If you own a Smart mobile phone, chances are you have downloaded a mobile application (app) or have used one at some point. According to a 2015 Pew Research Study, two-thirds of Americans own a Smart phone and more than half have used their phone to get health information.¹ Mobile apps are software applications designed to run on platforms, such as smartphones, tablet computers and other handheld devices. Apps are downloaded onto your mobile device and are designed to provide consumers with quick access to information and tools with or without internet connectivity. As of June 2015, more than 100 billion mobile apps have been downloaded from app stores and the number of mobile app buyers in the United States is projected to reach 85 million in 2019.² Apps developed specifically for health care are on the rise. There are over 150,000 mobile health, or mHealth, apps on the market focusing on various areas of wellness, including fitness, general health and drug information, disease management, telemedicine, and clinical workflow, to name a few. These are available for free or for a small fee and are typically intuitive and easy to use, even for those that are not technology savvy.

Fitness apps are perhaps the most widely used mHealth apps available today. Many of these apps have companion external devices known as wearables that help consumers track steps, weight, pulse, and calories. As a runner, I have used several training apps in preparation for long distance races. These assist in mapping routes, tracking training sessions, and calculating distance and speed. Some provide feedback on performance, while others send motivational reminders to users to get out and exercise. These digital coaches can facilitate healthy lifestyle changes and can be very cost effective to the average consumer, but only when integrated into a regular routine.

General health care apps provide a range of capabilities, such as allowing patients to organize documents, appointments, and medications into a personal file that can be easily accessed at provider appointments and by family members. Others allow consumers to have direct access to all of their electronic health records (EHR) integrated into one place that automatically update with new information, such as medical history, medications, allergies, prior surgeries and procedures, vital signs, changes in weight, and glucose readings via a patient portal. These apps facilitate the sharing of medical records with providers in real-time, which may promote patient safety, disease prevention, continuity of care, and patient self-management.

Drug information apps provide clinicians with medication references, such as drug indications, dosages, contraindications, safety information, and prescription interactions. Apps aimed at improving medication compliance provide patients with reminders to take their pills, how many to take, and when to refill a prescription. Disease management apps help clinicians monitor patients’ health status and streamline communication. For example, there are several apps on the market targeting diabetes therapy. Some simply help patients monitor blood glucose levels, while others provide sophisticated data analytics to the patient’s health care provider and team, along with a patient self-management plan. Telemedicine apps support communication between patients and providers and is one of the fastest growing areas of app development. These apps enable patients to connect with clinicians via video or text consultation in real time. Some healthcare providers are able to refer to specialists, order lab tests and prescribe medications through the app. Others allow providers to make a diagnosis and determine if an emergency room visit is necessary.

Finally, clinical workflow improvement apps streamline communications and data management for nurses and other providers within the clinical setting. These are the most advanced apps on the market, often linking multiple health information systems and improving efficiencies in the workplace. Incorporating mHealth apps into the in-patient care setting, however, involves a high level of commitment, coordination, and resources. Questions hospital administrators should consider when developing a strategy involving mHealth include⁴:

1. Do mHealth technologies enhance workflow, reimbursement, and quality of patient care?
2. Which mHealth apps are approved for recommendation to patients?
3. When can an mHealth app be recommended to the patient and how would this information be communicated to the health care team?
4. Who will provide guidance to the patient on the use of the mHealth app, and who is responsible for monitoring compliance and outcomes?
5. What is the evaluation process for new mHealth apps? How will effectiveness be tracked?
6. What new skills are needed by clinicians, information technology professionals, and hospital executives to ensure successful implementation of new digital tools?

Integrating mHealth has the potential to improve disease management, communication, and overall patient care. Complete adoption of mHealth, however, will depend largely on:

1. Payers’ recognition of the value apps provide in health care management
2. Establishment of standards for security and privacy guidelines that protect patient’s personal health information
3. Evaluation and regulation of health care apps
4. Full integration into health information systems⁴

Technology has and will continue to rapidly transform every aspect of our daily lives. Managing our health is no exception. As mHealth apps become more sophisticated and increasingly ubiquitous in our modern society, patients and consumers will demand higher quality and functionality. We, as health care providers, need to be armed with the skills to adopt and manage digital tools as they will inevitably become an integral part of how we deliver patient care.
 

References

1. U.S. Smartphone Use in 2015. The Pew Research Center. Retrieved on June 15, 2016 from http://www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015/

2. Mobile App Usage – Statistics & Facts. Retrieved on June 20, 2016 from  www.statista.com. http://www.statista.com/topics/1002/mobile-app-usage/

3. AJN Reports (2015). The World of Apps in Healthcare: Opportunities and Challenges for Nurses. American Journal of Nursing. 2016; 115 (11): 18-19.

4. Austin R, Hull S. (2014). The Power of Mobile Health Technologies and Prescribing Apps. Computers, Informatics, Nursing.

​Myrna B. Schnur, RN, MSN
 

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