an accelerometer 7 . The nerve stimulator causes a short burst of muscle twitches the force of which is related to the degree of muscle paralysis 7 . Whilst nerve stimulators are easily accessible, accelerometers are generally more difficult to access in the clinical setting. By combining the built in accelerometer in the iPhone along with the iSeismology app (Figure 1), clinicians have developed an alternative way of measuring the aforementioned ratio 6 .