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Jordan Safirstein, MD Headshot

Smartphone Apps for a Healthier Heart

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The number of apps over the past five years has exploded for both health care professionals and patients alike. We are talking exponential growth. A recent count of the iTunes app store identified nearly 20,000 health care and wellness apps! To help control this influx of apps, the FDA has actually inserted itself and defined a difference between a "health" app and a "wellness" app.

A health app is categorized by the FDA as mobile software that diagnoses, tracks or treats disease.

A wellness app is mobile software that enhances or tracks the overall health of the user.

That said, there is a ton of crossover between the two classes -- e.g., a calorie counter that can then make recommendations about how to adjust your intake, or a BP tracker that alerts you to call your physician when there are too many consecutive high numbers.

A relatively quick and easy way to identify successful patient apps is to check out which patient-centered apps have the most downloads in the iTunes store and peruse the reviews written by patients (often the younger set). Here are some apps that I feel have transcended the niche medical category and gone into the widely used and useful category:

The Encyclopedic Health App

WebMD -- This is the one of the major categories of patient apps -- education (the other categories would be data recording/tracking and the last category would be management). It's easy to use, full of reliable information, has a trusted brand and offers side tools like a pill identifier. Oh yeah, and it's free and available for iPhone and Android.

The Doctor in Your Mobile Phone App

iTriage -- A cool and rather progressive app that allows patients to find the nearest emergency rooms and can often provide estimated waiting times (although the accuracy on that is questionable). It also serves as a crude diagnostic tool when you provide symptoms and gives a ton of reference information on medications, procedures, conditions, etc. It is free and available for both platforms.

"Your Doctor's Best Friend" Apps

BP Monitor or BP Tracker by HeartWise -- Probably the most success I've had (from a personal standpoint) in getting my patients to use mobile apps. While there are blood pressure cuffs available at Walgreens and the Apple Store that hook into the iPhone directly or wirelessly, the most common BP apps just serve as a substitute for the yellow legal pad on which most people record their daily blood-pressure reading. The benefit of these BP trackers is that they can be exported rather easily in graphic or tabular form to the doctor by email or printed out in a presentable fashion. My patients that use them love them. And on a personal note, the printouts are displayed in a clear and easy way.

Glucose Companion -- Or one of the numerous other glucose/calorie-tracking apps. There are several and they serve a similar purpose to the hypertension apps listed above. Recently, apps like WellDoc are attempting to integrate their data with existing electronic health records (EHR) -- and have been successful, improving the management of patients while physically seeing them less!

The Fully Engaged Patient Apps

Gazelle -- For specialists, i.e., non-general practitioners, keeping track of patients' labs is a chronic issue and patients are often inconvenienced of the fact that we do not do labs in our offices and inconsistently receive copies of their recent bloodwork. This app by Quest Diagnostics allows patients to make appointments online and track their lab data and keep it on their phone. To me, this is one of the most obvious and logical utilizations of mobile apps, and will likely be the standard in the near future.

Pill Reminder
-- Medication adherence has been identified by the mobile medical community (and Big Pharma) as the low-hanging fruit of this sector. This app by Drugs.com attempts to achieve success in this space. Logically, it sends reminders when to take meds, as well as reminders about when you might need a refill and provides a drug reference geared toward patients. It takes a user manually entering their individual meds and the instructions for administration, which will exclude a large group of patients, but it's a start. In the future (and it does exist already to some extent), one could imagine that the pharmacy would electronically input your medical regimen into their own app that you would have on your phone and all you would have to do is log in and your meds would automatically populate.

The Get-in-Shape Apps

My Fitness Pal or Calorie Counter -- There are numerous apps in this space and I have not had time (or exercise tolerance) to sort through all of them, but they all attempt to acheive the same goal -- provide the patient with info so that he or she may make healthful changes. Some even make recommendations. They vary is their ease of use, and some will interface with a wearable device (such as Fitbit or the Nike FuelBand) that count your steps and monitor your breathing while you sleep giving you biofeedback info as well.

C25K (Couch to 5K) -- If you are the type of exerciser who requires structure, this is a great one. Apps like RunTracker primarily log your distance run and then post it (somewhat annoyingly) to social media outlets to inform all your acquaintances that you ran 4.7 miles. This one actually starts you slow and gradually increases your run-walk ratio as you progress through a four-week program, culminating in you running a 5K. From personal use, I can attest to its benefits. The best part is it can run behind any other app you have running, so that if you want to listen to music or a radio app while you run, this will politely work in the background and alert you when to walk/run.

The Panacea Apps

Google App -- Still, and likely always, the most common resource for health information. The results sometimes may be muddled, but overall it often serves as a wonderful resource for information. According to the Pew Research Center, nearly 70 percent of the web-surfing population have looked up a health topic in the last year -- the most commonly sought topics are specific diseases and conditions. More interestingly, almost half of online health searches are on behalf of someone else. Perhaps even more impressive, 52 percent of smartphone owners have used their phone to look up health or medical information. We are increasingly becoming a wireless, laptop-less, mobile society and before too long we will be coordinating medical care, receiving test results, and perhaps even seeing our health care providers all on our phones.

ZocDoc --
The above brings us to our last app, perhaps the most paradigm shifting one of the bunch -- until there's one that does video-conference medical evaluations on your phone (coming soon I'm sure). As medicine continues its evolution towards a more patient-centered, service-oriented approach, ZocDoc and several others that have followed suit, now permit patients to input their insurance info and make appointments immediately with a doctor in their desired location. Why shouldn't medicine be more like every other service industry? That's a debate for another time.

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