Open Access

An overview of clinically and healthcare related apps in Google and Apple app stores: connecting patients, drugs, and clinicians

  • Samuel Ken-En Gan1, 2Email author,
  • Cornelius Koshy1,
  • Phi-Vu Nguyen1 and
  • Yu-Xuan Haw1
Scientific Phone Apps and Mobile Devices20162:8

https://doi.org/10.1186/s41070-016-0012-7

Received: 18 February 2016

Accepted: 6 June 2016

Published: 19 July 2016

Abstract

Successful clinical outcomes involve both clinician and patient factors such as good decision making, accurate diagnosis, patient compliance, effective monitoring of the condition, and accurate interpretation of clinical results. With a general trend in healthcare towards personalized medicine, the smartphone holds great potential to play a role in personalized care and aid in the above mentioned factors. Through the use of apps, the increasingly powerful smartphone may be a useful aid in the healthcare and clinical industries. This review surveys the currently available apps in Google and Apple app stores that are purposed for aiding healthcare and clinical use, and discusses how they may also help transform the smartphone in a medically relevant device.

Introduction

In ancient times, physicians made house visits to the sick, often administering medical attention within the comforts of the patient’s home. Although house-visits do continue to exist today, they are more common in smaller towns or village communities and the very affluent in cities. In the developed world, there is a trend of reversal in the mode of medical care of our forefathers: from doctors attending to patients in their homes, to patients consulting doctors in hospitals.

Such changes have risen out of the necessity for efficiency and improved healthcare. In a hospital/clinic, the concentration of medical expertise, equipment and sanitized environment improves the quality of healthcare over house-visits. Nonetheless, both models of consultation have their own disadvantages. In house visits, the physician’s travelling time slows down the immediacy of care and compromises diagnostic accuracy without the necessary medical equipment (e.g. X-Ray machine). On the other hand, we have the very real problem of long patient waiting hours just for a few minutes of consultation or the collection of test results.

Regardless of the consultation model, today’s world offers a solution which overcomes the flaws of each model: the smartphone. With the advancement and incorporation of technology into healthcare, it might be possible to do away with physical visits, especially with video or other imaging technology through smartphones. Patients can get a quick consultation or access their test results with accompanying clinical comments easily. If advanced equipment are required, there might be possibility to leverage on smartphone sensors as simple medical equipment (e.g. microphone as a stethoscope), turning the smartphone into a multi-purpose mobile medical equipment that can be used by both patients and clincians.

Nonetheless, when dealing with clinical procedures, accuracy and precision outweighs convenience and time. With the growth of technology in medical diagnostics (e.g. electronic ECG, electronic X-Ray), accuracy and efficiency are not necessarily mutually exclusive. Thus, there is potential for the use of apps and wirelessly connected peripheral added sensors to enable the smartphone to change the workings of the healthcare industry.

In spite of this potential and the pockets of activity towards this cause, there is a dearth of literature covering the already available clinical aid apps that both the patient and the clinician can leverage on. To address this, this review discusses the currently available clinically and medically relevant apps and how they might be incorporated into practice for better outcomes.

The future of mobile apps

Efficiency is one of pursuits of excellent healthcare especially in today’s growing demands of ageing populations in many developed societies. Incorporating mobile apps with internet connectivity into routine medical processes (e.g. consultations) enhances the convenience for both doctors and patients alike. In the common problem of long waiting times, registration and appointments can be booked using mobile apps without long queues for the receptionist. Similarly, medical results or clinically relevant pictures taken by patients can be sent through secured apps to physicians and specialists for consultations without the physical transfer of document between hospital departments. With increased efficiency in consultations and diagnosis, patients can be treated earlier, thereby improving prognosis. It might even be possible to do away with face to face outpatient consultations or routine follow-up through the use of apps. Patients can receive professional consultation through apps in the comfort of their homes, a scenario that is especially beneficial for elderly patients or those with high dependency to getting around.

