Use of Smartphones in Hospitals

Mobile technology has begun to change the landscape of the medical profession with more than two-thirds of physicians regularly using smart phones. Smartphones have allowed healthcare professionals and the general public to communicate more efficiently, collect data and facilitate the clinical decision making. The methodology for this study was a qualitative literature review following a systematic approach of the smartphone usage among physicians in hospitals. Fifty-one articles were selected for this study based on inclusion criteria. The findings were classified and described into seven categories: use of smartphone in obstetrics, pediatrics, surgery, internal medicine, radiology, and dermatology which were chosen based on the documented use of smartphone application in different healthcare practices. A last section of patient safety and issues with confidentiality is also described. This study suggest that smartphones have been playing an increasingly important role in healthcare. Medical professionals have become more dependent upon medical smartphone applications. However, concerns of patient safety and confidentiality will likely lead to increased oversight of mobile device use by regulatory agencies and accrediting bodies

Can You Diagnose Me Now? A Proposal to Modify the FDA’s Regulation of Smartphone Mobile Health Applications with a Pre-Market Notification and Application Database Program

Advances in mobile technology continually create new possibilities for the future of medical care. Yet these changes have also created concerns about patient safety. Under the Food, Drug, and Cosmetic Act, the Food and Drug Administration (FDA) has the authority to regulate a broad spectrum of products beyond traditional medical devices like stethoscopes or pacemakers. The regulatory question is not if the FDA has the statutory authority to regulate health-related software, but rather how it will exercise its regulatory authority. In September 2013, the FDA published Final Guidance on Mobile Medical Applications; in it, the Agency limited its oversight to a small subset of medical-related mobile applications, referred to as “mobile medical applications.” For the Final Guidance to be effective, the FDA must continue to work directly with all actors—including innovators, doctors, and patients as the market for mobile health applications continues to develop. This Note argues that the FDA should adopt a two-step plan—a pre-market notification program and a mobile medical application database—to aid in the successful implementation of its 2013 Final Guidance. By doing so, the FDA will ensure that this burgeoning market can reach its fullest potential

A Research on the Classification and Applicability of the Mobile Health Applications

Mobile health applications are applied for different purposes. Healthcare professionals and other users can use this type of mobile applications for specific tasks, such as diagnosis, information, prevention, treatment, and communication. This paper presents an analysis of mobile health applications used by healthcare professionals and their patients. A secondary objective of this article is to evaluate the scientific validation of these mobile health applications and to verify if the results provided by these applications have an underlying sound scientific foundation. This study also analyzed literature references and the use of mobile health applications available in online application stores. In general, a large part of these mobile health applications provides information about scientific validation. However, some mobile health applications are not validated. Therefore, the main contribution of this paper is to provide a comprehensive analysis of the usability and user-perceived quality of mobile health applications and the challenges related to scientific validation of these mobile applications.This work was funded by FCT/MCTES through national funds and when applicable co-funded EU funds under the project UIDB/EEA/50008/2020 (Este trabalho é financiado pela FCT/MCTES através de fundos nacionais e quando aplicável cofinanciado por fundos comunitários no âmbito do projeto UIDB/EEA/50008/2020)

Can You Diagnose Me Now? A Proposal to Modify the FDA’s Regulation of Smartphone Mobile Health Applications with a Pre-Market Notification and Application Database Program

Advances in mobile technology continually create new possibilities for the future of medical care. Yet these changes have also created concerns about patient safety. Under the Food, Drug, and Cosmetic Act, the Food and Drug Administration (FDA) has the authority to regulate a broad spectrum of products beyond traditional medical devices like stethoscopes or pacemakers. The regulatory question is not if the FDA has the statutory authority to regulate health-related software, but rather how it will exercise its regulatory authority. In September 2013, the FDA published Final Guidance on Mobile Medical Applications; in it, the Agency limited its oversight to a small subset of medical-related mobile applications, referred to as “mobile medical applications.” For the Final Guidance to be effective, the FDA must continue to work directly with all actors—including innovators, doctors, and patients as the market for mobile health applications continues to develop. This Note argues that the FDA should adopt a two-step plan—a pre-market notification program and a mobile medical application database—to aid in the successful implementation of its 2013 Final Guidance. By doing so, the FDA will ensure that this burgeoning market can reach its fullest potential

M-health review: joining up healthcare in a wireless world

In recent years, there has been a huge increase in the use of information and communication technologies (ICT) to deliver health and social care. This trend is bound to continue as providers (whether public or private) strive to deliver better care to more people under conditions of severe budgetary constraint

Mobile clinical decision support systems and applications: a literature and commercial review

