Health: Is There an App for That?

Because he has atrial fibrillation, my uncle was interested in the Fitbit Charge HR because it gives him 24-hour recording of his heart rate. But he never considered it a medical device and only occasionally brought up what he observed during meetings with his cardiologist.

When Kardia Mobile by AliveCor became available, he became even more interested. This small device, coupled with his smartphone, allows him to record an EKG (electrocardiogram) of his heart as often as he wants and see the results on the screen of his smartphone. And Kardia Mobile is approved as a medical device by the Food and Drug Administration.

For individuals who want to monitor their health, technology is providing an increasing number of tools. The number of health apps (software applications) is doubling every year, and the number of users is estimated to be in the hundreds of millions. Whether you want to track your physical activity, count calories, measure your blood sugar or monitor your heart rate or rhythm, there is an app for that.

Are they reliable? That is a fair question, and a 2014 editorial in the New England Journal of Medicine warns of the dangers associated with unreliable or under-regulated health apps.

Most of these apps, like my uncle’s activity tracker, are best suited to keep you motivated to exercise, improve your diet and weight and follow other healthy lifestyle practices. If a tracker is somewhat off in its calculation of the steps that you have taken or the calories you have consumed, there is generally little harm.

When it comes to making decisions about possible medical conditions, however, there is worry that some persons will rely on an app for self diagnosis rather than seeing a doctor. Many health apps are developed by pharmaceutical or medical device companies through collaboration between technology developers, physicians and legal experts. And many are widely used by physicians and other health care professionals.

According to a 2012 survey, 87 percent of physicians used a smart phone or tablet in their practice. Medical school faculty, residents and students reported similar use.

Resources available to health care professionals through medical apps include drug reference guides, medical calculators, clinical guidelines, literature searches and other aids for making patient-care decisions. Medical journals and textbooks are available.

Apps can also be used for patient education, scheduling, coding, billing and continuing medical education.

One of the most popular apps, MedPage Today gives information about drugs, disease and medical procedures plus podcasts, videos, news updates and coverage of professional meetings and symposia.

Epocrates provides drug prescribing and safety information, including possible drug-drug interactions; clinical practice guidelines; disease information; medical news alerts; and contact information for consults and referrals.

Pepid offers decision-making support targeted toward emergency room physicians but useful to nurses, students, residents, pharmacists, emergency medical technicians and paramedics. Information is frequently updated with new research, drug approvals and black box warnings.

Doximity serves as a social networking tool for physicians who use it to find and consult with other doctors on the network through HIPAA-secure communication.

These are just a few of the many apps available for healthcare professionals. In addition, about 15 percent of doctors recommend mobile health apps to their patients for feedback regarding treatment of chronic medical conditions. This might include monitoring of blood sugar, heart rate and heart rate variability.

Generally, though, some doctors are skeptical regarding the accuracy and reliability of some of the apps most popular among consumers.

Popular apps include Sworkit, Map My Run, Green Kitchen, Sleepbetter with Runtastic and Calorie Counter & Diet Tracker by MyFitness Pal. The Apple Watch will remind you to take your medication; and it has apps such as Hello Heart, which records and uploads vital signs and helps monitor heart conditions in real time.

The role played by mobile devices continues to grow. Nathan G. Cortez, who authored the New England Journal editorial, points out that while these mobile devices and apps provide healthcare professionals and patients with many advantages, “they are currently being used without a thorough understanding of their associated risks and benefits.”

This information was submitted by Northeastern Vermont Regional Hospital in St. Johnsbury and is meant to complement, not replace, the advice and care you receive from your healthcare provider.