Displacing medical equipment for lower healthcare costs

The rising costs of healthcare, contributed by the increasing costs of skilled personnel, medical equipment and infrastructure, poses a challenge to accessible healthcare to the less privileged in society. On this problem, the smartphone might help to reduce costs by displacing expensive medical equipment with clinical mobile apps that leverage on the many sensors in smartphones. One such example is the displacement of a heart rate monitor (costing between USD$70 - $150) with a free heart rate monitor app that functions via the in-built microphone or camera. Coupled with internet connectivity, one can even easily send results to clinicians, a feature that most current medical equipment lack. Should artificial intelligence be incorporated, these apps may further aid in diagnosis by detecting abnormalities.

Patient compliance

Patient compliance to clinical advice and care is essential for successful clinical outcomes (Martin et al. 2005). The most effective treatment regimens would be rendered ineffective if patients failed to comply. This is particularly true for chronic diseases where patient compliance directly affects disease control. On this aspect, mobile apps that monitor patient conditions and sends reminders of treatment would certainly be a boon for chronic disease management. This is especially so if clinicians can use such apps to monitor disease/symptoms for diagnosis and adjustment of treatment methods.

Clinical mobile apps

In view of the potential for mobile apps in the abovementioned areas, we did a survey of apps in the Google and Apple app stores using key words: “patient info management”, “patient health monitor”, “eye diagnosis”, “skin diagnosis”, “blood pressure”, “heart beat rate”, “medical calculator” and “patient compliance”. As of early 2016, we found over 1121 and 536 apps in Google Play Store and Apple App Store, respectively. Only about 139 apps of these were directly relevant to practical uses for healthcare. Of these, 30 apps were for patient data management and communication; 44 apps for patient health monitoring; 36 apps for clinical diagnosis; 21 apps for medical calculations; and 7 apps for patient compliance. Within these, we further classified them into nine categories based on their functions.

The various categories of apps relevant to healthcare and medical purposes

Clinical care communication [Table 1]

Table 1

Clinical apps classified in ‘communication’ (as of Jan 2016)

App name

OS

Description

App type

Hardware

DrBridge

Android

Helps doctors to follow up with patients and deliver care plans through text messaging, email and app-to-app interactions

Hybrid

None

Drchrono EHR/EMR

iOS

Allows doctors to communicate with their patients

Hybrid

None

GatherPro

Android

Allows doctors to communicate with their patients

Hybrid

None

- Patient Portal by ConstantMD

 

Allows doctors to communicate with their patients

  

HealthJump

iOS

Communicates with doctors to schedule appointments

Hybrid

None

Medical & Health Records Caddy

Android & iOS

Manages and share patient list as well as patient tasks, notes, medications, records, images, and messages.

Hybrid

None

Message patient management

iOS

Organises patient and treatment sessions

Hybrid

None

MedBooking

iOS

Allows patients to book their appointments

Hybrid

None

Practo Ray

iOS

Calls Patients for appointments

Hybrid

None

SirenMD

iOS

Sends messages, medical records and photos between health professionals

Hybrid

None

In healthcare, timely communication between a patient and doctor enables the former to get medical advice and the latter to keep track of the patient condition and intervene when necessary. A range of clinical communication apps have been developed to facilitate better communication between patients and clinicians. One notable example of such apps is ‘HealthJump’ (Healthjump Inc 2015) which not only allows patients to schedule their appointments with their doctors, but also provides medical records securely.

Patient data management [Table 2]

Table 2

Clinical apps classified in ‘patient data management’ (as of Jan 2016)

App name

OS

Description

App type

Hardware

Clinic On Go - My Patients

Android

Manages patient information and appointments

Hybrid

None

Doctors Aid - OPD Management

- Doctor Assist

- Doctor Assistant

- My patients

- Patient Doctor Records

Android

Manages and stores patients’ health and medical records

Native

None

Doctor Buddy – Patients Manager

HouseOfficer

Lybrate For Doctors

iOS

Manages and stores patient info for Doctors

Manages and store patient info for Doctors

Manages and store patient info for Doctors

Native

None

Hospital Rounds Management

iOS

Stores patient details, diagnosis and billing codes

Native

None

iGrade for psych

iOS

Manages patient info for psychotherapists

Native

None

MDclick for Physicians

iOS

Shares patient info with other health professionals

Hybrid

None

MedicoSA

Android

Enables Physicians to access patient appointments, patient history, and write e-prescriptions

