The smartphone in medicine: a review of current and potential use among physicians and students

Errol Ozdalga, Ark Ozdalga, Neera Ahuja, Errol Ozdalga, Ark Ozdalga, Neera Ahuja

Abstract

Background: Advancements in technology have always had major impacts in medicine. The smartphone is one of the most ubiquitous and dynamic trends in communication, in which one's mobile phone can also be used for communicating via email, performing Internet searches, and using specific applications. The smartphone is one of the fastest growing sectors in the technology industry, and its impact in medicine has already been significant.

Objective: To provide a comprehensive and up-to-date summary of the role of the smartphone in medicine by highlighting the ways in which it can enhance continuing medical education, patient care, and communication. We also examine the evidence base for this technology.

Methods: We conducted a review of all published uses of the smartphone that could be applicable to the field of medicine and medical education with the exclusion of only surgical-related uses.

Results: In the 60 studies that were identified, we found many uses for the smartphone in medicine; however, we also found that very few high-quality studies exist to help us understand how best to use this technology.

Conclusions: While the smartphone's role in medicine and education appears promising and exciting, more high-quality studies are needed to better understand the role it will have in this field. We recommend popular smartphone applications for physicians that are lacking in evidence and discuss future studies to support their use.

Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Flow diagram of the process of article selection and results.
Figure 2
Figure 2
DynaMed’s medical reference program with organization of topics shown at left.
Figure 3
Figure 3
QuantiaMD allows for interactive case challenges within multiple specialties, features guest lecturers, and allows physicians to earn continuing medical education points, all from the smartphone.
Figure 4
Figure 4
Doximity connects colleagues from around the United States and allows for secure communication.

