Apps as Tools for Managing Health
Whether it’s counting calories, tracking training runs or managing a chronic disease, to use a tired phrase, “There’s an app for that.” Now more than ever people are using applications for smartphones and tablets to manage their health and fitness regimens.
Whether it’s counting calories, tracking training runs or managing a chronic disease, to use a tired phrase, “There’s an app for that.” Now more than ever people are using applications for smartphones and tablets to manage their health and fitness regimens.
Medical practices, hospitals and government health institutions are getting in on the act too, with mobile-optimized websites for phones or specially customized apps for their patients or the public. The level of sophistication ranges from basic location and contact information on some apps to comprehensive health information and interactive capabilities, such as appointment setting, on others. On the practice side, there are a host of apps that let a medical practitioner use a phone or tablet to read lab reports or scans and monitor a patient remotely. Many ask: what are the best apps to use personally and to recommend to patients?
“There’s a whole world of what you can do. I think we are just scratching the surface as far as what is possible,” said Samuel Park, president of Pathos Ethos, a web strategy company in Research Triangle Park, N.C., that designed an app for WakeMed Health & Hospitals, based in Raleigh, N.C. Park said the WakeMed app is “another touch point” for consumers to find locations for treatment, including turn-by-turn GPS directions from your current location, a doctor-finder feature searchable by location, specialty and even the type of insurance accepted. The app also lets you store a photo of your insurance card and health profile listing your current medications and connects to the hospital’s Twitter and Facebook feeds. Down the road, he said they may add emergency department wait times, along with other new features.
iTriage is one free app to consider for those emergency moments. As the name implies, iTriage helps users determine how serious a set of symptoms or a situation is, whether it needs immediate treatment and where to go for help.
“We don’t ever diagnose anybody. We provide people with information that helps them make decisions,” said Wayne Guerra, M.D., a practicing emergency physician and chief medical officer of Healthagen, in Lakewood, Colo. “All the content is written specifically for the mobile device. When you have something wrong with you, the last thing you want to do is get some information and there’s five pages to read.”
In classically mythical inventor style, Guerra, and partner, Peter Hudson, M.D., also an emergency physician and CEO of Healthagen, came up with the idea of iTriage – and literally drew it on a napkin – several years before the iPhone was introduced. Once the timing was right, they developed and began marketing iTriage.
Guerra uses the analogy of the telephone book white pages vs. yellow pages to explain both iTriage’s operation and business model. Location information is provided on as many as 500 emergency departments or urgent care centers nationwide, which can be important if the user is traveling. Organizations that want to enhance their listings with more detail can do so by buying advertising.
Another example of a new decision support app is the Concussion Recognition and Response App. Developed by Jason Mihalik, Ph.D., a specialist in exercise, sport science and head trauma at the University of North Carolina at Chapel Hill, and Gerry Gioia, Ph.D., a pediatric neuropsychologist, at Children’s National Medical Center in Washington, D.C., it helps athletic trainers and coaches recognize the sometimes subtle signs and symptoms of concussion and guides them through the next steps on the sidelines of a ball field.
Apps for Runners and Dieters
A quick check of popular apps reveals, first of all, there are almost too many to count and they vary widely in level of sophistication, which is a good thing. Depending on a person’s needs, they may want a simple calorie counter that does only that – add up the calories for food you’ve eaten in a day – but you have to already know how many calories there are in that tuna sandwich and bag of chips you had for lunch. Other calorie counters, like MyFitnessPal, let you pull up menus from restaurants and select the items to have it calculate your intake.
For runners, gmap-pedometer.com isn’t actually a phone app, per se, but a website, worth mentioning. Want to map out a training run of, say, five miles from your front door, or your hotel in an unfamiliar city? Zoom into the world map and find the location and see all the streets in the surrounding neighborhood. Place pins at the start and end points, find the exact route, distance and even calorie count for a given run.
Marcia Noyes, of Golden, Colo., swears by the RunKeeper app as she trains for marathons. RunKeeper uses the GPS feature built into the phone enabling a runner to track how far they’ve gone, how long it took, pacing, even heart rate monitoring, synchronize it to a website history and even share data with the runner’s community via Facebook and Twitter. Important to Noyes, the app also provides the data audibly through ear buds.
“I’ve found RunKeeper to be a Baby Boomers God-send! In my last marathon, I realized that I could no longer see my split times with my deteriorating near vision. When I found out about RunKeeper, I discovered that the technology was there for me to get everything right in my ear with regard to pace, mileage, times, etc.,” she said.
Noyes said she also often uses the LoseIt app as well, when she is focusing on weight loss, because “I love knowing how much I’m putting into my body and how much I’m exerting.”
Another popular app is MyFitnessPal, mentioned above, which claims to be “the easiest to use food diary on the web” with over 1 million food items listed in the database, including name brand groceries and restaurant items. Users can even upload their own recipes for calculating calories, tracking carbohydrates, fats, proteins, fiber, etc., and find support for popular diet plans, like Atkins, South Beach and Zone. It also contains over 350 exercises (both cardiovascular and strength training) and social media connections for finding and giving support to others in healthy living.
“I really am enjoying it because it is accessible, easy to use, has a variety of features that allow you to monitor your progress,” said Gayle Harris, director of the Durham County (N.C.) Public Health Department.
Apps for Credible Health Information
Besides tracking calories or miles run, sometimes what you need most is health information from a trusted source to answer questions, research conditions and help you determine next steps in your care when not in an emergency. Government health agencies, academic institutions and other private health enterprises in recent years have greatly enhanced all manner of their web-accessible health information and social media efforts. Here are a few things you can now do, or recommend to patients that they do, through a phone or tablet:
- Quit smoking with the help of the Smokefree QuitGuide app from the National Cancer Institute.
- Find information on seasonal flu, H1N1 flu, public health emergencies and more from the Centers for Disease Control and Prevention through its mobile website at m.cdc.gov.
- Manage Type 2 diabetes with the help of DiabetesManager, an FDA-approved app from WellDoc that was recently shown in a randomized controlled trial as effective in lowering patients’ A1C blood glucose levels. Results are published in the September issue of the American Diabetes Association’s journal Diabetes Care.
- Check symptoms, identify pills, search drugs, treatments and a host of health conditions at the free mobile version of WebMD.
In July, the FDA proposed guidelines for mobile health applications, and accepted public comments until October 19. One thing is certain, this whole area of using technology, particularly in terms of mobile phone applications, to manage health and fitness is only likely to grow. With increasing emphasis on prevention and self-management of chronic conditions in an atmosphere of cost containment, phone apps are no longer just for calculating how old you are in monkey years – though there really is an app for that.
From Med Monthly, Nov.3, 2011
