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Smartphone Apps in Health Care: Do the Risks Outweigh The Benefits?

By IHI Open School | Monday, November 26, 2012

Being a fourth-year medical student at the University of Leeds in the UK due to graduate in 2014, using technology to help supplement my learning is nothing new to me. For example, when I have a lecture, I will take along a voice recorder. And I spend countless hours on YouTube trying to find a more engaging way of learning than reading countless books and notes.

In short, I use technology every day to help with my learning and, to be honest, I’d be pretty lost without it.

This year, my medical school went a bit over the top and gave each student an iPhone 4s as a “learning tool.” Don’t get me wrong; I was thrilled by the idea! My BlackBerry was starting to bore the life out of me and Siri seemed like a nice, shiny replacement. Still, I couldn’t see how it would make any difference to my learning. We were handed our new toys along with some paperwork that gave instructions on how to download some boring medical apps (which got stuffed to the bottom of my bag) and we proceeded to Google funny questions to ask Siri.

The next day was the first day of my six-week pediatric placement and I spent the morning downloading the apps I should have downloaded the day before. To my surprise, there were full books contained in some of these apps! Being able to search all of the books on my phone for a particular keyword made my life so much easier and meant I found it easy to keep up in the morning ward round.

The calculators were invaluable, too. I could work out the BMI of a patient in seconds or use one of the apps to work out how much maintenance fluids to give a particular patient. Not only did having the smartphone make me more confident in my approach to answering questions and presenting cases, it meant that I got more respect from my consultant; he didn’t mind that I had to look it up and he was happy I’d taken the initiative to do so. The fact that I had read about the cases as I was seeing them meant that I was able to retain the information, too.

During the next week, I started getting more adventurous with my apps, a popular but expensive one being a “stethoscope” which you can put onto your chest and hear your heartbeat through the headphones. The app also gives little tutorials on different murmurs (the bane of my life) and even tells you what rhythm you are in and then explains it to you!

This left me wondering about the integrity of these apps and about who reviews them for medical use. The answer? Not all of them are reviewed. I found this extremely worrying. I wouldn’t take everything that a gadget says to me as gospel, but I wonder if some students would. And what’s worse? There are a lot of patients out there who could be using exactly the same apps to convince themselves they have something seriously wrong with them, or that there is nothing wrong with them when they are actually pretty ill.

A quick glance at the categories section in my App Store (or in Google Play) shows me that there are more than 40,000 medical apps. How do we monitor these? The Food and Drug Administration (FDA) is looking to start regulating the apps which are put onto the market, to ensure that they are viable. With apps that are now able to check and monitor your blood sugar, it is clear that there needs to be some sort of vetting because a person’s life could depend on it.

A study done in 2011 by the General Medical Council found that 30% of doctors were using smartphones and medical apps to facilitate the delivery of patient care, and it predicted that 80% would be using them by the end of 2012. With hundreds of textbooks and guidelines being available at the touch of a button, it is no wonder so many of us use them. But when does the use of smartphones or tablets go too far?


The majority of medical or health apps are harmless — if used in the correct way. They are great educational tools, but the trick to using them for the treatment of patients is to only use them as a reference – and not in place of a trained medical professional.


- Niqui Stubbs, Medical Student, University of Leeds

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