References

    1. Lippi G, Plebani M. Laboratory applications for smartphones: risk or opportunity? Clin Biochem. 2011 Mar;44(4):273–4. doi: 10.1016/j.clinbiochem.2010.12.016.S0009-9120(11)00021-X
    1. Kiser K. 25 ways to use your smartphone. Physicians share their favorite uses and apps. Minn Med. 2011 Apr;94(4):22–9.
    1. Franko OI, Tirrell TF. Smartphone App Use Among Medical Providers in ACGME Training Programs. J Med Syst. 2012 Oct;36(5):3135–9. doi: 10.1007/s10916-011-9798-7.
    1. Sposaro F, Danielson J, Tyson G. iWander: An Android application for dementia patients. Conf Proc IEEE Eng Med Biol Soc. 2010;2010:3875–8. doi: 10.1109/IEMBS.2010.5627669.
    1. Wu HH, Lemaire ED, Baddour N. Change-of-state determination to recognize mobility activities using a BlackBerry smartphone. Conf Proc IEEE Eng Med Biol Soc. 2011;2011:5252–5. doi: 10.1109/IEMBS.2011.6091299.
    1. Worringham C, Rojek A, Stewart I. Development and feasibility of a smartphone, ECG and GPS based system for remotely monitoring exercise in cardiac rehabilitation. PLoS One. 2011;6(2):e14669. doi: 10.1371/journal.pone.0014669.
    1. Edgar S, Swyka T, Fulk G, Sazonov ES. Wearable shoe-based device for rehabilitation of stroke patients. Conf Proc IEEE Eng Med Biol Soc. 2010;2010:3772–5. doi: 10.1109/IEMBS.2010.5627577.
    1. Yamada M, Aoyama T, Mori S, Nishiguchi S, Okamoto K, Ito T, Muto S, Ishihara T, Yoshitomi H, Ito H. Objective assessment of abnormal gait in patients with rheumatoid arthritis using a smartphone. Rheumatol Int. 2011 Dec 23; doi: 10.1007/s00296-011-2283-2.
    1. Nishiguchi S, Yamada M, Nagai K, Mori S, Kajiwara Y, Sonoda T, Yoshimura K, Yoshitomi H, Ito H, Okamoto K, Ito T, Muto S, Ishihara T, Aoyama T. Reliability and validity of gait analysis by android-based smartphone. Telemed J E Health. 2012 May;18(4):292–6. doi: 10.1089/tmj.2011.0132.
    1. Mellone S, Tacconi C, Chiari L. Validity of a Smartphone-based instrumented Timed Up and Go. Gait Posture. 2012 May;36(1):163–5. doi: 10.1016/j.gaitpost.2012.02.006.S0966-6362(12)00057-4
    1. Lee BC, Kim J, Chen S, Sienko KH. Cell phone based balance trainer. J Neuroeng Rehabil. 2012;9:10. doi: 10.1186/1743-0003-9-10. 1743-0003-9-10
    1. Bsoul M, Minn H, Tamil L. Apnea MedAssist: real-time sleep apnea monitor using single-lead ECG. IEEE Trans Inf Technol Biomed. 2011 May;15(3):416–27. doi: 10.1109/TITB.2010.2087386.
    1. Kirwan M, Duncan MJ, Vandelanotte C, Mummery WK. Using smartphone technology to monitor physical activity in the 10,000 Steps program: a matched case-control trial. J Med Internet Res. 2012;14(2):e55. doi: 10.2196/jmir.1950. v14i2e55
    1. Boulos MN, Wheeler S, Tavares C, Jones R. How smartphones are changing the face of mobile and participatory healthcare: an overview, with example from eCAALYX. Biomed Eng Online. 2011;10:24. doi: 10.1186/1475-925X-10-24. 1475-925X-10-24
    1. Charpentier G, Benhamou PY, Dardari D, Clergeot A, Franc S, Schaepelynck-Belicar P, Catargi B, Melki V, Chaillous L, Farret A, Bosson JL, Penfornis A, TeleDiab Study Group The Diabeo software enabling individualized insulin dose adjustments combined with telemedicine support improves HbA1c in poorly controlled type 1 diabetic patients: a 6-month, randomized, open-label, parallel-group, multicenter trial (TeleDiab 1 Study) Diabetes Care. 2011 Mar;34(3):533–9. doi: 10.2337/dc10-1259.dc10-1259
    1. Harvey P, Woodward B, Datta S, Mulvaney D. Data acquisition in a wireless diabetic and cardiac monitoring system. Conf Proc IEEE Eng Med Biol Soc. 2011;2011:3154–7. doi: 10.1109/IEMBS.2011.6090860.
    1. Kostikis N, Hristu-Varsakelis D, Arnaoutoglou M, Kotsavasiloglou C, Baloyiannis S. Towards remote evaluation of movement disorders via smartphones. Conf Proc IEEE Eng Med Biol Soc. 2011;2011:5240–3. doi: 10.1109/IEMBS.2011.6091296.
    1. Puiatti A, Mudda S, Giordano S, Mayora O. Smartphone-centred wearable sensors network for monitoring patients with bipolar disorder. Conf Proc IEEE Eng Med Biol Soc. 2011;2011:3644–7. doi: 10.1109/IEMBS.2011.6090613.
    1. Palmerini L, Mellone S, Rocchi L, Chiari L. Dimensionality reduction for the quantitative evaluation of a smartphone-based Timed Up and Go test. Conf Proc IEEE Eng Med Biol Soc. 2011;2011:7179–82. doi: 10.1109/IEMBS.2011.6091814.
    1. Rigoberto MM, Toshiyo T, Masaki S. Smart phone as a tool for measuring anticipatory postural adjustments in healthy subjects, a step toward more personalized healthcare. Conf Proc IEEE Eng Med Biol Soc. 2010;2010:82–5. doi: 10.1109/IEMBS.2010.5626162.