Hybrid

None

OPD MANAGEMENT

Android

Stores information such as Patient History, Patient Diagnosis, and Prescription

Native

None

Patient History Taker

Android

Database app for medical history for patients

Native

None

Practice Management

Android

An application that helps record data of patient

Hybrid

None

Patient Management System

Android

Manages the patient’s medical record and able to standardize diagnosis and action.

Native

None

Patient List

iOS

Keeps track on patients’ info

Hybrid

None

Prescapp - Doctors

iOS

Manages and stores patient info

Native

None

Patient data management is tantamount for accurate diagnosis/disease management and has to be secured to ensure patient confidentiality. Incomplete or missing reports can result in the loss of crucial information that could have serious clinical consequences (e.g. drug allergies). Apps in this area facilitate the viewing, storage and management of patient data without the spatial constraints of desk-bound medical computer systems. ‘My Patients’ (Evgeny 2015) and ‘Patient Reports Doctor ON GO-T’ (Siyami Apps 2015) are example apps that allow the clinicians to view patients’ medical history, diagnosis and prescription on the go. Such apps make clinical rounds in the ward or house visits much more convenient, doing away with bulky files and folders.

Besides secured data transmission and data encryption necessary for patient confidentiality, there are other limitations for such apps. One such limitation is the accessibility of file formats where certain medical equipment may store data (e.g. X-Ray, ECG printouts etc.) in specific file formats not easily accessed on the apps. It is also questionable if the small screen of these mobile devices would allow sufficient analysis of important test results (e.g. small abnormalities in X-Rays). Although difficult viewing conditions may increase human errors, this can be mitigated with image processing algorithms that perform automated diagnostic parameters to detect anomalies.

Patient health monitors and trackers [Tables 3, 4, 5, 6, 7, 8, 9, 10 and 11]

Table 3

Clinical apps classified in ‘patient health monitors and trackers’ (general health) (as of Jan 2016)

App name

OS

Description

App type

Hardware

Cure companion

Android

Keeps track of patients’ health records

Hybrid

None

Data Manager for Fitbit

iOS

Track health related data such as weight, sleep and body fat

Native

None

HealthTouch

iOS

Records and tracks key health stats

Native

None

iThermonitor

iOS

Monitors the body temperature

Native

None

Table 4

Clinical apps classified in ‘patient health monitors and trackers’ (heart rate) (as of Jan 2016)

App Name

OS

Description

App type

Hardware

Cardiograph pro

Android

Saves patient’s daily Blood Pressure and Heart Rate

Native

None

Heart Rate monitor

iOS

Tracks and records heart rate

Native

None

PulsePRO

iOS

Monitors patient heart rate

Hybrid

None

Table 5

Clinical apps classified in ‘patient health monitors and tracker’ (blood pressure) (as of Jan 2016)

App Name

OS

Description

App type

Hardware

Acc. Blood pressure

Android

Keeps track on blood pressure measurements

Native

None

Best Blood Pressure Monitor

iOS

Tracks and automatically collect blood pressure measurements via bluetooth

Native

Tonometer

Blood Pressure

iOS

Manages and track blood pressure progress

Native

None

Blood Pressure (BP) Watch

Android

Collect, track, analyze and share your blood pressure record

Native

None

Blood Pressure Companion

iOS

Tracks Blood pressure, weight and heart health

Native

None

Blood pressure diary

Android

Keeps track on blood pressure records

Native

None

Blood pressure monitor pro

Android & iOS

Keeps track on blood pressure records

Native

None

Blood Pressure log diary

Android

Keeps track on blood pressure records

Native

None

Blood Pressure Tracker

Android

Tracker of Patients’ blood pressure records

Hybrid

None

Blood Pressure PRO

Android

Collect and analyze blood pressure measurements

Native

None

Blood Pressure lite

Android & iOS

helps keep track of blood pressure and weight

Native

None

Blood Pressure + Pulse Grapher lite

iOS

Records blood pressure and pulse rate measurements

Native

None

Bloody Pressure

iOS

Record, track and share blood pressure measurements.

