Mobile Devices and Apps for Health Care Professionals: Uses and Benefits

How HCPs Use Mobile Devices and Apps

Health care professionals use medical devices and apps for many purposes, most of which can be grouped under five broad categories: administration, health record maintenance and access, communications and consulting, reference and information gathering, and medical education. The many uses for mobile devices and types of medical apps that fall under these categories are discussed in the following section, and are also listed in Tables 1 and ​and22.

Information and Time Management

One of HCPs’ most frequent uses for mobile devices is information and time management.¹ Popular information management apps, such as Evernote and Notability, enable users to write or dictate notes, record audio, store photographs, and organize material into categories within a searchable electronic database.⁶ E-book reader apps, such as GoodReader and iAnnotate, allow users to view, underline, highlight, enlarge, and annotate text in PDF files.^2,5

Cloud-based storage and file-sharing services that can be accessed using a mobile device are also useful for information management, since they allow users to store, update, and share documents or photographs with others without exchanging a flash drive or CD.^2,5,6 Most cloud-based storage systems provide users with a few gigabytes of memory for free; additional space often requires payment of an annual subscription.² Cloud-based information storage provides the additional advantage of permitting information to be accessed instantaneously from multiple devices, which allows people who are collaborating together to share materials quickly.^2,5,6

Dropbox is a popular cloud-based storage service that can be used with multiple devices.^2,5 Google Drive also allows file uploading, sharing, and management through Google Docs.^2,5 SkyDrive, a cloud-based storage service that is compatible with mobile devices, uses the Windows 8 operating system.⁵ Box is a cloud-based storage service that is reportedly compliant with both the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act.¹⁹ However, it should be noted that some cloud-based storage services are not compliant, and therefore may not be suitable for storing or exchanging patient information.² Access to cloud-based storage services requires an Internet connection, but files can be saved to the mobile device’s internal memory for offline use.⁵

An additional advantage provided by information management apps is that they can be used in combination. For example, GoodReader can be connected to a cloud service, allowing PDF files to be downloaded from the cloud into the reader app.⁵ Evernote, as well as some other information management apps, can be used in conjunction with a cloud service and reader.⁵ This enables a PDF downloaded from the cloud to be viewed with a reader, then sections of the document can be cut and pasted into the information management app.⁵

HCPs frequently use mobile device apps for time management. This doesn’t require a special app; native apps that come installed on mobile devices are often sufficient to organize and track appointments, meetings, call schedules, and other clinical obligations.^1,3 Mobile apps such as ZocDoc, which allow patients to view information about and make appointments with participating doctors, are also available for the iPhone, Android, and Blackberry devices.⁴

Health Record Maintenance and Access

Apps are also available that aid in data collection and retrieval, such as entering information into a patient’s EHR or EMR.^3,7 Hospital information systems often include features that allow HCP management of EHRs and PACSs, permitting secure access to patient information (medical history, vitals, prescriptions, lab results, x-rays, scans, consultations, and discharge notes) either on site or remotely.^3,7

One health care software company, Epic Systems, has partnered with Apple and released versions of the Epic scheduling, billing, and clinical support app for the iPhone and iPad.⁴ PatientKeeper Mobile Clinical Results provides physicians with access to patient clinical data via either Apple or Android mobile devices.⁷ Teamviewer is a general-purpose record maintenance and access app that can be installed on mobile devices, allowing remote access to desktop PCs.⁵ In the absence of such apps, a virtual private network (VPN) log-in can often be obtained from the hospital to allow remote secure access into the in-house network through the Internet to view records for emergency consultations.⁵

Specialized apps are also available for remote viewing of medical imaging scans.¹⁰ Mobile MIM is a free app for the iPad and iPhone, approved by the Food and Drug Administration, that allows remote viewing of x-rays and imaging scans when users cannot access imaging workstations.⁶ This software works with a paid subscription or pay-per-use plan using MIMCloud, a HIPAA-compliant server that allows users to store and share medical images.⁶ Images can be downloaded from the cloud and viewed with the MIMViewer paid app in any setting, whether during discussions with team members or patients.⁶

In some instances remote evaluation of image scans via a medical device has been proven to be just as effective as viewing them at a standard workstation.⁴ In fact, one group demonstrated that its members could use their iPhones to diagnose acute stroke on CT brain scans just as accurately as when a workstation was used.⁴ Mobile devices’ cameras are also useful for documenting images to aid in diagnoses, such as taking pictures of gross or microscopic pathology specimens to get a colleague’s opinion or for personal reference.³

Communication and Consulting

Health care systems are often highly dispersed, encompassing multiple locations such as clinics, inpatient wards, outpatient services, emergency departments, operating theaters, intensive care units, and labs.⁷ Consequently, HCPs not only need to be mobile themselves, they also need to be able to communicate and collaborate with people in different locations.⁷ Mobile devices satisfy this need by offering multiple means of communication, including: voice and video calling; text, e-mail, and multimedia messaging; and video conferencing.^3,7 Clinical communication apps are available for mobile devices that are specifically designed to simplify communication among clinicians.⁷

Mobile devices have been proven to improve contact between HCPs and their colleagues.^1,4 In one study, mobile devices were shown to improve communication between doctors and nurses on inpatient wards.⁴ In a survey of medical school HCPs and students, more than 80% of respondents described using mobile devices to communicate with colleagues about patient care via e-mail, telephone, and text messages.¹ They described texting as a more efficient means of communication than telephone conversations or in-person meetings.¹ Mobile devices also allow rapid response to e-mail, allowing users to keep up with communication.¹ Texting or calling colleagues directly on their mobile devices, rather than paging them, has also been shown to save critical time in emergency cases.^3,7 Mobile devices can also be used by HCPs to aid long-distance patients by allowing them to text or send pictures regarding problems or questions.³

