Even in Medicine, There’s an App for That

Even in Medicine, There’s an App for That

The launch of the iPhone and Android smartphone platforms spurred a boom in medical application use, thanks to the ability to run much more complex medical apps at the point of care than earlier, text-based apps used on personal digital assistants, or PDAs. “Physicians can now explore disease pathology and review medical literature anywhere and anytime,” says Iltifat Husain, MD. “Physicians can use medical apps to enhance their own learning as well as teach patients at the bedside and improve the patient–physician relationship.” What’s the App Adoption Holdup? Despite the potential benefits, smartphone app use is far from ubiquitous among physicians. “Many physicians don’t know how to use mobile devices,” says Dr. Husain. “In some cases, physicians may be concerned that patients will look at them in a different way if they need to look up information. There is a stigma; patients expect their providers to be able to recall any medical information immediately and precisely.” “App use can actually introduce new information to the conversation.” Another stigma associated with smartphone app use occurs among colleagues. “There’s a concern among some physicians that they’ll give the appearance of being disengaged if they pull out their phone to use a medical app when conversing with colleagues,” Dr. Husain says. “The other way to look at these situations is that app use can actually introduce new information to the conversation.” Dr. Husain believes that time is the biggest barrier to overcoming these stigmas. “It’s mostly a generational issue,” he explains. “Fortunately, the incoming generation of physicians has grown up with computers. As this group moves from medical school or residency into longer-term...

Controlling Glucose: Mobile Apps to the Rescue

In the United States, diabetes affects 25.8 million people, for whom the costs of care exceed $100 billion annually. Clinical trials suggest that improved self-care and lifestyle changes can lead to better diabetes-related outcomes. Unfor­tunately, other studies indicate that just 55% of patients with type 2 diabetes receive diabetes education, and only 16% report adhering to recommended self-care practices. Part of the problem behind the poor dissemination of and adherence to behavioral interventions is that patients with diabetes are generally limited to 15-minute office visits with their primary care providers. In that short period, it’s often challenging for physicians and healthcare providers to thoroughly educate patients on their disease. Further complicating the issue is that many patients do not have access to one-on-one or group interventions that can enhance adherence to important self-care practices. Testing a Mobile Apps on Glucose Control In a study published in the September 2011 issue of Diabetes Care, my colleagues and I tested a diabetes coaching system for patients with type 2 diabetes. The system uses mobile phone applications and patient/provider portals to provide feedback on self-management and blood glucose results. It also collects data on lifestyle behaviors and clinical manage­ment. The hope was that this program could reduce A1C levels over 1 year. In our analysis, three intervention groups consisting of patients and physicians received different amounts of infor­mation. Maximal treatment consisted of automated, real-time education and behavioral messaging in response to individu­ally analyzed blood glucose values, diabetes medications, and lifestyle behaviors communicated by cell phone. Quarterly reports were given to providers that summarized patients’ gly­cemic control, medication management, lifestyle behaviors, and evidence-based...