The final publication is available at Springer via http://dx.doi.org/10.1007/s10916-013-0004-y[EN] Background: The latest advances in eHealth and mHealth have propitiated the rapidly creation and expansion of mobile applications for health care. One of these types of applications are the clinical decision support systems, which nowadays are being implemented in mobile apps to facilitate the access to health care professionals in their daily clinical decisions. Objective: The aim of this paper is twofold. Firstly, to make a review of the current systems available in the literature and in commercial stores. Secondly, to analyze a sample of applications in order to obtain some conclusions and recommendations. Methods: Two reviews have been done: a literature review on Scopus, IEEE Xplore, Web of Knowledge and PubMed and a commercial review on Google play and the App Store. Five applications from each review have been selected to develop an in-depth analysis and to obtain more information about the mobile clinical decision support systems. Results: 92 relevant papers and 192 commercial apps were found. 44 papers were focused only on mobile clinical decision support systems. 171 apps were available on Google play and 21 on the App Store. The apps are designed for general medicine and 37 different specialties, with some features common in all of them despite of the different medical fields objective. Conclusions: The number of mobile clinical decision support applications and their inclusion in clinical practices has risen in the last years. However, developers must be careful with their interface or the easiness of use, which can impoverish the experience of the users.This research has been partially supported by Ministerio de Economía y Competitividad, Spain. This research has been partially supported by the ICT-248765 EU-FP7 Project. This research has been partially supported by the IPT-2011-1126-900000 project under the INNPACTO 2011 program, Ministerio de Ciencia e Innovación.Martínez Pérez, B.; De La Torre Diez, I.; López Coronado, M.; Sainz De Abajo, B.; Robles Viejo, M.; García Gómez, JM. (2014). Mobile clinical decision support systems and applications: a literature and commercial review. Journal of Medical Systems. 38(1):1-10. https://doi.org/10.1007/s10916-013-0004-yS110381Van De Belt, T. H., Engelen, L. J., Berben, S. A., and Schoonhoven, L., Definition of Health 2.0 and Medicine 2.0: A systematic review. J Med Internet Res 2010:12(2), 2012.Oh, H., Rizo, C., Enkin, M., and Jadad, A., What is eHealth (3): A systematic review of published definitions. J Med Internet Res 7(1):1, 2005. PMID: 15829471.World Health Organization (2011) mHealth: New horizons for health through mobile technologies: Based on the findings of the second global survey on eHealth (Global Observatory for eHealth Series, Volume 3). World Health Organization. 2011. ISBN: 9789241564250Lin, C., Mobile telemedicine: A survey study. J Med Syst April 36(2):511–520, 2012.El Khaddar, M.A., Harroud, H., Boulmalf, M., Elkoutbi, M., Habbani, A., Emerging wireless technologies in e-health Trends, challenges, and framework design issues. 2012 International Conference on Multimedia Computing and Systems (ICMCS). 440–445, 2012.Luanrattana, R., Win, K. T., Fulcher, J., and Iverson, D., Mobile technology use in medical education. J Med Syst 36(1):113–122, 2012.Yang, S. C., Mobile applications and 4 G wireless networks: A framework for analysis. Campus-Wide Information Systems 29(5):344–357, 2012.Kumar, B., Singh, S.P., Mohan, A., Emerging mobile communication technologies for health. 2010 International Conference on Computer and Communication Technology, ICCCT-2010; Allahabad; pp. 828–832, 2010.Yan, H., Huo, H., Xu, Y., and Gidlund, M., Wireless sensor network based E-health system—implementation and experimental results. IEEE Transactions on Consumer Electronics 56(4):2288–2295, 2010.IDC (2013) Press release: Strong demand for smartphones and heated vendor competition characterize the worldwide mobile phone market at the end of 2012. http://www.idc.com/getdoc.jsp?containerId=prUS23916413#.UVBKiRdhWCn . Accessed 11 September 2013.IDC (2012) IDC Raises its worldwide tablet forecast on continued strong demand and forthcoming new product launches. http://www.idc.com/getdoc.jsp?containerId=prUS23696912#.US9x86JhWCl . Accessed 11 September 2013.International Data Corporation (2013) Android and iOS combine for 91.1 % of the worldwide smartphone OS market in 4Q12 and 87.6 % for the year. http://www.idc.com/getdoc.jsp?containerId=prUS23946013 . Accessed 11 September 2013.Jones, C., (2013) Apple and Google continue to gain US Smartphone market share. Forbes. http://www.forbes.com/sites/chuckjones/2013/01/04/apple-and-google-continue-to-gain-us-smartphone-market-share/ . Accessed 11 September 2013.Apple (2013) iTunes. http://www.apple.com/itunes/ . Accessed 11 September 2013.Google (2013) Google play. https://play.google.com/store . Accessed 11 September 2013.Rowinski, D., (2013) The data doesn’t lie: iOS apps are better than android. Readwrite mobile. http://readwrite.com/2013/01/30/the-data-doesnt-lie-ios-apps-are-better-quality-than-android . Accessed 11 September 2013.Rajan, S. P., and Rajamony, S., Viable investigations and real-time recitation of enhanced ECG-based cardiac telemonitoring system for homecare applications: A systematic evaluation. Telemed J E Health 19(4):278–286, 2013.Logan, A. G., Transforming hypertension management using mobile health technology for telemonitoring and self-care support. Can J Cardiol 29(5):579–585, 2013.Tamrat, T., and Kachnowski, S., Special delivery: An analysis of mHealth in maternal and newborn health programs and their outcomes around the world. Matern Child Health J 16(5):1092–1101, 2012.Martínez-Pérez, B., de la Torre-Díez, I., López-Coronado, M., and Herreros-González, J., Mobile Apps in Cardiology: Review. JMIR Mhealth Uhealth 1(2):e15, 2013.de Wit HA, Mestres Gonzalvo C, Hurkens KP, Mulder WJ, Janknegt R, et al., Development of a computer system to support medication reviews in nursing homes. Int J Clin Pharm. 