Home  |   Subscribe  |   Resources  |   Reprints  |   Writers' Guidelines

October 2013

An App a Day Helps Keep the Doc Away
By Lindsey Getz
For The Record
Vol. 25 No. 14 P. 28

There’s an app for seemingly everything these days, and health care is no exception. In fact, according to a 2011 report from MobiHealthNews, consumers now have approximately 5,500 medical apps at their disposal. While many of these apps are directed at health care professionals, there also is a wide selection geared toward helping individuals manage their own health.

“Smartphones are a great way for people to track how their daily activities impact their health,” says Aaron Michelfelder, MD, a physician at Loyola University Health System and a professor in the department of family medicine at the Loyola University of Chicago Stritch School of Medicine. “They give patients instant access to the effects their habits have on daily living, and they are better able to make connections between what they do and how they feel.”

Michelfelder views apps as an opportunity to empower patients. “Apps can be very useful in helping patients track data,” he says. “Patients can keep a journal on mood for conditions like depression or anxiety; they can track timing of headaches; for asthma, they can track their peak flow data on how well they’re breathing; and for diabetes, they can track calories or blood sugar readings. There’s even an app for the iPhone where you can plug a blood pressure cuff into the phone.”

Beyond data tracking, apps can assist in scheduling medical appointments and receiving data from physician offices, promising features that likely will be utilized even more in the near future. “I think that the most common utilization of health apps may actually be for convenience purposes,” says Gary Hamilton, president of InteliChart, an HIT provider. “Apps that can help streamline the process of making a doctor’s appointment or receiving appointment reminders are very helpful to patients. Patients also like the convenience factor of looking at medications and simply clicking on them to request a renewal.”

User Profile
Despite the plethora of useful apps on the market, many patients still do not take full advantage of the technology. According to Ruder Finn’s mHealth survey, only 31% of the US population used health apps in 2012, with many citing that they either don’t need them or would prefer to talk to their physician in person, says Kevin Silverman, director of health care innovation at Ruder Finn.

App users typically are patients who are truly invested in their health. This group may be a combination of patients who are healthy and committed to staying that way as well as patients with chronic conditions who are serious about managing their care. The Ruder Finn survey found that those with chronic conditions were 53% more likely to use apps. “Patients with chronic diseases are more concerned with their overall well-being, which makes them more prone to want to monitor their status,” Silverman says.

Regardless of their health, patients who are fond of apps are more likely to follow recommended practices. “The fact is that the people using health apps are typically the compliant patients,” says Scott Frederick, director of clinical insight at PointClear Solutions, a health care technology development company. “They’re the patients who are invested in their health and want to take an active role in managing it. This may also include parents. Parents may be using apps to monitor certain biometric information for their children because they have a more vested interest.”

Although the technology may be shiny and progressive, it’s not necessarily attracting more users. “Ten years ago, we asked patients to track data using pen and paper, and not everyone did it,” Michelfelder says. “The bottom line is that an app is not going to make patients more likely to track data; it just may make it more convenient for them. But the same people who would have tracked their data on pen and paper are the ones doing it on mobile phones. It’s still a relatively small number of my patients overall, but it can be very powerful for those who are doing it.”

One reason it’s so powerful is that it provides real-time data to physicians. “It helps me better analyze a patient’s health than just the information I get from an office visit,” Michelfelder says. “Instead of maybe having two blood pressure readings, I’ll have 25. This allows me to have a more in-depth conversation with the patient about where to go next.”

Physician Acceptance
Are today’s physicians accepting of the data generated by apps? “Mobile applications are a vital necessity, and physicians know that,” says Anne Meneghetti, MD, director of clinical communications for Epocrates, a mobile health software company. “Physicians themselves are using apps in their daily process.”

In fact, many times it’s physicians who are recommending apps to their patients. “A 2012 survey we did found that more than 40% of physicians have recommended apps to a patient,” Meneghetti says. “The top apps recommended were supportive, things like calorie counters or weight-loss trackers. About 40% of physicians surveyed say they got app recommendations from a colleague. But I will say that physicians do listen to their patients, and many of them have also gotten app recommendations directly from the patient.”

While many physicians are receptive to receiving data, the way in which they’re transmitted can be a barrier. “Many apps will allow you to e-mail the data, but most physicians aren’t connected with their patients via e-mail,” Michelfelder says. “A patient could hand the physician their phone or tablet, but some may find that cumbersome. So the way that the data is transmitted to the physician does pose the possibility of being a barrier.”

There are several privacy issues to consider as well, with regular e-mail and messaging security posing a particular roadblock. Hamilton says applications that connect to a practice’s EHR system are the best route. “The information has to come through a mechanism that is trusted and known,” he says. “The very best way is to tap into the platform of data that providers are already utilizing through their EHR. A provider will already have secure messaging in the EHR system.”

Appointment Health
While apps can do a lot these days—send photos of suspicious skin rashes, for example—they aren’t meant to replace face time with a physician. “I do hope that patients won’t begin utilizing apps for self-diagnosing,” Frederick says. “Information is power and can be incredibly helpful, but the physician still needs to be involved in the process.”

Meneghetti also views apps as more of a supplement to traditional care practices. “There’s a lot of interest in extending care beyond the face-to-face encounter with things like home blood pressure readings, blood glucose readings, and more,” she says. “But right now our model is still very much based on face time with the doctor aided by supplements. One of the best ways to incorporate data from an app is to bring those findings to a meeting with your doctor. Apps are wonderful, but they still can’t replace that face-to-face experience. With medicine, there are things that can be seen and felt as well as intuition that comes into play. These factors simply don’t come across with numbers transmitted from an app; therefore, I don’t think the face-to-face encounter will ever be replaced. But there’s no question that apps can serve as a wonderful supplement and help improve patients’ health in many ways.”

— Lindsey Getz is a freelance writer based in Royersford, Pennsylvania.