An App a day, are you ready for another way?

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 A Canadian Perspective on Nursing Informatics Column

by Lynn Nagle, PhD RN
Senior Editor


Nagle, L. (2013). An App a day, are you ready for another way?  Online Journal of Nursing Informatics (OJNI), 17 (3), Available at  http://ojni.org/issues/?p= 2839


 nagleLess than a few years ago, who knew that our world would come to be defined by the apps on our mobile devices? First there were simple apps for email, managing your calendar, and then came the mindless apps to while away hours playing the likes of Angry Birds™, or apps like Skype™ and Facetime™ to support real time chats with family and friends or miscellaneous   Twitter™ feeds on just about any topic or event you might imagine, and of course the important task of checking into Facebook™ to be sure there isn’t a message from one of your imaginary friends.

At the same time, the ubiquity of mobile devices has begun to revolutionize the delivery of care and the means by which citizens can be actively involved in their care. There are hundreds of health apps currently available for free and many more that can be purchased for use on a mobile device and some with peripheral attachments to mimic existing medical devices. For example there are apps designed to measure blood glucose, monitor blood pressure and heart rate and others that can be used to perform an ultrasound or an ECG. To this end, the Food and Drug Administration (FDA) has recently indicated that it will move to regulate those apps that function in a manner akin to medical devices such as ultrasounds and ECG’s (Tavernise, 2013). In the interest of public safety, these apps will be subject to the same regulatory standards that apply to the medical devices they resemble.

But what does this emerging mobile care mean for the care givers and care recipients alike? The mobile community nurse is being afforded tools that deliver on efficiency, safety and connectivity that did not previously exist. Think about the use of a GPS to plot home visits and find the most expedient route. And what about the inherent safety of having cell phone access for emergency situations and access to colleagues for consultation when and where you need them. Think about the family care givers and individuals who can now submit vital signs, blood serum levels and other key observations to health professionals without ever leaving home. Self-management of chronic illness is being enabled by innumerable apps: diabetics young and old, monitoring diet, exercise, blood glucose, receiving alerts and reminders, and engaging online with others “Patients like Me.” Clearly, these apps are just the beginning of a wave of much more to come – just Google™ health care apps and you will be astounded at the results. Albeit many currently represent variations within a narrow range of wellness and illness tools, but they are plentiful and surely to multiply in the years ahead.

For nurses, the emerging reality of m-Health or mobile health and virtual health solutions suggests new opportunities for engaging with patients and families. So the question arises as to whether citizens are actually interested in having different means of communicating with their providers. Early indications would suggest a clear affirmation of this increasing desire among citizens. The participation of more than 2,400 Canadians in a study conducted earlier this year (PwC, 2013) uncovered important perspectives that should be given consideration by all health professions.

Overall, respondents are satisfied with the health care they receive. They believe their security and privacy are well protected and they rate the quality of care they’ve received as high. But respondents also indicate that there are areas for improvement. Specifically, they expect improved access to their health care providers through the use of more modern communication channels (PwC, 2013, p.4).

The report defines and addresses the increasing popularity of virtual and mobile health. While virtual health (vhealth) allows health care professionals to collaborate with each other and deliver care remotely, mobile health (mHealth) is described as the use of wireless tools to deliverand access virtual care and health information (PwC, 2013, p 5). Seventy-nine percent of respondents reported that they are definitely ready to correspond with their health care providers via email and 83% indicated that they would like to have the option for online prescription renewals. Further while almost 50% of the participants supported the belief that mobile health apps will make health care more convenient in the next three years, almost two-thirds would also consider using vHealth options in their own care or for someone they care for. A majority also suggested that care should be increasingly delivered virtually whenever possible and offered strong support for virtual health to improve communication among providers, decrease costs, and increase timeliness of access to care and quality and efficiency in care management (PwC, 2013). The report provides additional findings related to the respondents’ views but overall suggests that trends to self-management of wellness and illness are being accelerated by virtue of available apps. Nevertheless, it clearly suggests that health care providers need to be prepared for an inevitable increase in citizens’ demands for ready access to information and care.  Are you ready for the App way?


Pricewaterhouse Coopers LLP (PwC). (2013). Making care mobile: Shifting perspectives on the virtualization of health care. Retrieved from http://www.pwc.com/ca/en/healthcare/virtual-health-making-care-mobile-canada.jhtml

Tavernise, S. (2013). FDA to regulate some health apps. New York Times, September 23, 2013. Retrieved from http://www.nytimes.com/2013/09/24/health/fda-to-regulate-only-some-health-apps.html.

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