26, 2013.Dahlström, O., Thyberg, I., Hass, U., Skogh, T., and Timpka, T., Designing a decision support system for existing clinical organizational structures: Considerations from a rheumatology clinic. J Med Syst 30(5):325–31, 2006.Lambin P, Roelofs E, Reymen B, Velazquez ER, Buijsen J, et al., ‘Rapid learning health care in oncology’ - An approach towards decision support systems enabling customised radiotherapy’. Radiother Oncol. 27, 2013.Graham, T. A., Bullard, M. J., Kushniruk, A. W., Holroyd, B. R., and Rowe, B. H., Assessing the sensibility of two clinical decision support systems. J Med Syst 32(5):361–8, 2008.Martínez-Pérez, B., de la Torre-Díez, I., and López-Coronado, M., Mobile health applications for the most prevalent conditions by the World Health Organization: Review and analysis. J Med Internet Res 15(6):e120, 2013.Savel, T. G., Lee, B. A., Ledbetter, G., Brown, S., LaValley, D., et al., PTT advisor: A CDC-supported initiative to develop a mobile clinical laboratory decision support application for the iOS platform. Online J Public Health Inform 5(2):215, 2013.Doctor Doctor Inc. (2009) iDoc. iTunes. https://itunes.apple.com/es/app/idoc/id328354734?mt=8 . Accessed 13 September 2013.Hardyman, W., Bullock, A., Brown, A., Carter-Ingram, S., and Stacey, M., Mobile technology supporting trainee doctors’ workplace learning and patient care: An evaluation. BMC Med Educ 13:6, 2013.Lee, N. J., Chen, E. S., Currie, L. M., Donovan, M., Hall, E. K., et al., The effect of a mobile clinical decision support system on the diagnosis of obesity and overweight in acute and primary care encounters. ANS Adv Nurs Sci 32(3):211–21, 2009.Divall, P., Camosso-Stefinovic, J., and Baker, R., The use of personal digital assistants in clinical decision making by health care professionals: A systematic review. Health Informatics J 19(1):16–28, 2013.Chignell, M, and Yesha, Y, Lo, J., New methods for clinical decision support in hospitals. In Proceedings of the 2010 Conference of the Center for Advanced Studies on Collaborative Research (CASCON’10). Toronto, ON; Canada, 2010Charani, E., Kyratsis, Y., Lawson, W., Wickens, H., Brannigan, E. T., et al., An analysis of the development and implementation of a smartphone application for the delivery of antimicrobial prescribing policy: Lessons learnt. J Antimicrob Chemother 68(4):960–7, 2013.Klucken, J., Barth, J., Kugler, P., Schlachetzki, J., Henze, T., et al., Unbiased and mobile gait analysis detects motor impairment in Parkinson’s disease. PLoS One 8(2):e56956, 2013.Hervás, R., Fontecha, J., Ausín, D., Castanedo, F., Bravo, J., et al., Mobile monitoring and reasoning methods to prevent cardiovascular diseases. Sensors (Basel) 13(5):6524–41, 2013.Di Noia, T., Ostuni, V. C., Pesce, F., Binetti, G., Naso, N., et al., An end stage kidney disease predictor based on an artificial neural networks ensemble. Expert Syst Appl 40(11):4438–4445, 2013.Velikova, M., van Scheltinga, J. T., Lucas, P. J. F., and Spaanderman, M., Exploiting causal functional relationships in Bayesian network modelling for personalised healthcare. Int J Approx Reason, 2013. doi: 10.1016/j.ijar.2013.03.016 .Medical Data Solutions (2012) Pediatric clinical pathways. Google play. https://play.google.com/store/apps/details?id=com.ipathways . Accessed 17 September 2013.QxMD Medical Software Inc. (2013) Calculate by QxMD. Google play. https://play.google.com/store/apps/details?id=com.qxmd.calculate . Accessed 17 September 2013.Skyscape (2012) ACC pocket guides. Google play. https://play.google.com/store/apps/details?id=com.skyscape.packagefiveepkthreeundata.android.voucher.ui . Accessed 17 September 2013.Skyscape (2013) Skyscape medical resources. Google play. https://play.google.com/store/apps/details?id=com.skyscape.android.ui&hl=en . Accessed 17 September 2013.Pieter Kubben, M.D., (2012) NeuroMind. Google play. https://play.google.com/store/apps/details?id=eu.dign.NeuroMind . Accessed 17 September 2013.Mobile Systems, Inc. (2013) 2013 Medical diagnosis TR. Google play. https://play.google.com/store/apps/details?id=com.mobisystems.msdict.embedded.wireless.mcgrawhill.cmdt2013 . Accessed 17 September 2013.World Health Organization (2013) The global burden of disease: 2004 update. http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf . Accessed 18 September 2013.Martínez-Pérez, B., de la Torre-Díez, I., Candelas-Plasencia, S., and López-Coronado, M., Development and evaluation of tools for measuring the Quality of Experience (QoE) in mHealth applications. J Med Syst 37(5):9976, 2013