Native

None

HeartStar Blood Pressure Monitor

iOS

Monitors blood pressure and automatically records via bluetooth

Native

none

My Blood Pressure

Android

Records blood pressure measurements taken

Native

None

Table 6

Clinical apps classified in ‘patient health monitors and trackers’ (skin conditions) (as of Jan 2016)

App name

OS

Description

App type

Hardware

FotoSkin

Android & iOS

Tracks photos of patient’s skin for easy diagnosis of skin cancer for dermatologist.

Hybrid

Camera

Skin Tagger

iOS

Tracks photos of skin pictures

Hybrid

Camera

Table 7

Clinical apps classified in ‘patient health monitors and trackers’ (eye conditions) (as of Jan 2016)

App name

OS

Description

App type

Hardware

Paxos checkup

iOS

Allows patients to monitor their vision and physicians to keep track

Hybrid

None

Table 8

Clinical apps classified in ‘patient health monitors and trackers’ (blood constituent levels) (as of Jan 2016)

App name

OS

Description

App type

Hardware

Calcium Pro

Android

Tracks and monitors the blood calcium,vitamin D levels of Patient for osteoporosis

Native

None

Glucose Buddy : Diabetes Log

Android

Manages Diabetes by tracking glucose levels

Native

None

Glucose Monitor

iOS

Tracks glucose level and weight

Native

None

Iron Tracker – Hemochromatosis

Android

Allows patients to track and monitor their iron levels

Native

None

One Drop

iOS

Manages Diabetes by tracking glucose levels

Native

None

Table 9

Clinical apps classified in ‘patient health monitors and trackers’ (female menstrual cycle) (as of Jan 2016)

App name

OS

Description

App type

Hardware

Eva Diary

iOS

Tracks patients’ period cycles and ovulation

Native

None

Period Tracker

Android

Helps keep track on menstrual cycle

Native

None

iObstetrics Pro

Android

A tool to allow specialists to monitor and synchronise the progress of every patient’s pregnancy from their Pc, SmartPhone or Tablet.

Hybrid

None

Table 10

Clinical apps classified in ‘patient health monitors and trackers’ (versatile health management) (as of Jan 2016)

App name

OS

Description

App type

Hardware

BloodPressureDB

Android & iOS

Track, monitor and store your blood pressure along with your pulse, blood sugar and BMI

Hybrid

None

BP Wiz

iOS

Tracks Blood pressure, weight and heart health. It also tracks medication

Native

None

Diabetes Manager

iOS

Tracks Blood glucose, blood pressure, weight and etc.

Native

None

Health Tracker & Manager

iOS

Tracks blood glucose and pressure levels

Native

None

Heart Wise Blood Pressure Tracker

iOS

Tracks Blood pressure, weight and heart rate

Native

None

Qardio Heart Health, Weight and Blood Pressure Monitor

iOS

Tracks Blood pressure, weight and heart health

Native

None

Table 11

Clinical apps classified in ‘patient health monitors and trackers’ (disease, pain and injury) (as of Jan 2016)

App name

OS

Description

App type

Hardware

FIND TB

Android

Supports clinicians in making decisions on the diagnosis and treatment of TB.

Native

Camera

Managing My Hepatitis C

iOS

Monitors patients’ health condition on Hepatitis

Native

None

Mobile REMM

Android & iOS

For clinical diagnosis and treatment of radiation injury during radiological and nuclear emergencies.

Native

None

Pain Stethoscope

Android

Assess and graph patient-reported outcomes of chronic pain management over time.