Social networking apps are useful tools for enabling discussion, consultations, and collaboration among HCPs.⁵ Doximity is a HIPAA-compliant social networking site that has been described as a “Facebook for doctors.”⁴ Registration on Doximity requires validation of a potential user’s credentials through verification against a medical license database.⁴ Once registered, physicians can network with colleagues from medical school, residency, or elsewhere, and exchange patient-related information via text messages.⁴ Facebook itself has also reportedly been used to establish a “nondisclosed” forum for consultations, discussions, and mini-lectures among infectious disease specialists who are registered university professors.⁵ Such forums can provide a convenient and efficient means for medical specialists to rapidly and efficiently share opinions.⁵ Chatting apps that allow text messaging and image exchange can be used to trade detailed information during consultations.⁵ It should be noted that Facebook, as well as many other social media and chatting apps, is not HIPAA compliant.⁵

Reference and Information Gathering

Patient Management

Convenience

Many mobile apps have made the practice of evidence-based medicine at the point of care more convenient.^7,14 Health care professionals associate numerous conveniences with using a mobile device in clinical practice, such as: portability, rapid access to information and multimedia resources, flexible communications, and a choice of powerful apps to accomplish many different purposes.^1,12 Medical school HCPs and students cite access to information instantaneously at the time of need as a major convenience.¹ Other studies describe keeping current through access to updates about new books, guidelines, reviews, and medical literature as an appreciated convenience.¹⁰ Health care students also no longer have to carry reference books, since many can now be accessed with a mobile device.⁶ Consequently, students can carry all of the information found in standard medical textbooks and other necessary references in one small device that fits in a lab-coat pocket.⁹

Better Clinical Decision-Making

Many medical apps make mobile devices invaluable tools that support clinical decision-making at the point of care.^7,10 This quality is very important when practicing evidence-based medicine, since clinicians may not always seek answers to clinical questions after the completion of every clinical encounter.^2,7,10 Practicing clinicians, as well as medical and nursing students, cite the most useful mobile tools for supporting evidence-based medicine and clinical decision-making as being drug reference, medical textbook, disease diagnosis, and medical calculator apps.⁷ The use of mobile devices can also support better decision-making by pharmacists by providing instant access to multiple drug information sources and other medical references.²

Studies have reported an increase in the appropriateness of diagnoses and treatment decisions when mobile devices were used for clinical decision support, particularly when a CDSS app was used.⁸ Data have shown that when electronic references were consulted, there were twice as many adjustments in patient management decisions compared to cases in which only paper resources were available.¹⁰ Another study tested participants’ understanding of prescribing accuracy and found that the use of a mobile device improved drug knowledge and understanding to a statistically significant level (P = 0.005).⁸ Similarly, a risk assessment study evaluated the occurrence of gastrointestinal side effects with nonsteroidal anti-inflammatory drugs and found that unsafe prescribing was significantly reduced (P = 0.001) in the group of HCPs that used a mobile device app compared with a control group.^8,10

Improved Accuracy

Mobile devices have repeatedly been found to improve the completeness and accuracy of patient documentation, an effect that has often been attributed to ease of use.^2,8,10,15 More accurate diagnostic coding, more frequent documentation of side effects, and increased medication safety through reduced medical errors have been reported.¹⁰ Based on a more detailed description of clinical findings and a correct progress assessment, documentation prepared using a mobile device was judged to be of higher quality than documentation prepared using paper records.¹⁰ Inclusion of specific intervention rules on a mobile device has been found to significantly reduce prescription error rates (P < 0.05).¹⁰ Use of a mobile device significantly reduced discharge order list errors (from 22% to 8%, P < 0.05) and yielded fewer discrepancies in recording neonatal patient weights in intensive care compared to using paper records.¹⁰ Timely communication within hospitals has also been determined to reduce medical errors, especially in critical care environments.⁷

Increased Efficiency

Evidence has shown that mobile devices allow HCPs to be more efficient in their work practices.^3,10 The Deloitte Center for Health Solutions 2013 Survey of U.S. Physicians found that most doctors believe that meaningful adoption of health information technology (EHRs, e-prescribing, health information exchange, analytics/decision support, patient support tools [websites, mobile apps, tools to track and manage health and wellness], and mobile health technologies [ tablets, smartphones]) can improve the efficiency of clinical practice.²¹

The use of mobile devices has been shown to provide HCPs with numerous enhanced efficiencies, including: increased quality of patient documentation through fewer errors and more complete records, more rapid access to new information, and improved workflow patterns.¹⁰ Physicians have reported that the use of a mobile device for retrieving information from a drug database led to more efficient decision-making and patient care.¹⁰ Physicians working in health care organizations have cited improved care coordination, as well as quicker and more efficient access to clinical support resources (guidelines, lab tests, and reports) as principal benefits associated with mobile device use.¹⁰ Physicians who used mobile devices during patient rounds reported spending less time accessing, retrieving, and recording data and said that the increased efficiency freed up more time for direct patient care.¹⁰ In contrast, another study found that the increased efficiency in median doctor–patient encounter time (227 vs. 301 seconds) provided by the use of mobile devices, rather than paper resources, resulted in less time spent with the patient.¹⁰