Health Apps Extend Care Beyond Practice Walls

A recent report by Berlin-based research2guidance, a mobile market research firm, indicates that 500 million smartphone users -- or more than one-third of all smartphone users -- will be using mobile health applications by 2015. According to the report, “Global Mobile Health Market Report 2010-2015,” both providers and consumers are embracing the technology.

“It’s clearly a growing market,” says David Edelson, MD, founder and medical director of Long Island, N.Y.-based HealthBridge. “Right now, [the mobile health app market] is probably filtering up from the younger generation, who are the big users of these smartphones,” he says. “But I see people in the senior citizen population starting to use them as well.”

Photographic Food Diaries

Edelson is the creator of Thin-cam, a mobile phone app that turns users’ phones into photographic food diaries. He says patients who maintain a detailed food log are not only more mindful of what they eat, but the information they compile is very useful to their physicians. The problem, however, is that patients often find it a chore to maintain a food log, and almost nobody carries around a pen and notepad any more. These days, though, almost everyone carries a smartphone.

“To me, it seemed like a natural bridge to provide something that could give that information not only quickly and easily, but also in a way much more accurately,” Edelson says. “You just snap a picture and all of a sudden it’s sitting there staring you in the face. Not only do you have to confront it later if you look at it, but if you bring it to your nutritionist or healthcare provider, they can give you a lot of very useful information about portion size, and about the quality of the foods you’re using.”

The Thin-cam app, which debuted in late summer 2010, is about to enter its second iteration -- providing consumers with the ability to link their photos to their Facebook and Twitter accounts as a way of developing community support for their nutritional and healthcare efforts. Phase 3, currently in development, will add geo-tracking capabilities to the app, enabling users to identify restaurants that offer healthy food options.

Reinforcing the Office-Visit Message

Suzanne Clough, MD, is the founder and chief medical officer of WellDoc Inc., a Baltimore, Md., developer of technology solutions to improve chronic-disease management outcomes. The firm’s FDA-approved DiabetesManager System, a mobile health system, enables healthcare providers to extend care beyond the traditional office visits using mobile phones, as well as the Internet.

So much of what happens with chronic disease is really about behavior change, behavior support, self-management, education and improving health literacy, Clough says. And these things cannot occur in three- or six-minute office visits, she says.

“These types of systems can actually help you enforce your treatment plan, such that when the patient walks out of the office they can use a solution like the DiabetesManager that will continuously reinforce that message you were hoping was heard during the clinic visit,” Clough says. “And in the world that we’re moving to with pay for performance, any patient who, whether directly or indirectly, is doing better because of your practice or a service your practice is offering, will only be beneficial to the physician.”

Empowering Patients to Improve Their Health

HealthBridge’s Edelson says that smartphones are the way people communicate and obtain their information today. “For physicians to ignore that … it’s kind of foolhardy to think you can continue to practice the way we did 20 years ago,” he says. “We have to start adopting these new technologies.”

Doing so, Edelson says, certainly comes with an upfront investment, but the residual benefits are undeniable. By sharing information at the office about how to manage chronic illnesses, and then using a mobile health app to reinforce the message and track those behaviors, it keeps people healthier, he says: “You’re actually proactively keeping them healthy, which makes your time more efficient.”

And, adds Clough, the use of mobile health apps makes patients more responsible for their own healthcare. “We as people ultimately are patients and have to take responsibility for our healthcare,” she says. “But we’re not trying to replace the physician. I want these applications and solutions to be thought of as synergistic to what your provider can do.” Inevitably, patients must learn how to manage their chronic illnesses to improve their own health, and mobile health apps are an effective way to do that.