The rapid adoption of mobile devices by clinicians and integration of apps into the clinical workflow has created significant opportunities for these devices to become primary tools in the diagnosis and management of disease. This presentation provides an overview of the drivers behind adoption, what clinicians are using and how one can drive more value from these tools. This data was presented at the Technology in Clinical Practice Cruise Conference - April 2013.

1. iPhone iPad Android – Driving Clinical
Value from Devices
Dr. Alan Brookstone

2. Who is Using What?
• 2012 Survey conducted by AmericanEHR Partners to to better
understand health practitioners’ use of mobile technology
• Objectives:
– Assess health practitioners’ usage of smartphones in their
medical practice
– Determine if there are any differences in technology usage
and demographics between physicians who have adopted
EMR and those who have not
2

3. Methodology
• A total of 702 physicians completed the online survey from October 10 –
December 8, 2012. The sample sizes and corresponding margins of error
are provided below:
Sample Size Margin of Error
US physicians who have implemented EMR 585 +/-4.1%
US physicians who have not implemented EMR 117 +/-9.1%
Total 702 +/-3.7%
• Red circles ( ) indicate differences between key sub-groups.
3

4. Smartphone Usage in the Medical Pactice
• Apple iPhone is the most popular smartphone brand used by physicians who have adopted EMR.
Mobile Phone Brand
Mobile Phone Brand Smartphone Brand
Smartphone Brand
iPhone
Motorola
EMR users
BlackBerry
Samsung
Non-EMR
users HTC
LG
Other
Unclassified
Base: EMR users who use a smartphone in medical practice
Base: Physicians (EMR Users: n=585; Non-users: n=117) (n=451)
Q1b. What type of mobile phone do you use most often in your medical practice? Q2. Which of the following smartphone brands do you
personally use most often for some clinical purposes?
4

5. Activities on the Smartphone

6. Use of Mobile Devices
• Among physicians who have adopted EMR, two-
thirds (65%) send and receive email on their
smartphones every day, while half use apps (51%)
and instant messaging (50%) on a daily basis

7. Usage + Medical Apps
• Survey data – Top 3 apps for GPs and Specialists – Epocrates, Medscape and
MedCalc, although specialists report a higher usage of Medscape than GPs

8. Credibility?
• http://www.pocket.md

9. The App Explosion

10. Android
https://play.google.com/store/search?q=medical+apps&c=apps&price=1&sort=0

11. The App Explosion
• Country specific
• Reference
• Medical Education
• EMR & Patient Monitoring
• Imaging
• Point of Care
• Personal Care
• Productivity

12. ACP Immunization Advisor (itunes)
• https://itunes.apple.com/us/app/acp-immunization-advisor/id503636536?mt=8

13. Medical App Review Sites
http://www.imedicalapps.com/

14. BurnMed Pro – Johns Hopkins ($4.99)
• Johns Hopkins physicians were inspired to create BurnMed after a mass casualty incident in Kenya where a
gas tanker exploded, killing one hundred people instantly and severely burning many others. The influx of
burn patients overwhelmed local health resources, so many did not receive correct treatment initially.
• https://itunes.apple.com/us/app/burnmed-pro/id498379749?mt=8

15. Neuro Localizer HD - University of Michigan (Free)
• A medical app created by the University of Michigan Neurology department to help teach
neuro-anatomy and how to identify neuro lesions based on exam findings.

16. Vcath - By Bangor University (Free)
• vCath is an app developed by Bangor University in the UK. It is designed to teach neurosurgical trainees the art of
cannulating the lateral ventricles of the brain. The objective of the app is to guide a neurosurgical trainee through the steps
of positioning and inserting a catheter into the brain of a 3D virtual patient.
• https://itunes.apple.com/us/app/vcath/id568887198?mt=8

17. Doctor Mole - Skin Cancer App ($3.99)
• DoctorMole is an app dedicated to assessing skin moles using the Asymmetry,
Border, Color, Diameter and Risk (ABCDE) approach.
• https://itunes.apple.com/us/app/doctormole/id562711395?mt=8

18. Wrist Repair – Patient Education (Free)
• Meditech developed Wrist Repair to help educate patients on the steps required when undergoing Open
Reduction and Internal Fixation (ORIF) of a distal radius fracture – a common orthopedic surgery.
• https://itunes.apple.com/us/app/wrist-repair/id551439954?mt=8

19. Best practices
• Security and privacy
– Password protection
– Device tracker
– Ability to remotely wipe your device
• Use of mobile devices for email
– Colleagues vs. Patients
– Secure vs. Non-secure
– Email policy (Appointment cards, Website)

20. Email Policy

21. Mobile Device Usage Guidelines
• Be aware of the potential for distraction
• Know the rules at your workplace. Many practices have privacy rules
related to electronic health records. If there are also rules in place in your
hospital, clinic or private office on how, when and where physicians can
access mobile devices, learn them.
• Think of a mobile device as a patient chart. Patient data comes with a
raft of privacy concerns, and viewing today’s technology in the same vein
as an “old school” chart can help ensure that otolaryngologists do not
create a privacy issue.
• Limit the number of devices. Many physicians carry multiple devices,
including a work phone, a personal phone and maybe a tablet or mobile
computer. Interacting with multiple devices and trying to attend to a
patient’s needs and questions is just as difficult as it sounds.
• Focus on the patient. Avoid texting or reading e-mail in front of a patient,
unless absolutely necessary.
ENT Today - Sept 2012 - Mobile Devices in the Medical Setting Can Lead to Distracted Doctors and Medical Error http://bit.ly/XGMmhN

22. The Path Forward
• Will Falk, managing partner of health care at
PricewaterhouseCoopers and a professor at the Rotman
School of Management, suspects that eventually
regulators and doctors will begin filtering the thousands
of medical smartphone apps just as they do
pharmaceuticals, with doctors prescribing the most
reliable apps to their patients.
• “Your family doctor is going to have to have an opinion
on this, the same way they have an opinion on the drugs
you take, because devices are replacing drugs,” he says.
“But we’ve got to have some control over these apps. It’s
going to be an app pharmacy. Not an app store.”

23. Medical App Regulation
• FDA: “when a mobile app is doing the job of a medical
device that requires FDA clearance or approval, it’s only
logical that both should be governed by the same rules.”
March 21, 2013
http://blogs.fda.gov/fdavoice/index.php/2013/03/keeping-up-with-mobile-app-innovations/
• FDA will be issuing guidance:
• Limited to mobile apps that meet the definition of device
and are intended for use:
– to transform a mobile device into a medical device already
regulated by FDA
– as an accessory to a medical device already regulated by FDA

24. Discussion
• What are your favorite Apps?
• How do you currently use them in your practice?