Search

Self Care Pharmacy Blog

 

Medical Mobile Apps Not Enough to Replace Face-to-Face Consultation

November 26th, 2013

by Lauren Williams, PharmD student

Today’s use of mobile technology heavily influences and expands the way we interact and communicate with others. Not only has it provided us new ways to interact with our friends and family, but it is currently expanding patient access to medical advice and opening the way for innovative interactions with medical professionals. According to the Research2Guidance mobile research specialists, “500 million smartphone users worldwide will be using a health care application by 2015”.1 With the great ease of access to medical information and advice today, self-care is very prevalent. Are patients more likely to skip out on pharmacist consultation and doctor appointments to rely on their easily attained materials and video calls with physicians?

The article, “Study finds dermatology apps useful, but they can’t replace a doctor’s visit”, published by MedCity News, discussed a study on the use and availability of dermatology applications.2 After searching the Apple, Android, BlackBerry, Nokia and Windows app stores for products related to dermatology, researchers reported finding over 200 apps that offered its users medical material, treatment help and guidance to self-diagnosis concerning dermatology. Specifically, they give the users what they need to identify and treat dermatological concerns without having to consult with their pharmacist or visit their doctor. Although these apps increase user accessibility to medical information and advice, researchers are highly concerned that people may be getting the wrong information since only a few of these apps were clearly created by medical professionals. Their other concern was that some patients would value and grow confident in their app facts, and forego actually visiting the dermatologist. Despite these concerns, mobile apps are used not only by patients, but also by health care professionals. Because trusted professionals use these, the FDA has stepped into the picture and declared that they will regulate and set apart medical apps intended for the use of doctors.

I agree with the article that medical apps may be great sources to increase medical knowledge; however, we must approach them with skepticism, recommending users to cross-reference the information and consult with their pharmacist or doctor before beginning treatment options based on apps. I am comfortable with patients self-educating and treating on more minor topics, such as sunburn, but I believe that they should present to their doctor with any more serious concerns, such as a lumpy mole that has changed color, which could indicate melanoma. Common conditions, such as eczema, dry skin, contact dermatitis, insect bites, stings, head lice and sunburn can all be immediately self-treated or referred with consultation from a pharmacist. Pharmacists are easily assessable and qualified to identify self-care exclusion criteria with these dermatological conditions. Some conditions may easily be detected simply by viewing, but others may not be so simple since a biopsy, or other procedure, may be necessary for better understanding. Mobile apps cannot perform biopsies; they cannot give thorough follow-up examinations. Teledermatology, one of the most promising apps, has similar limitations.3 Although the patient and dermatologist evaluate via a live video call, the patient’s interpretation of symptoms may be different from the dermatologist’s interpretation. These mobile apps can only be used so much in self-treatment and self-examination, but they can continue to educate the user.

A study published by University of Florence’s Department of Dermatology asked the question “Is skin self-examination for cutaneous melanoma detection still adequate?” Researchers found that although the largest percentage, 36%, of found melanomas were results of a regular annual skin examination by a dermatologist, the next largest group, 33%, of found melanomas were by self-detection. Because these percentages were so close, one may think that self-detection is just as good as a visit to the dermatologist. This study also concluded “self-detection was associated with a greater probability of having a thick melanoma and, therefore, a poor prognosis (odds ratio 1.56)”. 4 Therefore, I believe that although self-detection with the aid of medical applications is beneficial, it is more beneficial and important to pay a visit to the dermatologist or seek immediate recommendation from a pharmacist.

Using mobile devices for self-care is different from the standard of care, but it is progressive, innovating, and exciting to try. We must always be cautious with any type of progression simply because it often takes us on an untraveled road to new outcomes, studies, and experiments. I believe that the utilization of mobile applications is a part of the natural movement of converging health practices with modern technology. Mobile technology is heavily integrated in our society, so it makes sense that patient care and medical advice is accessible by it.

The point of these applications is to increase medical knowledge, not to replace face-to-face interaction with a medical professional. Do you believe that the designers of these apps are aiming to increase medical knowledge, or to replace face-to-face interaction with a physician or pharmacist? How do you think patients will use them?

References

 [1] Mikalajunaite, E. 500m people will be using healthcare mobile applications in 2015. http://www.research2guidance.com/500m-people-will-be-using-healthcare-mobile-applications-in-2015/. Published November 10, 2010. Accessed November 12, 2013.