    1. Meankaew P, Kaewkungwal J, Khamsiriwatchara A, Khunthong P, Singhasivanon P, Satimai W. Application of mobile-technology for disease and treatment monitoring of malaria in the "Better Border Healthcare Programme". Malar J. 2010;9:237. doi: 10.1186/1475-2875-9-237. 1475-2875-9-237
    1. Rajput ZA, Mbugua S, Amadi D, Chepngeno V, Saleem JJ, Anokwa Y, Hartung C, Borriello G, Mamlin BW, Ndege SK, Were MC. Evaluation of an Android-based mHealth system for population surveillance in developing countries. J Am Med Inform Assoc. 2012 Jul 1;19(4):655–9. doi: 10.1136/amiajnl-2011-000476.amiajnl-2011-000476
    1. Gregoski MJ, Mueller M, Vertegel A, Shaporev A, Jackson BB, Frenzel RM, Sprehn SM, Treiber FA. Development and validation of a smartphone heart rate acquisition application for health promotion and wellness telehealth applications. Int J Telemed Appl. 2012;2012:696324. doi: 10.1155/2012/696324.
    1. Hii PC, Chung WY. A comprehensive ubiquitous healthcare solution on an Android™ mobile device. Sensors (Basel) 2011;11(7):6799–815. doi: 10.3390/s110706799.sensors-11-06799
    1. Oresko JJ, Duschl H, Cheng AC. A wearable smartphone-based platform for real-time cardiovascular disease detection via electrocardiogram processing. IEEE Trans Inf Technol Biomed. 2010 May;14(3):734–40. doi: 10.1109/TITB.2010.2047865.
    1. Sicari R, Galderisi M, Voigt JU, Habib G, Zamorano JL, Lancellotti P, Badano LP. The use of pocket-size imaging devices: a position statement of the European Association of Echocardiography. Eur J Echocardiogr. 2011 Feb;12(2):85–7. doi: 10.1093/ejechocard/jeq184. jeq184
    1. Huang CC, Lee PY, Chen PY, Liu TY. Design and implementation of a smartphone-based portable ultrasound pulsed-wave Doppler device for blood flow measurement. IEEE Trans Ultrason Ferroelectr Freq Control. 2012 Jan;59(1):182–8. doi: 10.1109/TUFFC.2012.2171.
    1. Anonymous How to put your smartphone "on call." Applications that run on your cell phone put health and wellness aids just a touch away. Harv Womens Health Watch. 2010 Dec;18(4):2–4.
    1. Ly K. MHealth: better health through your smartphone. Community Pract. 2011 Feb;84(2):16–7.
    1. Gan KO, Allman-Farinelli M. A scientific audit of smartphone applications for the management of obesity. Aust N Z J Public Health. 2011 Jun;35(3):293–4. doi: 10.1111/j.1753-6405.2011.00707.x.
    1. Cohn AM, Hunter-Reel D, Hagman BT, Mitchell J. Promoting behavior change from alcohol use through mobile technology: the future of ecological momentary assessment. Alcohol Clin Exp Res. 2011 Dec;35(12):2209–15. doi: 10.1111/j.1530-0277.2011.01571.x.
    1. Abroms LC, Padmanabhan N, Thaweethai L, Phillips T. iPhone apps for smoking cessation: a content analysis. Am J Prev Med. 2011 Mar;40(3):279–85. doi: 10.1016/j.amepre.2010.10.032.S0749-3797(10)00708-7
    1. Rabin C, Bock B. Desired features of smartphone applications promoting physical activity. Telemed J E Health. 2011 Dec;17(10):801–3. doi: 10.1089/tmj.2011.0055.
    1. Anonymous Smartphone app speeds registration. ED Manag. 2011 Mar;23(3):28–9.
    1. Takao H, Murayama Y, Ishibashi T, Karagiozov KL, Abe T. A new support system using a mobile device (smartphone) for diagnostic image display and treatment of stroke. Stroke. 2012 Jan;43(1):236–9. doi: 10.1161/STROKEAHA.111.627943.STROKEAHA.111.627943
    1. León SA, Fontelo P, Green L, Ackerman M, Liu F. Evidence-based medicine among internal medicine residents in a community hospital program using smart phones. BMC Med Inform Decis Mak. 2007;7:5. doi: 10.1186/1472-6947-7-5. 1472-6947-7-5
    1. Wong BM, Quan S, Cheung CM, Morra D, Rossos PG, Sivjee K, Wu R, Etchells EE. Frequency and clinical importance of pages sent to the wrong physician. Arch Intern Med. 2009 Jun 8;169(11):1072–3. doi: 10.1001/archinternmed.2009.117.169/11/1072
    1. Wu RC, Morra D, Quan S, Lai S, Zanjani S, Abrams H, Rossos PG. The use of smartphones for clinical communication on internal medicine wards. J Hosp Med. 2010 Dec;5(9):553–9. doi: 10.1002/jhm.775.
    1. Wu R, Rossos P, Quan S, Reeves S, Lo V, Wong B, Cheung M, Morra D. An evaluation of the use of smartphones to communicate between clinicians: a mixed-methods study. J Med Internet Res. 2011;13(3):e59. doi: 10.2196/jmir.1655. v13i3e59
    1. Lo V, Wu RC, Morra D, Lee L, Reeves S. The use of smartphones in general and internal medicine units: a boon or a bane to the promotion of interprofessional collaboration? J Interprof Care. 2012 Jul;26(4):276–82. doi: 10.3109/13561820.2012.663013.
