Nearly one in two of us in America has a smartphone. More than one in four own some brand of e-reader, and nearly one in three of us owns a tablet computer, according to a January report by the Pew Internet and American Life Project.
Wendy Clark, a family nurse practitioner with Northeast Medical Associates and assistant professor of nursing at the University of Saint Francis, is rarely without any one of these tech devices. In her practice on any given day she might use an interactive app (application) to explain to a just-diagnosed teenager how to give herself insulin shots or to help an adult patient better understand hypertension.
In the classroom, Clark shows master's level nursing students apps that give them immediate access to diagnostic criteria for various medical conditions.
As in other aspects of life, apps now play an increasing role in health diagnosis and treatment.
“We used to require big textbooks that students had to lug around. There were four or five we'd recommend,” Clark explains while using her iPad to access a free medical app called Epocrates. “We hoped that, among a group of 10 students, they would have access to all of them. Now everyone can have the best products at their fingertips.”
The Epocrates Rx lists prescription and over-the-counter (OTC) drugs, prescribing information and potential interactions with other drugs. No longer does Clark have to use the heavyweight, annually published Physicians' Desk Reference (PDR).
Not only is the app more convenient, it can be updated more quickly than a traditional book when new drugs come on the market or the U.S. Food and Drug Administration issues a warning about a drug.
The number of health and medical apps is growing almost exponentially, with more than 40,000 currently available, according to industry trackers.
It is no surprise then that the FDA issued guidelines within the past year on what kinds of apps must have FDA approval. While they are still just guidelines and not regulations, app developers and marketers see regs coming soon. Some have already sought FDA approval for their apps.
According to MobiHealthNews.com, which tracks trends in the medical app industry, at least 75 medical apps have received FDA approval in a process similar to what the FDA uses for makers of medical devices such as artificial joints or heart pacemakers.
Just how extensively are health-care providers using apps in their day-to-day work?
Dr. Eric Topol of Scripps Health in San Diego told NBC medical correspondent Dr. Nancy Snyderman in a recent interview he now “prescribes more apps for patients than he does medications.”
In the TV report, Topol demonstrated how easily an electrocardiogram (EKG) can be done using a smartphone app. He snapped a device onto his iPhone, put his fingers on the device and, in seconds, had a clear reading of his heart's rhythmic activity.
Health-care providers have at their fingertips immediate access to apps that give them treatment protocols for certain conditions, listings and locations of clinical trials, and access to nearly every medical reference book and journal.
Medical students can use Heart Murmur Pro to listen to 23 heart sounds. The app helps them hone their skills in differentiating the sounds and gives clinical information about each sound.
Health practitioners can send X-rays and other medical imaging tests to colleagues via HIPPA-compliant apps.
For consumers, apps are available to monitor your oxygen levels, blood sugar and blood pressure, among other things. Many of these kinds of apps use another device that connects to your smartphone or tablet.
Apps that help you count calories and track exercise and weight loss are among the most popular.
One developer, Mango Health, is refining an app aimed at increasing patients' adherence to taking medications as prescribed. The app includes a reward system that enables users to earn points for taking their medications. The points can be exchanged for actual merchant or restaurant gift cards.
“There are many devices now that can measure things,” Clark concurs. “As a consumer, I wouldn't want to base my health decision on them.”
Clark encourages her patients and students to arm themselves with as much information as possible and says medical apps can enhance the doctor-patient partnership model of care she strives for.
But consumers need to check out the reliability of apps before assuming they are evidence-based. For example, the Federal Trade Commission filed a complaint against one company that advertised its app for treating acne. The app said the light from a smartphone could cure acne.
On the other hand, WellDoc has developed the DiabetesManager system that has FDA approval and is expected to be available very soon. The user enters food intake information, medications and exercise activity level. It also can be linked to a glucose monitor to record blood sugars.
Periodically throughout the day, the system advises on foods to eat or avoid and gives other tips for managing diabetes, based on information input. The information is also analyzed using an algorithm and sent to the doctor.
The app is pricey: More than $100 a month. But some people spend two to three times that amount on diabetes medications.
The marriage between mobile technology and medicine is only going to grow stronger — and I am convinced that is a good thing if used appropriately.
Ask your health-care provider which apps he or she recommends. Review those approved by the FDA, and check on ratings by independent trades groups that track this exploding health industry. Then start downloading.