Native

None

Apps in this category facilitate the recording and monitoring of disease conditions after diagnosis. In the example of hypertension, ambulatory monitoring may enable better diagnosis (Gan et al. 2003) as compared to readings taken at clinics that may be confounded by psychosomatic fear. Some apps in this category can do more to make a comparison analysis with previous data and alert the user of significant fluctuations in the condition. ‘Blood Pressure Diary’ (FRUCT 2016) and ‘PulsePRO’ (Cocoalena Software 2015) are examples of such apps that record, analyse and send the clinical measurements to attending physicians without the need of an ambulatory machine (typically costing up to hundreds of dollars). With a wide range of types and functions, other apps are also made to track patient’s general health, skin problems, eye problems, blood parameters, menstrual cycles and the presence of diseases. With such monitors and trackers, behavioural changes that improve eating habits and physical activity levels have been observed in young adults. Thus such monitoring apps do encourage patients to be more aware of their daily condition (Higgins 2015).

Heart rate measurement [Table 12]

Table 12

Clinical apps classified in ‘heart rate measurement’ (as of Jan 2016)

App name

OS

Description

App type

Hardware

Cardiometer ANT+ Heart Rate

Android

Measures and monitors heart rate

Native

Heart rate Chest Straps

Cardiograph Heart Rate Monitor

Android & iOS

Measures and monitors heart rate

Native

Camera with Flash

Heart Beat Rate

Android

An application to measure heart rate

Native

Camera with Flash

Heart Rate Plus LITE

iOS

Measures and monitors patients’ heart rate

Native

Camera with Flash

Heart Rate Monitor

Android

Measures heart rate via placing your index finger on the phone’s camera len

Native

Camera with Flash

Heart Rate Monitor Ant+

Android

Measures and monitors heart rate

Native

Heart rate Chest Straps

Medtimer

iOS

Measure the time for each heart beat or breath to calculate heart rate

Native

None

iStethoscope Pro

iOS

Records heart beat and showing heart waveform for practioners.

Native

Camera with Flash

Instant Heart Rate

Android & iOS

Measures heart rate via placing your index finger on the phone’s camera len

Native

Camera with Flash

Runtastic Heart Rate Monitor

Android & iOS

Measures heart rate via placing your index finger on the phone’s camera len

Native

Camera with Flash

What’s My Heart Rate

Android & iOS

Measures the heart rate and breath rate through the lens of the camera

Native

Camera

As a subgroup of the health monitoring apps, heart rate measurement apps form a significant bulk of the group in the mega app stores. Basic heart rate information can be an indicator of general health and aid in both monitoring and detection of cardiac problems. Apps in this category often function like a stethoscope by using the microphone or camera in the smartphones. One example, the ‘Cardiograph Heart Rate Monitor’ (BIG DREAMS Lab 2014) app measures the user’s heart rate via the placement of the index finger on the camera. Through the inbuilt camera flash, the app would then track the colour changes on the finger. There is also a significant move in this area towards peripheral devices, where there has been an increase in smart watches (built by major smartphone makers e.g. Apple, Samsung, etc., and other technology companies e.g. Fitbit) that monitors heart rate and send data to the smartphone.

Blood pressure measurement [Table 13]

Table 13

Clinical apps classified in ‘blood pressure measurement’ (as of Jan 2016)

App name

OS

Description

App type

Hardware

BP Calculator

Android

Measures the blood pressure and keep record of blood pressure at regular intervals.

Native

None

iBP Blood Pressure

Android & iOS

Blood pressure tracking and analysis tool.

Native

Blood Pressure scrap

iHealth BPM

iOS

Measures blood pressure using a blood pressure dock.

Native

Blood Pressure Dock

Perf.Blood Pressure(BP)Monitor

Android

Calculates and measures your blood pressure via touching thumb on the screen

Native

None

Similar to measuring heart rate, measuring blood pressure is also another indicator of health status and condition. However unlike heart rate apps, the typical measurement of blood pressure would require the use of peripheral cuff devices connected to the smartphone. Nonetheless one app seems to be able to measure the parameter indirectly without the use of external devices. The ‘Instant Blood Pressure’ (Auralife 2014) relies on inbuilt camera and flash to provide blood pressure readings. As the technology is protected, it is likely that the dominant apps in this type would be more dependent on peripheral devices.