[2] Pittman, G. Study finds dermatology apps useful, but they can’t replace a doctor’s visit. http://medcitynews.com/2013/09/study-finds-dermatology-apps-useful-cant-replace-doctors-visit/. Published September 26, 2013. Accessed October 23, 2013.

[3] Brewer A, Endly DC, Henley J, et al. Mobile Applications in Dermatology. JAMA Dermatol. 2013;149(11):1300-1304. doi:10.1001/jamadermatol.2013.5517.

[4] De Giorgi, V., Grazzini, M., Rossari, S., Gori, A., Papi, F., Scarfi, F.,Gandini, S. Is skin self-examination for cutaneous melanoma detection still adequate? A retrospective study. Dermatology. 2012;225(1), 31-6. doi: 10.1159/000339774.

Tags: ,

5 Responses to “Medical Mobile Apps Not Enough to Replace Face-to-Face Consultation”

  1. Nathanael J Smith Says:

    That is an interesting topic. Before I read your blog, I had not even realized the amount of apps that not only I but many other people have on their phones alone. In addition, to see that there was over 200 apps for that essentially aided in self diagnosing! What is to stop people relying solely on their apps if it costs a significant amount less than seeing their physicians? This could lead to a potential explosion of misdiagnoses. I think that it is interesting that the FDA has decided to delegate the apps that are beneficial for doctors to use. Nevertheless, that is very helpful in choosing which app to use. Today in America, it seems that the necessity for instant gratification can lead to more potential problems, especially with a diagnosis. Have you researched apps for other diseases outside of just the skin? It appears that the cold app for iPhone is very popular right now as well.

  2. McKenzie Shenk Says:

    Thank you for bringing this to our attention. As Nathanael recognized, FDA regulation will be an interesting development to follow. If the FDA regulates phone applications, should they not also regulate online websites? It seems many apps as well as websites aim to provide characteristics of symptoms. From there, patients self-diagnosis. As such, a next steps seems to be regulation of medical websites. On the other hand, our desire as medical professionals is for out patients to be educated. Now, we would prefer to educate them ourselves; however, many are seeking to educate themselves. I do not want to discourage this. How can we educate patients to seek reliable sources? Maybe as pharmacists, we should be more aware in self-diagnosising apps so as to direct patients to more appropriate apps.

  3. Mallory Martin Says:

    As an avid Webmd user, I can appreciate the availability of medical apps such as the ones mentioned. What you have to keep in mind are the kinds of people who are using and would be drawn to apps such as these. They are most likely well educated people who may be hypochondriacs who are quick to visit the physician over minor or benign problems. I see these apps as a benefit, weeding through people’s over-reactions and unneeded worries. As far as misdiagnoses are concerned, I think that’s a fair point. However, I think it’s obvious from the fact that the most popular medical app is a dermatology app, that people know serous conditions when they see them. With the exception of melanoma, most skin conditions are not concerning. I myself often self diagnose using these types of media and I feel as though something truly suspicious would warrant a doctor’s visit. People want these types of apps to reassure themselves they don’t have an illness. If they truly thought something was wrong, they’ll want it confirmed by a physician.

  4. Jacques N Allou Says:

    Thanks for this wonderful information. I am not surprise to hear that there was over 200 apps for that essentially aided in self diagnosing. The University of North Carolina defined app as “paid, impersonal, one-way marketing of persuasive information from an identified sponsor disseminated through channels of mass communication to promote the adoption of goods, services or ideas.” Because advertisers want to generate increased consumption of their commercial products and services, they make the app looks so enticing, but the question is do the products really do what the apps say? It is surprising to hear that, these mobile apps are not used only by patients, but also health professionals. Even though, patients have the right to go whichever way they want in terms of their treatment, I do agree that patients awareness should be raised concerning the dangers of self-diagnosing apps so that they will be directed to more appropriate apps. Also, the FDA should speed up their regulations to set apart medical apps intended for the use of doctors in order to save these concerned patients.

  5. Lauren Williams Says:

    Nathanael, it seems like some of the common medical app topics outside of dermatology are weight loss, pregnancy and diabetes. A lot of these ones have to do with maintenance or tracking of progress while treating conditions and achieving new goals!

Leave a Reply