Took a couple months off, but it’s time to rejoin Research Tuesday! Time to share and critique more research, thanks to the SLP Blogger challenge set up by Rachel Wynn over at Gray Matter Therapy. I’m re-entering the challenge with a review of an article on using apps in a clinical setting. (Oh, how appropriate.) It also isn’t exactly a research study, but rather a review of the present state of affairs, introduction to current issues, and suggestions for guidelines. It also provides a good overview of the numbers and preliminary research (and lack thereof) that is available.
Article: Lindley, J, & Fernando, J. (2013). Being smart: Challenges in the use of mobile applications in clinical settings. European Journal of ePractice, 21, 4-13.
Background: Mobile apps are being incorporated into every field, including medical. Although benefits are obvious, there is a lack of established guidelines or formal acknowledgment of the risks and disadvantages. This needs to more fully scrutinized in order for healthcare professionals to be adequately equipped for integration of apps into their practice.
Current Use of Apps: Some numbers to consider…
- There are 97,000 healthcare apps, approximately 15% of which are specifically designed for use by healthcare professionals.
- US market research found 70% of doctors have downloaded medical apps.
- 1/3 physicians and nearly 3/4 nurses use apps on a daily basis for work.
The Pros: Clearly, using apps in clinical practice has some awesome benefits. Previous research has highlighted the following pros of using apps as a clinician:
- Access to data and high quality images
- Support for clinician-patient interactions (e.g. providing a patient resources)
- Convenience/enjoyability of use.
- Time saving
The authors of this article broke the benefits down into the following categories:
- Resources (e.g. storing data on a device, social networking)
- Convenience (e.g. mobility, multiple resources)
- Speedier access (e.g. no boot-up time, voice activated apps)
- Kinesthetics (e.g. ease/pleasure of use)
- Work practices (e.g. accessing data bedside)
The Cons: Is it all good though? Previous research has highlighted the following cons of using apps as a clinician:
- Sometimes slow access to the device/applications
- Potentially slowed speed of interaction with patients
The authors of this article broke the disadvantages/risks down into the following categories:
- Infrastructure (e.g. too many simultaneous users slowing Internet speed)
- Distractors (e.g. pop-ups within the app, email notifications)
- Privacy/Security (e.g. stolen devices, social media communication stored on the device)
- App Developers (e.g. lack of understanding of healthcare standards, limited critique during development)
- User Deficits/Concerns (e.g. clinicians lacking app know-how, students using apps improperly, clinicians worried about using apps in front of patients and seeming inattentive)
- Limited Control/Regulation (e.g. governments are just beginning to place limitations on what app developers can claim an app can do)
Next Steps: So what needs to happen? The authors suggest the following:
- We need to change the way we educate future healthcare professionals to include best practice regarding app use in clinical settings.
- Recognized healthcare associations/authorities need to be more actively involved in developing guidelines for this area.
Real Life Applications: Okay, so how does this affect us as speech-language pathologists? I don’t think we need to drop all of our apps and run. 😉 In fact, the authors of this article are quick to mention that they are not attempting to deter people from technology, but rather to be a bit more careful and purposeful with it. What I am taking away from it:
- We need to be conscientious of how our patients/students react to technology. Some of them thrive in the presence of an iPad. Others see it as inattentiveness or can be frustrated by tech glitches and difficulty with the device.
- We need to limit the distractions. I’m going to pick on app developers here – quit it with the obnoxious flashing ads in apps! Especially those of you who are developing SLP/education/medical-specific apps. (I won’t even get started on the children’s book apps that feature very adult-themed advertisements.) Have some basic understanding of cognition, friends. On the SLP end, however, we also need to be smart enough with our devices to know how to turn off Facebook, Twitter, Instagram, email, etc notifications when we are using our devices in therapy.
- We need to place greater emphasis on privacy. If you use SLP apps, it might be scary how much patient/student information can be accessed from your iPad. It worries me how few SLPs have password locks on their iPads. It also worries me that most SLP assessment/data-storing apps don’t have password protection options. I know this is difficult from a tech standpoint, but the industry as a whole needs to come up with a good solution for this.
- We need to start explicitly training students in this. I get so frustrated by the excuse “it’s a generational thing” when it comes to university SLP departments. That is a blatant cop-out for becoming knowledgeable about current practice. It also sets students/future professionals up for failure by refusing to address appropriate and current usage of apps.
- We need to be contributing to reviews and development of apps. I think we can greatly improve the end-user experience significantly with more app reviews (on blogs as well as in the iTunes store and other app markets), getting involved in beta testing, and voicing concerns when necessary (e.g. letting a developer know about potential privacy violations or unfounded claims about the app).
Your Thoughts: Since you’re reading this blog, there’s a good chance you use apps in therapy. What are your positive/negative experiences with this? Are the concerns presented by these authors valid?