Disease Diagnosis Using Android

Disease diagnosis / Medical diagnoses is the process of determining which disease or condition\ud explains a person’s symptoms and signs. It is most often referred to as diagnosis with\ud the medical context being implicit. The information required for diagnosis is typically collected\ud from a case history and physical examination of the person seeking medical care. Diagnosis\ud is often challenging, because many signs and symptoms are non-specific.The term\ud Diagnosis refers to determination of the nature of a cause of a disease.In computer science\ud it is a typically used to determine the cause of symptoms and solutions.Our system enables\ud to deliver health care, diagnose patients,provide therapy,suggest medicines and gives health\ud tips related to users disease.The main aim is to provide expert-based health care to understaffed\ud remote sites and to provide advanced emergency to the user that is using the application

LipoDDx: a mobile application for identification of rare lipodystrophy syndromes

BACKGROUND: Lipodystrophy syndromes are a group of disorders characterized by a loss of adipose tissue once other situations of nutritional deprivation or exacerbated catabolism have been ruled out. With the exception of the HIV-associated lipodystrophy, they have a very low prevalence, which together with their large phenotypic heterogeneity makes their identification difficult, even for endocrinologists and pediatricians. This leads to significant delays in diagnosis or even to misdiagnosis. Our group has developed an algorithm that identifies the more than 40 rare lipodystrophy subtypes described to date. This algorithm has been implemented in a free mobile application, LipoDDx(R). Our aim was to establish the effectiveness of LipoDDx(R). Forty clinical records of patients with a diagnosis of certainty of most lipodystrophy subtypes were analyzed, including subjects without lipodystrophy. The medical records, blinded for diagnosis, were evaluated by 13 physicians, 1 biochemist and 1 dentist. Each evaluator first gave his/her results based on his/her own criteria. Then, a second diagnosis was given using LipoDDx(R). The results were analysed based on a score table according to the complexity of each case and the prevalence of the disease. RESULTS: LipoDDx(R) provides a user-friendly environment, based on usually dichotomous questions or choice of clinical signs from drop-down menus. The final result provided by this app for a particular case can be a low/high probability of suffering a particular lipodystrophy subtype. Without using LipoDDx(R) the success rate was 17 +/- 20%, while with LipoDDx(R) the success rate was 79 +/- 20% (p < 0.01). CONCLUSIONS: LipoDDx(R) is a free app that enables the identification of subtypes of rare lipodystrophies, which in this small cohort has around 80% effectiveness, which will be of help to doctors who are not experts in this field. However, it will be necessary to analyze more cases in order to obtain a more accurate efficiency value

Designing and developing a mobile application for indoor real-time positioning and navigation in healthcare facilities

Navigation portable applications have largely grown during the last years. However, the majority of them works just for outdoor positioning and routing, due to their architecture based upon Global Positioning System signals. Real-Time Positioning System intended to provide position estimation inside buildings is known as Indoor Positioning System (IPS)