Mobile medical apps have become a prominent part of many doctors’ practices. From viewing x-ray results to tracking symptoms and vital statistics, these apps help doctors to diagnose, monitor and treat many common diseases.
Apple’s App Store now features an entire collection dedicated to “Apps for healthcare professionals”, and the NHS also offers a library of apps that have been reviewed by medical experts to ensure they are clinically safe.
The prevalence of smartphones and tablets has enabled doctors to take advantage of increasingly flexible access to medical information. Health libraries commonly report that loans of printed material are declining, while subscriptions to electronic books and journals are increasing.
However, the recent growth of biomedical information has left many clinicians suffering from information overload, unable to sort the wheat from the chaff as the knowledge base continues to expand. Doctors need quick and easy access to quality information resources to be able to make informed decisions regarding patient care.
In order to tackle this problem, a number of NHS organisations have started to subscribe to online evidence-based reference products at a cost of several thousand pounds per year. These synthesise information from a variety of sources, bringing together standard textbook information with summaries of the findings of the latest research.
Evidence-based products provide an appraisal of the weight of the evidence, before giving recommendations about which treatment options might be considered in particular cases.
Over the last few years, several mobile apps have been developed that offer quick access to evidence-based medical research from mobile devices. The advantage of these apps is they allow the doctor or physician to look up information at the patient’s bedside.
One such app – UpToDate, published by Wolters Kluwer – offers evidence-based opinion and treatment recommendations on over 10,000 conditions. The information that goes into the app is peer-reviewed and collated by over 5,000 doctors and clinicians.
“Physicians have many questions that arise while they’re seeing patients, and the data suggests that if you can answer all of those questions, you can actually impact patient care and change decisions that physicians are making,” said Dr. Denise Basow, vice president and general manager of UpToDate at Wolters Kluwer.
“The idea behind UpToDate is to come up with the typical questions that clinicians have when they’re seeing patients, summarise the literature that can answer those questions, and put that all together and provide recommendations for clinicians so they can not only answer those questions but can actually apply them to the patient.”
In the UK, about 100 hospitals subscribe to UpToDate, three quarters of which are NHS trusts. A further 1,700 individual doctors also subscribe to the service, which is accessible across desktop, iOS, Android and Windows Phone 8.
Dr Anne-Marie Kelly, consultant chemical pathologist at University Hospital of South Manchester, said that one of the key benefits for doctors of digital information tools like UpToDate is that it means they don’t have to go back to the library every time they want to answer a question.
“It saves time because you can get an authoritative answer at your fingertips, when you are with a patient or communicating with another health care professional,” said Dr Kelly.
Doctors can also use UpToDate to reassure patients about their recommended treatment and give links to patient information sheets. This has become a useful tool in the doctor/patient relationship.
“Patients are growing accustomed to doctors using mobile devices during consultations and at the University of Manchester medical students are using iPads during their clinical placements on the wards and in the clinics,” said Dr Kelly.
“This has to be done sensitively to ensure that it doesn’t interfere with doctor-patient communication and so you need to explain to a patient exactly what you are using your mobile device for. However in my opinion patients don’t usually have an issue with you accessing data on your tablet during a consultation and often find it reassuring.”
Meanwhile Dr Effrossyni Gkrania-Klotsas, infectious diseases consultant at Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, has been using the web-based version of UpToDate since 2002, and recently downloaded the app onto her Android phone.
“One of my favorite things about using the UpToDate app is the access to Lexicomp, the Wolters Kluwer Health drug database. I had a patient the other day who was reporting a very unusual symptom that he was claiming was a side effect of an HIV medication he was on,” she said.
“I looked it up in our local BNF (British National Formulary) system and the information was very generic. I then looked it up on UpToDate and was able to show that in fact, he was right. UpToDate noted that 1-6% of patients experienced headaches while using this medication. With UpToDate, getting an answer was really quick and I was able to show the patient.”
UpToDate is one of several apps that provide access to this kind of evidence-based medical information, with others including Best Practice, DynaMed and Clinical Key. However, it is evidence of a new trend among doctors and medical professionals for tapping into medical research while on the go.
Some argue that this is only the beginning of the ‘digital doctor’ revolution. New cutting-edge mobile applications are now able to tap into networks of sensors, allowing doctors to their monitor patients on an ongoing basis on their mobile devices, from any location.
Meanwhile, a recent proof-of-concept demonstration from Accenture and Philips showed how a doctor wearing a Google Glass head-mounted display could simultaneously monitor a patient’s vital signs and react to surgical procedural developments without having to turn away from the patient or procedure.
In comparison to these applications, mobile reference guides seem pretty relatively low-tech, but a high proportion of doctors in the UK are still rushing back and forth to libraries to read up on patients conditions. By implementing simple technological solutions first, hospitals can lay the groundwork for an exciting digital future.