By Tom Stibolt, MD, Mobile Musings Column Editor

Last month I reviewed mobile applications for physicians, and this month we will look at applications for patients.

A global accounting firm, PwC, released a reportdiscussing the top healthcare industry issues for 2016. In it, they note that millions of American consumers will have their first video consults, be prescribed their first health apps, use their smartphones as diagnostic tools and manage medical expenses for the first time in 2016. Shift by shift, visit by visit, nurses, doctors and other clinicians will also learn to work in new ways especially incorporating insights gleaned from data analysis of their treatment plans. In 2013, 16 percent of consumers said they had at least one health app on their device. Two years later, 32 percent said they did. It seems that millennials, who are enthusiastically embracing  wearables and health apps, prefer virtual communication for health interactions.

A Samsung newsletter called Insights has an article examining whether patients rely more on mobile health care apps than their physicians. It notes that we have gone from a system in which patients relied on physicians to provide all of their care and condition monitoring to patients using wearables and mobile health care apps to monitor their own health data and get continuous guidance and information from the devices they carry with them every day. Patients use the tools to track diet/nutrition, physical activity, and their symptoms, as well as sign up to receive medication reminders.

The vast majority of currently available medical applications target diabetes and heart disease. There are, however, a few more generally applicable apps.

iTriage is an app that allows patients to easily get medical answers, find care options and securely maintain and track their health information. It allows searching on symptoms and conditions and provides information about medications. The content is written and continually updated by an in-house team of clinicians and then reviewed by the faculty of Harvard Medical School. The app helps a patient to figure out what could be wrong and where to go for care. Recently, iTriage has merged with WellMatch, a company that provides cost information so the app now also can tell a patient how much care may cost.

The Mayo Clinic provided an application that allowed communication with triage nurses about a patient’s condition. The app was about $60 a month. It appears that it has now become an app specific to patients actually cared for by Mayo and provides access to parts of the patient’s medical record.

MyChart is an app created by Epic Systems, a supplier of medical record software. It provides access to health information for patients of the any institutions using Epic software. Most of the institutions using Epic also have an app providing this service.

Pulmonary patient apps come and go. A review of asthma apps in BMC Medicine in 2015 (volume 13:58) found that from 2011 to 2013 the number of asthma apps more than doubled from 93 to 191. This was despite withdrawal of 25 percent of existing apps. Newer apps unfortunately were no more likely than those available in 2011 to include comprehensive information, such as the use of action plans, or offer guidance consistent with evidence. Alarmingly, 13 percent of all apps and 39 percent of those intended to manage acute asthma, recommended self-care procedures unsupported by evidence.

There have been a number of other instances of patient apps being withdrawn either voluntarily, or more recently by order of the FDA. Another ongoing issue is that these apps and wearables can generate large amounts of data, which current medical record systems do not integrate. There is also a question of reliability and usefulness of the data.

There is much room for improvement and innovation with patient health apps.

Editor’s note: The ATS does not endorse any of the programs or products mentioned in this column.