The tension between being innovative and being pragmatic is a crucial issue in an industry where a person’s life could depend on the choice. Mobile applications in health care are seen as tools to track health but also as avenues for inaccurate self-diagnosis.
Doctors can be wary of apps if they fear that patients will not feel the need for office visits. The Internet has also enabled the spread of unreliable information in the gray area between the patient’s independence and the doctor’s expertise. Still, some apps are finding their way into physician offices.
Some 40,000 apps are used for health care, reports say. Resources like iMedicalApps help to inform practitioners about how best to incorporate mobile technology into a medical practice.
Genesis Pediatrics LLC in East Rochester recommends an app called Kids Doc Symptom Checker from healthychildren.org. The app helps parents identify a child’s symptoms to decide what steps are needed for care.
The reason Genesis Pediatrics decided to recommend the app was that it is approved by the American Academy of Pediatrics.
"This application, we felt confident recommending it because it is approved by the pediatric association. So we were recommending that if you’re going to look at anything, please look at something that the American Academy of Pediatrics actually approved," says Bridget Magar, practice manager at Genesis Pediatrics.
The app helps parents better understand ailments that their child might suffer. Each illness is described and listed with statistical data, along with suggestions on when to call the doctor, care advice and photos to explain the problem further. Genesis Pediatrics believes the app could be a useful tool for patients.
Other practices in Rochester are not as ready to adapt apps. Louis Papa M.D., a primary care physician at Olsan Medical Group, says that while new technology is available, it should be adopted gradually, not instantly relied upon.
"There’s just this assumption with a lot of technology that people are more interested in having information, and I think, more importantly, what’s their question?" Papa says. "I think a lot of patients have issues in health literacy despite all this stuff that we have."
Papa believes the only way to accurately apply an application is with education.
"Compliance with medication, compliance with appointments, getting blood work done-it still hasn’t moved much," Papa says. "The only thing that really moves that needle is when there is a more comprehensive approach toward the patient’s management with more outreach.
"I think the app, in and of itself, isn’t going to be useful unless there’s something that can help the health literacy to be addressed, and that’s where … the gold is in terms of improving health outcome."
In orthopedics, apps have not made their way into local practices. For Raymond Stefanich M.D., an orthopedic surgeon at the Orthopedics Association of Rochester, apps are not part of patient care.
"I guess I’d need to know what’s out there," Stefanich says. "I have to research every idea that I have before I commit to (it). We’re pretty progressive; we have most of the tools that we need, that everybody else has."
John Oats, director of Internet technology for Finger Lakes Health System, is a proponent of technological advances but warns that apps may create more confusion than clarity.
"There might be things out there for specific practices, but hospital-based stuff, not so much," Oats says. "I embrace technology. I’ve been doing this a long time, (but) there comes a point where people try to oversell technology for stuff that we can easily do ourselves."
The negatives of apps outweigh the good for most local practices.
"I think first and foremost we would be concerned about people getting medically accurate information," Magar says. "With children, I think people need that direct information. It’s not black and white, and we’ve all had personal experiences-either ourselves or in our family-where there’s something going on and it took one to two doctor’s visits to figure out what it was. A lot of us still have a hard time figuring out, is it the cold or is it the flu?"
Tracking patients through apps or new means of technology would help doctors to ensure that patients who have a hard time getting in to see their doctors are maintaining their health.
Informational functions that could be helpful in the practice of medicine would include transmitting blood pressure information or pill counts or checking blood sugar on a more regular basis for those hard-to-reach patients.
Papa says he sees value in "an expanding of telemedicine to get these patients that have limited access or limited support, so we can make sure that they’re getting the care they need."
"It’s just a mere slice of time that we get that we see the patients-you know, a couple of times a year. The rest of the time they are out there in the real world and we don’t know what they are doing or how they are doing."
A tracking app to combat child obesity would be a way for tech-savvy young people to take ownership of their health.
"I love the idea of the tracking apps," Magar says. "The Weight Watchers (app) is wonderful, but I’d love to see something that was really for kids and for teenagers that was more about exercise, so that you’re tracking how active you were in conjunction with tracking the types of food that you were eating. … They are not going to play a game or something about their immunizations; that’s just not any fun. "
Oats believes new apps would be most beneficial to medical practitioners and not their patients.
"The apps and the stuff that are working with electronic records are more for the clinicians than they are for the patient," he says.
Those who would use the apps for their smartphones are likely not the people who need much medical care, he says.
"The problem is the assumption that because the technology is there that everybody is going to use it, and that’s not true," Oats says. "Unfortunately, the people that typically use the technology are the ones we don’t need to follow so much. They are a little bit more engaged; they have been more interested in health.
"I think the entrenched patients that have a lot of medical issues are probably not going to be able to use or willing to use or savvy enough to use these apps to really help them. I think it remains to be seen if it really helps the general health of the community."
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