Doctors Prescribe Apps for Patient Connections

Mobile apps connect healthcare providers with patients in ways users increasingly use and understand. Widespread use of apps also opens the door to widespread privacy violations. Physicians must be extra cautious.

Dr. Narciso Tapia is keenly aware of the benefits and pitfalls of apps. He heads the Research Office of Vicente Sotto Memorial Medical Center in Cebu City, the Philippines. The doctor also is research coordinator for the University of Cebu School of Medicine and an adjunct faculty of the University of the Philippines Manila National Teacher Training Center for the Health Professions.

“We live in a mobile world with increased use of smartphones,” Tapia said. “Mobile health is believed to be part of the wider ‘eHealth’ movement, which uses technology such as mobile phones and computers for health services and information.”

He refers to mobile apps as programs that can be uploaded to a smartphone or tablet. In his case, these mobile apps are used for varied purposes to aid in clinical practice.

“Lightning-fast processors, improvements in memory as well as batteries, together with the increased availability of highly efficient open-source operating systems performing complex functions, ushered the development of many medical mobile device apps for clinical use,” Tapia said.

He explained that with the rise of many new mobile apps, healthcare professionals look to experienced users for more guidance regarding apps that might be useful for clinical practice.

“I relied on apps for my rural practice,” said Dr. Jaifred F. “Jim” Lopez, a member of the public health faculty and a health policy consultant in the National Capital Region, the Philippines. “I was using my BlackBerry to access apps eight years ago. The apps provide remotely located clinicians with the necessary information to properly prescribe. They ‘saved my life’ a lot of times.

“My favorite apps let me calculate renal function, menstrual period, even body mass index,” he said. “It pays not to forget, but sometimes you do, especially in a busy practice.”

Lopez also endorses journal apps.

“They are fantastic,” he said. “They helped me to get updated such as when I was still in the field and a new version of the Journal of Nuclear Cardiology came out. It is important to get updated and to let my colleagues and teammates know.”

Obstetrician-gynecologist and infectious disease specialist Dr. Helen Madamba is thankful for the power of mobile phones.

“They let us track our health, our patients, our appointments, our surgeries, our classes,” she said. “Our colleagues are just a click away. There are also apps that provide more information on diseases in a language patients can understand. A phone helps with tips as well.

“One of the apps I use is MyFitnessPal,” she said. “It helps me count my calorie intake, look at my personal trends, see inputs on the quality of food I eat and monitor my exercise activity. It helps with motivation, too, because friends are also on the app.”

Madamba cautioned against relying on apps as the ultimate doctor-patient relationship solution.

“I came across drawMD, which allowed me to draw on anatomic photos on the iPad,” she said. “But patients prefer paper so they could bring it home, along with the notes and scribbles.”

To illustrate how apps can help manage chronic diseases, endocrinologist Dr. Iris Thiele Isip Tan gave a presentation at a cardiology meeting in Australia a few years ago.

“Information management, communication, research, and patient monitoring are among several benefits from apps,” Tapia said. “So much information is available at your fingertips.”

To evaluate the credibility of a medical app, look at what organizations endorse the app and for what reasons. You also need to check their security as part of their reliability history. Be cautious about endorsing a particular app, lest you fall into conflict of interest, much like doctors passing out free samples of medicine from drug companies.

Lopez gave basic requirements for a medical app:

• It must be easy to use and easy to understand.
• It does not aim to replace the advice of a health professional but leads patients to seek it in case there are specific symptoms.
• It must be able to suggest preventive measures.

“Apps from medical institutions and professional societies are usually more reliable,” said sleep specialist Patrick Moral. “If the formulas and citations have their references in the information section, I tend to trust these more. Lastly, I weigh the cost factors vis a vis the functionality.”

Naturally, Madamba favors mobile devices pertinent to her own practice.

“I like the app on pregnancy tracker,” she said. “It’s easy to compute the age of gestation and estimate the date of delivery as well. It also has a time machine to tell you the dates when you complete each trimester or when it would be safe to deliver.

“It should stand the test of time insofar as its utility and the info that you get out of the app,” Madamba said.

Apps are not only for doctors – and not only for patients themselves.

“You’d be surprised that for couples trying to get pregnant, it’s the husbands who have mobile app trackers for menstrual cycles,” Madamba said. “They religiously record their wife’s menses to identify fertile periods.”

The healthcare providers had other mobile apps that they use for their practice for specific purposes or benefits.

Tan uses MediCalc to compute kidney function and the Monthly Index of Medical Specialties for drug interactions.

“In the BlackBerry era, I used Skyscape,” Lopez said. “Now, as an iPhone user, I use Medscape, MDCalc and Read. I also use my health app to track personal fitness.”

Madamba is grateful that Google Classroom is available on mobile phones. She feels it empowers her residents to answer their quizzes and take their exams anywhere through mobile phones.

Tapia hopes more healthcare professionals will partner with app developers to create medical apps or medical startups, a motion Madamba seconds.

“Mobile apps can make clinical practice a lot easier, compared to lugging around thick and heavy textbooks,” she said. “The downside would be if trainees no longer read books because Dr. Google provides everything within their reach. Mobile apps should supplement not replace.

“In our ‘masteral’ class, my groupmates and I will be forced to learn how to be techie,” Madamba said. “That will let us maximize and exploit technology to improve how we teach medical education.”