Multi-Purpose Apps? Some Applications Have “Curative” Potential
Mini-applications (apps) for smart phones and tablet computers are booming. What originally appeared to be nothing more than gimmicks could now be considered to be “coming of age”. Apps may not only revolutionize the private health market, some of them also have the potential to influence how we deal with medicine at home, in hospitals and in medical practices.
MEDICA 2012 in Düsseldorf, Germany (November 14 - 17), the world’s largest medical trade fair with more than 4,500 exhibitors from at least 60 different countries, will provide an overview of the latest app trends and some sample applications. Parallel to the products of the exhibitors, the “App Circus”, a program element organized in cooperation with “dotopen” as part of the MEDICA HEALTH IT FORUM, will demonstrate just how lively this field is. At the App Circus, innovative health apps will be presented by their creators with the goal of bringing developers, start-up companies and the organizations involved in the software development together with potential users and project partners from the medical sector and on the purchasing side.
Prof. Volker Amelung, Specialist Professor for International Health Systems Research, Hannover Medical School, and member of the Expert Circle of the MEDICA HEALTH IT FORUM (Hall 15) believes that these compact applications will certainly leave their mark and not only in the secondary health market (the privately financed market sector). He sees major opportunities particularly in the areas of prevention and treatment adherence. As an example of a successful app in this area, he mentions “MyPill” from the pharmacy “Zur Rose”, which offers assistance with correctly taking contraceptive pills. It not only reminds a person of the correct time, but also documents when the pill has been taken in the past. An adjustable warning can alert about an increased risk of pregnancy if a pill has been missed. Similar applications, especially for complex therapy regimens – i.e. many pills and a complicated schedule that must be followed precisely, for example in the case of HIV – could save money for the public health service. According to Prof. Amelung, apps like this would therefore be interesting for the health insurance companies. There are of course limits to what can be achieved, for example regarding dementia patient care. Prof. Amelung is nonetheless optimistic about the application potential: “Even if apps can only be used by 20% of the population, they would be of benefit to these people. There will never be a solution for all problems.”
The German Electrical and Electronic Manufacturers' Association (ZVEI) recently published a flyer stressing that based on the results of studies, the indications for the use of mobile devices should be thoroughly examined. In the area of teledermatology it has been shown that even though the quality of the diagnostic findings is not bad, it is well below the level required for a direct personal evaluation and the resulting treatment decision. In the meantime, ZVEI also stated that there are a broad variety of application areas in the professional medical sector; in particular:
- Simple data transfer (more or less as a modem)
- Mobile ward rounds
- Viewing of ECGs and X-ray images
- Displaying alphanumerical values
- Diagnosis and treatment decisions, etc.
According to ZVEI, users of the devices and apps ultimately have a certain amount of responsibility for the way in which they use them. They should ensure that they only use the devices in the context for which they were designed and advertised by the manufacturer.
App for dialysis patients undergoing trials
The current trials by organizations such as Siemens-Forschung Corporate Technology, Vivantes Clinic, Telemedicine Centre Charité (TMCC), Prisma, Tembit and other partners could also be relevant to the health market. They are looking at how patients with kidney damage can receive dialysis in a gentle and safe way in their own homes with the help of an app. In a test, which is the first of its kind in the world, selected dialysis patients in Berlin will be equipped with a telemedical assistance system. This should enable them to perform a telemedically assisted peritoneal dialysis every day by themselves, with a doctor helping via remote control. The field test, which will be conducted for several months, is part of the “Smart Senior” project funded by the Federal Ministry for Research. Its goal is to increase the quality of life for seniors and to enable them to live a largely independent life at home. In this field test, an app on a smartphone lists the vital signs as agreed with the doctor. It guides the patient through the measurement of blood pressure, heart rate, oxygen saturation or ECG. The measuring instruments encode the measurements and provide them with a pseudonym before sending them via a special router, known as a Med-I-Box, to the dialysis center. The app ensures that the data has arrived at its destination. Later, the data is saved in the patient’s medical record on the server of the TMCC. The doctor checks the vital signs and treatment data daily and also receives an automatic message if any abnormalities are detected. As a result, he can detect health changes earlier than before, contact the patients immediately and complications can be avoided.
App solutions for hospitals and practices
RAM Mobile Data has a more general approach, which the company already introduced at MEDICA 2011. All employees in hospitals and nursing facilities need to have fast access to various type of information and the company developed special organization-specific app stores for this purpose. Employees in hospitals and nursing facilities can use their own smartphones or tablet PCs to access the apps available to them and thus view all the relevant data. Direct editing and storage means that the patient data are always automatically up to date. Only authorized employees have access to the hospital-specific app store and the rights to download the individual apps can be defined for different user groups. For instance, a doctor can use an application to update the patient’s medical record, whereas the caregivers may only have reading rights on their version. That works independently of the platform – both at the backend and for mobile devices – and is compatible with all hospital information systems. This trend, known as “Bring Your Own Device”, could have several advantages. Hospitals, for example, could save money in the procurement area. On the other hand, problems are posed by the lack of a clear distinction between private and company hardware as well as the security aspect. In this regard, the solution of hospital-specific app stores is supposed to assist with saving the apps on a separate area of the mobile device. This way, it is possible to avoid any confusion between private and professional data. Also, if the smart phone or tablet gets lost or an employee leaves the organization, the hospital has the ability to delete the hospital-specific apps and the associated data from a distance, without affecting the private contents.
The CGM Mobile app from CompuGroupMedical is specially designed for the needs of doctors working in their own practice. In the future, physicians using this app in conjunction with their iPhone or iPad will always have their patients’ file card handy. The online technology platform “telemed.net” enables secure mobile access to medical documents from the medical software “ALBIS” and provides an optimized display on the iPhone or iPad. This trend-setting function is particularly useful for house calls and gives the doctor more mobility and comfort. It is also possible to view directions or call the patient directly from the app.