Eye diagnosis [Table 14]

Table 14

Clinical apps classified in ‘eye diagnosis’ (as of Jan 2016)

App name

OS

Description

App type

Hardware

Anomaloscope

iOS

Tests for colour vision of patients

Native

None

AmslerPro

iOS

Tests for abnormality in the foveal vision

Native

None

Color Blindness Test

Android

Tests for colour blindness

Native

None

Eye Care Plus - Eye Exercises

Android

Contains eye test to check visual acuity and information on eye health

Native

None

Eye Diagnosis

Android

Supports the visualization of eye photographs to help practitioners diagnose eye diseases.

Native

Camera

Eye test

Eye Test Charts

Full Visual Test

Vision Test 2.0

Android

Android

Android

Android

Contains many eye tests including Visual acuity test

Tests for visual acuity

Tests for visual acuity

Tests for visual acuity

Native

None

Morphision

iOS

Qualifies the symptom of distortion in their patient’s eyes

Native

None

Pain Eye

iOS

Takes pictures of eyes to diagnose eye pains

Native

Camera

TeleMed

Android

An application that connects to healthcare services and allows sending photos of eye as part of medical teleconsultation.

Hybrid

None

Visual Acuity Test

Android

Monitor acuteness and clearness of vision in person’s eyes

Native

None

Vision Test

Android

Includes visual acuity test

Native

None

Apps in this category leverage on the camera/screen to allow for convenient and quick analysis and storage of eye images and tests. The ‘Colour Blindness Test’ (DaDo 2014) app tests for colour blindness and provides category of colour blindness in the result analysis. Another app such as ‘Pain Eye’ (Medina 2014) helps to investigate eye pain using captured images of the pupil using the smartphone’s camera. Using clip-on peripheral camera adaptors, ‘Peek Retina’ (Peek 2015) was created by a team of eye specialists, software developers, designers and engineers for remote diagnosis. Many apps in this category leverage on the inbuilt cameras in smartphones, and there is potential for these apps to even aid in detecting abnormalities when coupled with advanced image processing and artificial intelligent algorithms.

Skin diagnosis [Table 15]

Table 15

Clinical apps classified in ‘skin diagnosis’ (as of Jan 2016)

App name

OS

Description

App type

Hardware

Doctor Mole – Skin Cancer App

Android

iOS

Automatic analysis of mole images to diagnose skin cancer.

Native

Camera

Mole Checker

iOS

Takes pictures of skin moles and keep track of changes

Native

Camera

Skin Analytics

Android

Takes photos of skin moles and compares for diagnosis of skin cancer

Native

Camera

Skin Cancer App – MySkinPal

Android

Takes photos of skin moles and compares for diagnosis of skin cancer

  

SkinVision - Melanoma app

Android

Takes photos of skin moles and compares for diagnosis of skin cancer

  

Skin MD Now - Expert Skin Help

Android

Send skin photos to Dermatologists for quick diagnosis.

Hybrid

Camera

Skin Scanner

Android

Takes photos of skin moles for analysis for skin cancer

Hybrid

Camera

SpotMole

Android

Scans photos of skin moles to detect for melanoma

Native

Camera

iDoc24 - Dermatologist Online

Android & iOS

Sends on-demand dermatologist skin photos for diagnosis and monitoring.

Hybrid

Camera

Like the ophthalmology apps, skin diagnosis apps leverage on the smartphone inbuilt camera and image processing algorithms. Captured images of the skin are compared against a database of disease images. Apps such as ‘Mole Doctor Skin Cancer App Dermatologist’ (Teodorescu 2014) and ‘Skin Analytics’ (Skin Analytics Development 2014) enable the comparison of mole pictures against skin cancer images. These images can then be sent to dermatologists, making diagnosis more convenient. One limitation of such image based apps is that they are sensitive to the lighting and environmental factors during image capture. Such factors may severely affect the quality of the images and lead to poor diagnostic accuracies.

