Timothy Dy Aungst

How to identify, assess and utilise mobile medical applications in clinical practice

There are thousands of medical applications for mobile devices targeting use by healthcare professionals. However, several factors related to the structure of the existing market for medical applications create significant barriers preventing practitioners from effectively identifying mobile medical applications for individual professional use.

Medical Applications for Pharmacists Using Mobile Devices

BACKGROUND Mobile devices (eg, smartphones, tablet computers) have become ubiquitous and subsequently there has been a growth in mobile applications (apps). Concurrently, mobile devices have been integrated into health care practice due to the availability and quality of medical apps. These mobile medical apps offer increased access to clinical references and point-of-care tools. However, there has been little identification of mobile medical apps suitable for the practice of pharmacy. OBJECTIVE To address the shortage of recommendations of mobile medical apps for pharmacists in daily practice. DATA SOURCES Mobile medical apps were identified via the iTunes and Google Play Stores via the “Medical” app categories and key word searches (eg, drug information, medical calculators). In addition, reviews provided by professional mobile medical app review websites were used to identify apps. STUDY SELECTION AND DATA EXTRACTION Mobile medical apps were included if they had been updated in the previous 3 months, were available in the US, used evidence-based information or literature support, had dedicated app support, and demonstrated stability. Exclusion criteria included apps that were not available in English, had advertisement bias, used nonreferenced sources, were available only via an institution-only subscription, and were web-based portals. DATA SYNTHESIS Twenty-seven mobile apps were identified and reviewed that involved general pharmacy practice, including apps that involved drug references, clinical references, medical calculators, laboratory references, news and continuing medical education, and productivity. CONCLUSIONS Mobile medical apps have a variety of features that are beneficial to pharmacy practice. Individual clinicians should consider several characteristics of these apps to determine which are suitable to incorporate into their daily practice.

Medical Application Use and the Need for Further Research and Assessment for Clinical Practice: Creation and Integration of Standards for Best Practice to Alleviate Poor Application Design

Since the launch of the modern smartphone, medical applications have become ubiquitous in both clinical practice and education. Despite the lack of a formal evidence base, many see mobile technology as being an integral part of future health care. A recent study by Wolf et al1 assessing the efficacy of commercially available smartphone applications designed to assess melanoma risk of suspicious skin lesions highlights this dilemma. Their findings of sensitivities and specificities ranging from 6.8% to 98.1% and 30.4% to 93.7%, respectively, illustrate the existing variability in applications currently available to patients and clinicians. We applaud the authors for their investigation into the accuracy of these applications as the prevalence and usage of mobile devices in clinical practice is extremely high despite the lack of formal US Food and Drug Administration regulation.2 However, their findings are not isolated. For example, Abroms et al3 have shown similar findings in the content of applications designed for smoking cessation. In addition, in an unprecedented action, the Federal Trade Commission brought civil charges against the developers of 2 applications that claimed to treat severe acne using light generated via the screen of a smartphone.4

Consensus on use of the term "App" versus "Application" for reporting of mHealth research.

The number of research studies published which focus on medical “applications” or “apps” continues to grow exponentially. Many academics use these terms interchangeably, however we believe that the discrepancy of terminology used may present a problem for future researchers to systematically identify and conduct appropriate literature searches. We believe it is now time for the mHealth research community to come to a universal consensus and reach a common standard on whether studies should refer to medical “apps” or “applications”. In this article we highlight a number of advantages that standardization of nomenclature will deliver. We also highlight a number of reasons why we believe that mHealth researchers should use the terminology: app [plural-apps]. We conclude by recommending that leading eHealth medical informatics publications such as Journal of Medical Internet Research (JMIR) to implement a policy to utilize common nomenclature moving forward to facilitate improved reporting of studies investigating mobile medical app interventions. [J Med Internet Res 2014;16(7):e174]

Potential uses of wearable technology in medicine: lessons learnt from Google Glass

Whether or not the general populace is ready to accept Glass or similar optical head mounted wearables into general mainstream use, Glass has made some inroads into the practice of medicine and healthcare in general (2,3). While medicine and the overall healthcare environment have often been lauded for their slow uptake of technology, there are still many new adopters who look to integrate technology into clinical practice. In such manners, these early ‘Explorers’ are determining the potential uses of new technology and its limitations. Three of the current business partners recognised by Google are actively still engaged in using Glass and similar products within the healthcare environment, and their results have been seen in the news and media as of late (4). However, in January 2015, Glass was moved out of its Beta development as part of the Google X Division. As such, public access to Glass has since been withdrawn, but access is still available to certified business partners to continue using Glass in business projects (4). While Glass has been reduced from public access outside these business outlets, Glass will continue to undergo refinement at Google and may be seen in an altered form in the future (5). Despite this setback, the knowledge that has been gained by the use of Glass in practice will have longstanding impact on the use of wearables in clinical practice. With the recent surge in mobile devices and associated wearable devices coming to the market, it may come as no surprise that many in the medical sphere are eagerly looking to integrate such devices as Glass into their practice. The impact of Glass and the use of optical head-mounted display has been explored in multiple areas within the practice of medicine and has made some advancement in terms of finding a utility for wearable devices in clinical practice that may see further widespread adoption.

