Transcript FetscherSIPosterWeek10x

The Clinical Relevance of Smartphone Applications
in Medicine and Audiology
Elizabeth Fetscher & Dr. Ann Perreau
CSD 470, Senior Inquiry, Fall 2016
Summary of Findings (cont.)
Background
Summary of Findings
The invention of the smartphone has changed the way
billions of people operate in day-to-day life as well as in the
workplace. Smartphones, by definition, are the mobile
phones that have similar capabilities as computers,
including Internet access (Medical Apps for Smartphones,
2010). Smartphones users can download programs (such
as from the Apple App Store) to use apps on their devices
(Medical Apps for Smartphones, 2010). Today, the App
Store offers millions of applications, or “apps” that
consumers can use in a variety of ways.
Physicians use mobile phone apps as a method of
teaching, for collecting data, for record keeping, and for
assessing and treating patients. Apps also allow patients to
monitor their own health status.
Paglialonga et al. (2015) categorized apps based on their clinical use to the field of
audiology. This framework has been adapted to categorize apps in the medical field.
In audiology, an emergence of apps has also been
observed in recent years. For example, there are many
apps available to screen and diagnose a hearing loss.
However, there are more apps available for the
intervention and rehabilitation of hearing loss compared to
the other application: screening & assessment, assistive
tools, and education & information (Palialonga, Tognola,
Pinciroli, 2015).
Figure 1: Categorization of Apps for Medicine
Screening & Assessment
Intervention & Rehabilitation
• OneMinuteUltrasound
• Performs ultrasounds
• Diagnosaurus ddx
• Aids in diagnosis
• GluCoMo
• Helps patient track glucose levels
• ihealth myvitals
• Helps patient track vitals
Apps used in Medicine
Assistive Tools
Education & Information
• Epocrates
• Aids in prescribing medicine and dosages
• MedCalc
• Calculates dosages of medications
• CDC Health Information for International Travel
• Provides information about medications and
vaccinations recommended to travel abroad
(adapted from Paglialonga, Tognola, Pinciroli (2015))
Physicians tend to use assistive tools apps more often than others apps. Epocrates is the most popular app used by
physicians. It is an app that helps prescribe medications and assign dosages. Patients use apps that serve for
intervention & rehabilitation to monitor health status. Education & Information apps often disclose important
information about medical issues that patients need to be aware of.
Figure 2: Categorization of Apps for Audiology
With the rise in usage of apps in the medical and audiology
fields, reviews of their effectiveness and studies of their
safety for patients are needed.
Purpose
Therefore, the purpose of this study was to investigate the
usefulness and clinical relevance of smartphone apps in
the medical and hearing fields.
Specifically, we will:
a) evaluate the effectiveness of apps available in the
healthcare field
a) explore the apps that are available for the diagnosis and
treatment of hearing loss and their overall effectiveness
a) determine any limitations and risks associated with
smartphone apps in the medical fields
Screening & Assessment
Intervention & Rehabilitation
• AudCal
• Pure-tone audiometry
• EarTrumpet
• Pure-tone audiometry, sound amplification
• CellScope
• Otoscopy
• Phonak Tinnitus Balance App
• Tinnitus masking
• Ear Machine
• Sound amplification
Apps used in Audiology
Assistive Tools
Education & Information
• ASL Coach
• ASL learning tool
• The ASL App
• ASL reference app
• Sound Level Meters
• Calculate loudness levels of surrounding environment
With regard to the limitations and risks of smartphone apps,
there are security and safety concerns that should be
reviewed. Huckvale et al. (2015) reported that approximately
half a billion smartphone users (including both physicians and
patients) use a health or wellness app, a number that is
expected to increase within the next three years. With the
limited safety standards in place, excluding security measures,
apps have the potential to cause serious medical errors
(Buijink, Visser & Marshall, 2013).
The FDA and HIPAA created their own set of regulations to
monitor medical apps. However, there are gaps in the
legislation that can disrupt the protection of health-related
app users (Flaherty, 2015). The FDA can only regulate apps
that “constitute medical devices and/or pose significant risks
to patients” (Flaherty, 2015). Smartphone apps are exempt
from HIPAA compliance rules, according to HIPAA, the only
medical information that must be concealed are “covered
entities” that include health plans, healthcare clearinghouses
(used for billing), and healthcare providers who transmit
health information in electronic form (Flaherty, 2015).
Conclusion
To dispute the overall skepticism that many professionals have
towards apps, more research is needed. Multiple studies
examining the effectiveness of apps need to be done to ensure
accuracy. Further guidelines need to be put in place to also
ensure the safety and security of patients who use the apps.
Technological advances have the ability to expand the clinical
relevance and effectiveness of smartphone apps and medical
professionals need to be accepting of possible changes in
medicine and audiology.
References
Buijink, A. G., Visser, B. J., & Marshall, L. (2013). Medical apps for smartphones: lack of evidence undermines quality and
Evidence Based Medicine, 18(3), 90-92.
safety.
Huckvale, K., Prieto, J. T., Tilney, M., Benghozi, P., & Car, J. (2015). Unaddressed privacy risks in accredited health and
wellness apps: a cross-sectional systematic assessment. BMC Medicine, 13(1), 1-13.
(adapted from Paglialonga, Tognola, Pinciroli (2015))
AudCal and EarTrumpet are apps that perform audiometric testing, they have yield similar results to traditional
audiometric testing. Apps in intervention & rehabilitation are most beneficial to patients, they have a variety of
roles such as tinnitus masking and sound amplification. Assistive Tools such as ASL Coach and The ASL App are
helpful for users who communicate with individuals with hearing loss. Sound level Meter app are also used to
however studies Nast, Speer & Le Prell (2014) found that they are not as accurate as traditional methods and
should only be used recreationally
Larrosa, F., Rama-Lopez, J., Benitez, J., Morales, J. M., Martinez, A., Alañon, M. A., & ... Rey Martinez, J. (2015).
evaluation of an audiology app for iPhone/iPad mobile devices, Acta Oto-Laryngologica, 135(11), 1119-1127.
Development and
Medical Apps for Smartphones. (2010). Telemedicine & e-Health, 16(1), 17-22.
Nast, D. R., Speer, W. S., & Le Prell, C. G. (2014). Sound level measurements using smartphone 'apps': Useful or
& Health, 16(72), 251-256.
inaccurate?. Noise
Paglialonga, A; Tognola, G; Pinciroli, F. Apps for hearing science and care, American Journal of Audiology. 24, 3, 293-298,
2015.
Sept.
Vashist SK, Schneider EM, & Luong JH. (2014). Commercial smartphone-based devices and smart applications for personalized
healthcare monitoring and management. Diagnostics (Basel, Switzerland), 4(3), 104-28.
Wunderlich, R., Stein, A., Engell, A., Lau, P., Waasem, L., Shaykevich, A., & ... Pantev, C. (2015). Evaluation of iPod-based
automated tinnitus pitch matching. Journal Of The American Academy Of Audiology, 26(2), 205-212.
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