Medical calculators [Tables 16 and 17]

Table 16

Clinical apps classified in ‘medical calculators’ (calculations) (as of Jan 2016)

App name

OS

Description

App type

Hardware

ACC Guideline Clinical App

Android

Contains interactive tools such as risk scores, dosing calculators, and algorithms.

Native

None

BODE Calculator

Android

Calculates the COPD levels to treat lung diseases.

Native

None

Calculate by QxMD

Android

Includes tools for calculations used in clinical practice.

Native

None

CuidApp - Nurses and Doctors

Android

Includes calculators and unit conversions.

Native

None

CKD Risk Calc Pro

iOS

Evaluates Chronic Kidney Disease via calculations

Native

None

Digoxin Calculator

Android

Estimates a patient’s digoxin requirements for the treatment of heart failure.

Native

None

Ezabx

Android

Contains a metric converter and references for common microbes and antibiotics.

Native

None

GRACE 2.0 ACS Risk Calculator

Android

Calculates the probability of fatality after an acute coronary syndrome.

Native

None

GFR & BSA Calculator

Android

Estimates the expected Glomerular filtration rate of patients

Native

None

Haemoscore

Android

Includes score calculators & algorithms to facilitate decision making in both diagnosis and treatment of thrombotic and bleeding problems.

Native

None

MedCalc 3000 Cardiac

Android

Provides medical equations, clinical calculator and dose/unit converters used by Cardiovascular specialists

Native

None

Medical Calculators & Equation

Android

Contains a wide range of calculators/convertors for medical purposes.

Native

None

Medical Formulas

Android & iSO

Medical Calculator that access to main equations, formula and scores used in clinical practice.

Native

None

Medical Tools

Android

Medical calculators, interpretation and scoring systems.

Native

None

Melanoma Visual Risk Calculator

iOS

Calculates the possibility of a mole being a malignant melanoma

Native

Camera

Opioid Converter

Android

Application designed to aid with opioid dose conversions.

Native

None

Ovulation calculator & fertility tracker

iOS

Calculates ovulation cycle and tracks fertility rate

Native

None

Pedia BP

iOS

Blood pressure calculator

Native

None

Pregnancy Calculator

Android

Estimates the expected due date for the born of a baby.

Native

None

Throid-SPOT (Dr and Patient versions)

Android and iOS

Calculates homeostatic euthryroid set points in thyroid diseases

Native

None

Table 17

Clinical apps classified in ‘medical calculators’ (checkers) (as of Jan 2016)

App name

OS

Description

App type

Hardware

Drugs.com Medication Guide

Android

Provides drug information, identify pills, check interactions and set up personal medication records for Health professionals.

Native

None

WebMD

Android

Includes decision-support tools such as WebMD’s Symptom Checker.

Native

None

One frequent clinical mistake that can be fatal in medical treatment is the calculation of dosage. To prevent these mistakes, there are apps available to provide necessary medical calculations, conversions and chemical formulae checks. One such app, ‘Calculate by QxMD’ (QxMD Medical Software Inc 2015) app provides a number of unique calculators specific to various medical specialities and decision support tools including risk analysis. Another example, the Thyroid-SPOT (Sim et al. 2016) apps (Doctor and Patient versions) compute the homeostatic euthyroid set point, guiding the optimization of personalized treatment plans as well as to monitor the patient’s condition. With these apps, more informed patients can also do their part and check their prescription or treatment regimen thus reducing clinical errors.

Patient compliance [Table 18]

Table 18

Clinical apps classified in ‘patient compliance’ (as of Jan 2016)

App name

OS

Description

App type

Hardware

Medisafe Meds & Pill Reminder

Android

Add medications, get reminders for taking pills and receive constant tracking of your health progress.

Native

None

Medica Reminders

iOS

Adds medications, get reminders for taking pills and receive constant tracking of your health progress.