Using a Hackathon for Interprofessional Health Education Opportunities

It was with great interest when I read Youm & Weichmann’s recent article about the Med AppJam hosted at UC Irvine School of Medicine, in light of my own recent experience at a similar event [1]. The concept of gathering individuals into teams to create a new product has become of interest across the country. These so called ‘Hackathons’ often at times find a home for the weekend on the campus of a University where participants form teams seeking to create a product centered around a theme or problem proposed by the organizers. While these hackathons tend to be heavily geared towards those in the tech field, they are slowly finding a niche in the medical community. Recently I had the privilege to attend the MedStart Innovation Challenge, which is a weekend hackathon hosted by the Tufts School of Medicine in conjunction with their MD/MBA program [2]. MedStart has been around since 2013, when it was developed with the mindset of bringing together multiple disciplines across the span of healthcare to work together in teams in conjunction with those in business, design, and technology developers. The hackathon works with multiple sponsors in the healthcare tech field to help donate funds, ideas, and mentor. This year’s hackathon was focused on rethinking medical education and how to integrate new technology developments, such as wearables and software packages. On hand were Ocullus Rifts, Leap Motions, Myo Armbands, and Pebble Smartwatches for teams to utilize and incorporate into the their ideas. The event was conducted over a course of three days at Tufts School of Medicine. The first day started in the evening where the premise of the hackathon was laid out and, more specifically, the problem to be addressed was presented, which was namely medical education. The following day involved speakers in the healthcare tech industry that shared their experiences and an introduction to the event overall. Individuals made pitches on ideas or products they felt could address areas that medical education could be innovated, and then teams were individually formed around promising ideas. After teams were formed, they then had 48 h to work on their project, create a demo, and pitch their ideas at the end of the hackathon to a set of judges to be scored. Similar to the Med AppJam, MedStart focuses on the creation of new products in the healthcare environment by leveraging mobile technology (e.g. apps, wearables). The primary difference between both events is the longevity of time in which the hackathon takes place along with the structure. As Youm and Wiechmann’s article describes, the Med AppJam is a more structured event that has developed teams split between medical students and programming students, compared to the MedStart program that allows participants to form their own teams of different talents. Nonetheless, both events utilized a similar approach with getting sponsorship and industry support, utilizing faculty and other experts as mentors, and directing participants to create a product with a feasible business avenue. A key point that Youm andWeichmann touched upon that I feel is worth further discussion relates to the implication of using these hackathon events as a means for interprofessional education. By bringing together multiple specialties and backgrounds, the Med AppJam exposed medical students to other means of thinking and allowed them to gain digital literacy and knowledge on technology [1]. The Institute of Medicine has advocated for the incorporation of interprofessional education (IPE) into the health professions for many years, and Timothy Aungst holds a PharmD degree at MCPHS University.

How mobile devices are changing pharmacy practice

The first mobile devices to enter the market were the personal digital assistants (PDAs) of the late 1990s and early 2000s, and they ushered in the era of handheld computers. PDAs combined popular features of electronic tools (e.g., calculator) and computer apps applications (e.g., e-mail, calendar

Identification and review of mobile applications for travel medicine practitioners and patients.

Advancements in technology have led to the development of medical applications (apps). Contents of 44 apps related to travel medicine were assessed demonstrating that many were updated infrequently and several developers had no medical background. There is an opportunity for healthcare professionals to develop apps in travel medicine.

Leveraging mobile smart devices to improve interprofessional communications in inpatient practice setting: A literature review

Abstract As mobile smart device use has increased in society, the healthcare community has begun using these devices for communication among professionals in practice settings. The purpose of this review is to describe primary literature which reports on the experiences with interprofessional healthcare communication via mobile smart devices. Based on these findings, this review also addresses how these devices may be utilized to facilitate interprofessional education (IPE) in health professions education programs. The literature search revealed limited assessments of mobile smart device use in clinical practice settings. In available reports, communication with mobile smart devices was perceived as more effective and faster among interdisciplinary members. Notable drawbacks included discrepancies in the urgency labeling of messages, increased interruptions associated with constant accessibility to team members, and professionalism breakdowns. Recently developed interprofessional competencies include an emphasis on ensuring that health profession students can effectively communicate on interprofessional teams. With the increasing reliance on mobile smart devices in the absence of robust benefit and risk assessments on their use in clinical practice settings, use of these devices may be leveraged to facilitate IPE activities in health education professions programs while simultaneously educating students on their proper use in patient care settings.

Lessons Learned and Looking Forward With Pharmacy Education: Informatics and Digital Health

Informatics is an increasingly important component of pharmacy practice. This domain, along with several technological modalities and services that underpin it, can facilitate the connection of the pharmacist to larger networks of information systems, healthcare providers, and health information technology (HIT). This, in turn, can help optimize all steps of the medication use process. In addition, digital health offers new roles and opportunities for pharmacy related to the leveraging of patient health-related data (e.g., medication adherence, behavioral, and wellness) over time. Informatics and digital health may also enhance patient-centered care within pharmacy and other allied health disciplines. Its inherently multidisciplinary nature also is suggestion of one route to enhance interprofessional education. Therefore, pharmacy educators and students should be familiar with the educational requirements and modalities associated with the integration of informatics and digital health in the goal of becoming practice-ready.