    1. Menon A. Confessions of a Wilderness Fellow: I Can't Live Without My Smartphone, Can You? Perm J. 2011;15(1):68–9.
    1. Choi JS, Yi B, Park JH, Choi K, Jung J, Park SW, Rhee PL. The uses of the smartphone for doctors: an empirical study from samsung medical center. Healthc Inform Res. 2011 Jun;17(2):131–8. doi: 10.4258/hir.2011.17.2.131.
    1. Mitchell JR, Sharma P, Modi J, Simpson M, Thomas M, Hill MD, Goyal M. A smartphone client-server teleradiology system for primary diagnosis of acute stroke. J Med Internet Res. 2011;13(2):e31. doi: 10.2196/jmir.1732. v13i2e31
    1. Rahme RJ, Fishman AJ, Hunt Batjer H, Bendok BR. The future is now: smartphones to join scalpels and stethoscopes? Neurosurgery. 2012 Apr;70(4):N19–20. doi: 10.1227/01.neu.0000413224.88090.66.00006123-201204000-00006
    1. Blaya JA, Fraser HS, Holt B. E-health technologies show promise in developing countries. Health Aff (Millwood) 2010 Feb;29(2):244–51. doi: 10.1377/hlthaff.2009.0894.29/2/244
    1. Bellina L, Missoni E. Mobile cell-phones (M-phones) in telemicroscopy: increasing connectivity of isolated laboratories. Diagn Pathol. 2009;4:19. doi: 10.1186/1746-1596-4-19. 1746-1596-4-19
    1. Tice AD. Gram stains and smartphones. Clin Infect Dis. 2011 Jan 15;52(2):278–9. doi: 10.1093/cid/ciq131. ciq131
    1. Choi BG, Mukherjee M, Dala P, Young HA, Tracy CM, Katz RJ, Lewis JF. Interpretation of remotely downloaded pocket-size cardiac ultrasound images on a web-enabled smartphone: validation against workstation evaluation. J Am Soc Echocardiogr. 2011 Dec;24(12):1325–30. doi: 10.1016/j.echo.2011.08.007.S0894-7317(11)00615-8
    1. Crawford I, McBeth PB, Mitchelson M, Tiruta C, Ferguson J, Kirkpatrick AW. Telementorable "just-in-time" lung ultrasound on an iPhone. J Emerg Trauma Shock. 2011 Oct;4(4):526–7. doi: 10.4103/0974-2700.86654. JETS-4-526
    1. Tseng D, Mudanyali O, Oztoprak C, Isikman SO, Sencan I, Yaglidere O, Ozcan A. Lensfree microscopy on a cellphone. Lab Chip. 2010 Jul 21;10(14):1787–92. doi: 10.1039/c003477k.
    1. Breslauer DN, Maamari RN, Switz NA, Lam WA, Fletcher DA. Mobile phone based clinical microscopy for global health applications. PLoS One. 2009;4(7):e6320. doi: 10.1371/journal.pone.0006320.
    1. Zhu H, Yaglidere O, Su TW, Tseng D, Ozcan A. Cost-effective and compact wide-field fluorescent imaging on a cell-phone. Lab Chip. 2011 Jan 21;11(2):315–22. doi: 10.1039/c0lc00358a.
    1. Sadasivam RS, Gathibandhe V, Tanik MM, Willig JH. Development of a point-of-care HIV/AIDS medication dosing support system using the Android mobile platform. J Med Syst. 2012 Jun;36(3):1583–91. doi: 10.1007/s10916-010-9619-4.
    1. Oehler RL, Smith K, Toney JF. Infectious diseases resources for the iPhone. Clin Infect Dis. 2010 May 1;50(9):1268–74. doi: 10.1086/651602.
    1. Low D, Clark N, Soar J, Padkin A, Stoneham A, Perkins GD, Nolan J. A randomised control trial to determine if use of the iResus© application on a smart phone improves the performance of an advanced life support provider in a simulated medical emergency. Anaesthesia. 2011 Apr;66(4):255–62. doi: 10.1111/j.1365-2044.2011.06649.x.
    1. Chang AY, Ghose S, Littman-Quinn R, Anolik RB, Kyer A, Mazhani L, Seymour AK, Kovarik CL. Use of mobile learning by resident physicians in Botswana. Telemed J E Health. 2012 Feb;18(1):11–3. doi: 10.1089/tmj.2011.0050.
    1. Woods CA, Dumbleton K, Jones L, Fonn D. Patient use of smartphones to communicate subjective data in clinical trials. Optom Vis Sci. 2011 Feb;88(2):290–4. doi: 10.1097/OPX.0b013e3181ff9b80.
    1. Yamada M, Aoyama T, Okamoto K, Nagai K, Tanaka B, Takemura T. Using a Smartphone while walking: a measure of dual-tasking ability as a falls risk assessment tool. Age Ageing. 2011 Jul;40(4):516–9. doi: 10.1093/ageing/afr039. afr039
    1. Rothschild JM, Lee TH, Bae T, Bates DW. Clinician use of a palmtop drug reference guide. J Am Med Inform Assoc. 2002 Jun;9(3):223–9.
    1. Terry M. Medical Apps for Smartphones. Telemed J E Health. 2010 Feb;16(1):17–22. doi: 10.1089/tmj.2010.9999.
    1. Alzheimer's Association 2010 Alzheimer's disease facts and figures. Alzheimers Dement. 2010 Mar;6(2):158–94. doi: 10.1016/j.jalz.2010.01.009.S1552-5260(10)00014-2
    1. Chen J, Park Y, Putzer GJ. An examination of the components that increase acceptance of smartphones among healthcare professionals. Electron J Health Inform. 2010;5(2)

Source: PubMed

3
Subscribe