Native

None

Pill Alert

iOS

   

MyPill

iOS

Birth control pill reminder

Native

None

Pill Reminder

iOS

Reminds patients to take medicine, contraceptive and other medication

Native

None

Pill Monitor Free

iOS

Medication reminder

Native

None

As discussed earlier, patient compliance is a key factor in the success of treatment regimens. Considering also that most patients are willing to receive medication reminders (Kebede, et al. 2015) and likely to possess smartphones, medication reminder apps can improve compliance. One such example, ‘Medisafe Meds & Pill Reminder’ (MediSafe™ 2016) monitors and has reminders for scheduled medication times. Such apps are particularly useful for the elderly and those with multiple treatment regimens concurrently.

Discussion

With the smartphone becoming increasingly versatile in different fields of work, there is great promise for its role in the future of personalized medicine. In the current survey of the available apps in the largest apps stores: Google and Apple, we surveyed relevant apps that benefit both clinicians and patients. While there are many apps within the various medical specialities that may exist, they were not covered as focus is given to areas where patients can play a role, such as taking pictures (skin/eye) for better monitoring and diagnosis. Obviously, certain levels of technical savviness and acceptance from the users (both patient and clinicians) are necessary for the desired benefits of using these apps. The apps surveyed in this review focus on the many clinical aspects with the end-goal of improving the efficiency, cost, simplicity and effectiveness of healthcare. While a horde of apps exist, the majority found in Google and Apple app stores are either glossaries of clinical information apps for health professionals, or basic health knowledge apps for the layman. Even amongst the numerous apps designed for clinical data management and monitoring health, only a minority were found to be of direct practical use. In fact, focussing on the directly practical apps, there is a paucity of evidence-based or professional-informed apps (Majeed-Ariss, et al. 2015; Krebs and Duncan 2015; Subhi et al. 2015). One contributing factor for the dearth of apps in certain medical specialties is that certain diagnostic or monitoring procedures may be dependent on peripheral devices (see example of blood pressure and Peek Retina above). Such demands of peripheral devices thus limit the exploitation of smartphones. Other factors include the administration and certification required of medical devices which would vary between countries, and also for the device type. As there are a large number of smartphone models and makers, the in-built sensors in these phones would vary. This results in significant inter-equipment errors that may prevent any standardized guidelines or procedures required for professional clinical use. These make certification and use of smartphone as medical devices more challenging and unlikely to be approved by various authorities (scope of this is beyond this article due to the varying requirements). In the event they are approved for use, it is likely that many of these smartphone-dependent devices will require skilled personnel. As a result, clinical apps will mostly play a supportive role rather than as direct medical equipment replacements. Such limitations may be slightly mitigated by standardised peripheral devices, but these peripheral devices have their own limitations in accessibility to the general public.

Nonetheless in societies with less stringent medical regulation and where specialized medical equipment may not be readily available, the smartphone certainly has a role not only as a patient companion, but also as a screening tool for health problems. The smartphone has already been shown to aid in numerous areas: patient monitoring, transmission of clinical data between patients and clinicians, encouraging patient compliance, and helping with clinical calculations and decision making. Certainly the patient now has the resources to take better ownership of their own health with such apps (regulatory board approved or not) at their disposal.

Conclusion

With an obvious role in personalized healthcare, the smartphone promises to be a portable medical toolkit/clinical gathering device for both clinicians and patients. Much remains to be done with much more apps and peripheral devices that can be made, but with the collaborative effort between medical specialists, software developers and hardware engineers, the future of the smartphone medical toolkit can be materialized. The days of convenient house-visits might return in the form of app consultations.

Declarations

Competing interests

The authors declare no competing interests.

Authors’ contributions

CK and YX drafted the manuscript. PV made the tables. SKEG directed and edited the writing of the manuscript. All authors have read and approve of the final manuscript.

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Authors’ Affiliations

(1)
Bioinformatics Institute, Agency for Science, Technology, and Research (A*STAR)
(2)
p53 Laboratory, Agency for Science, Technology, and Research (A*STAR)

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Copyright

© The Author(s) 2016