Running head: SMARTPHONE APPLICATIONS FOR MEDICAL SERVICES 1. Smartphone Applications for Medical Services. Meshari S. Alobaid IT

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Running head: SMARTPHONE APPLICATIONS FOR MEDICAL SERVICES 1 Smartphone Applications for Medical Services Meshari S. Alobaid IT-103-002 February 24, 2015 "By placing this statement on my webpage, I certify that I have read and understand the GMU Honor Code on http://oai.gmu.edu/the- mason- honor- code/. I am fully aware of the following sections of the Honor Code: Extent of the Honor Code, Responsibility of the Student and Penalty. In addition, I have received permission from the copyright holder for any copyrighted material that is displayed on my site. This includes quoting extensive amounts of text, any material copied directly from a web page and graphics/pictures that are copyrighted. This project or subject material has not been used in another class by me or any other student. Finally, I certify that this site is not for commercial purposes, which is a violation of the George Mason Responsible Use of Computing (RUC) Policy posted on http://copyright.gmu.edu/?page_id=301 web site."

SMARTPHONE APPLICATIONS FOR MEDICAL SERVICES 2 Introduction Smartphone applications use in medical care has been the focus of researchers and developers in the recent years. Different applications were introduced to the medical discipline and some are still under development. Some applications can help in holding the patient medical records, which may have a huge positive influence in the case of emergency. Other applications are designed to help the doctor or care provider to monitor his patients, view and examine their results, as well as provide clinical decisions based on given data. The purpose of this paper is to examine the smartphone applications role for medical services, and investigate its potential benefits. Moreover, this paper also discusses the legal, ethical, and social issues related to it as well as security concerns. Background Different medical applications were introduced in the market for in different areas such as pharmacology, clinical decision and laboratory data (Gross et al., 2014). The use of smart phones applications has many advantages and some disadvantages as well. Some of the advantages lies in the fact that most people have a smartphone these days and they are easy to carry and accompany people all the time (Epstein & Bequette, 2013). In addition, many medical applications can be easily used and they can be used to store patient history and to monitor psychological symptomatology (Epstein & Bequette, 2013). The disadvantages are represented in many ways such as the research limitations, incorrect user behavior, and security issues, which may affect the user s privacy (Epstein & Bequette, 2013). In addition, some applications such as Doctor on Demand would allow the patient to have a video chat and get the consultation and diagnosis from certified doctors, as well as having medications prescribed (Licht, 2014). Although this application can help in avoiding the waiting time in the hospital, it has limited

SMARTPHONE APPLICATIONS FOR MEDICAL SERVICES 3 physical diagnosis since the doctors will not be able to measure the blood pressure or temperature of the patient (Licht, 2014). Thus, this application is not intended for people with serious diseases, but for healthy individuals suffering from normal health problems such as pink eye or sore throat (Licht, 2014). Potential Benefits The smartphone applications have many benefits not only to the patients, but also the clinics and hospitals. Some applications would allow patients to save their medical records, which can also help the healthcare provider (doctor or even an ambulance in case of emergency) to understand and evaluate the patient situation better (Gross et al., 2014). In addition, an interesting application called AirStrip OB, introduced in 2008, allows the doctor to monitor from his smartphone the pregnant woman contractions and her fetal heartbeat in high-risk deliveries even when the doctor is not present at the hospital (Zimmerman, 2012). This application can also help sending the data from the ambulance to the emergency room so that they will be ready for the case when it arrives (Zimmerman, 2012). Another benefit from these applications is that some applications provide treatment for patients who could not gain access to therapy (Epstein & Bequette, 2013). For instance, an application helped a patient to restore her impaired memory after having a brain surgery (Epstein & Bequette, 2013). Furthermore, some applications such as Micromedex and ERres allow the user to have access to a database of drugs with explanations on potential drug interactions and compatibility, as well as providing a quick reference tool for emergency medicine (Gross et al., 2014). Legal and ethical issues The use of applications for the medical services has raised legal questions regarding the rights and duties of both patients and healthcare providers (Cushman, 2010). Normally, Law

SMARTPHONE APPLICATIONS FOR MEDICAL SERVICES 4 does not protect the privacy if the information was shared and revealed to different sources outside doctor-patient confidential circle (Cushman, 2010). This may cause issues specially if a third party, such as a social networking site, was used as a vehicle to exchange or transport data between the patient and the doctor or clinic since the commercial provider of the social networking site can delete, lose or even share information (Cushman, 2010). For this and other reasons, many states as well as the Health Insurance Portability and Accountability Act (HIPAA) have introduced data breach notification laws, in which these laws increase security requirements on organizations that contain personal data (Cushman, 2010). Security Concerns Although the medical services applications have many advantages, but there are still some problems with personal health records. Therefore, there are many questions about patient privacy and security. For example, the patient has his right if he is sensitive about his personal information (Cushman, 2010). One disadvantage is that sometimes different employees have access to see the personal health records, and that is not a good idea because most of the patients don t like this situation since they want their right in privacy with their doctor or care provider (Cushman, 2010). Smart phones are not good example for privacy, because of data transformed from the user s phone to the companies providing the phone service (Epstein & Bequette, 2013). Furthermore, the personal health records can be hacked to download all the patient history record, and there are many spy programs that can access your profile in your smartphone and steal your information. Moreover, there is an important issue about the confidentiality when the counselor or the doctor deicide to take the cellphone outside the work, since it will be a risk because maybe one of the doctor family or anyone else will see the personal information for the patient (Epstein & Bequette, 2013).

SMARTPHONE APPLICATIONS FOR MEDICAL SERVICES 5 Social Problems The advances in smartphone applications for medical services do not have a huge influence on a person s social life; however, in some cases it might cause some issues. To illustrate, some patients prefer to keep their medical problems and records from people around them, even their own families. Thus, they might face problems if by mistake a person in their family had some access to the information or records enclosed in their smartphone applications. Not only that, but also if a person suffers from a disease such as AIDS and it was reveled by someone, the word may spread and cause this person social problems. In addition, about 65-70% of smartphone users do not have security password to lock their phones, and many of them enable phone alerts to be displayed on the phone screen, which can also cause some social problems if they are sensitive about their medical records and information (Epstein & Bequette, 2013). Other problems may occur if parents have different opinions about whether to use these applications for the benefit of their children. Further required research Although many applications are already introduced in the market for users, there are still many of them under development and further research. To illustrate, mobile MIM was one of the applications that F.D.A approved for diagnostic use (Eisenberg, 2011). It allows doctors to view and examine scans such as x-rays and magnetic resonance imaging (MRI) (Eisenberg, 2011). The future focus will concentrate on applications that allow the smartphone user to use it as a diagnostic tool such as an x-ray device or even an electrocardiogram (EKG) machine to determine whether the patient is having a heart attack (Eisenberg, 2011). More applications are under development in order to enable records transmission and integration in existing IT platforms and medical records (Gross et al., 2014). However, there are still some barriers and

SMARTPHONE APPLICATIONS FOR MEDICAL SERVICES 6 limitations in the development of these technologies. As an example, funding is the main barrier in such research area since there are startup, development and equipment costs associated with it (Epstein & Bequette, 2013). In addition, the rate at which technology is developing is fast, thus causing sometimes researchers results to be outdated when their results are finally published (Epstein & Bequette, 2013). Conclusion The use of smartphone applications for medical services has been the interest of researchers, developer companies, and even medical care providers. Some applications are already in the market and are available for use, while others are still under development. These applications have many benefits for both the patient and the clinic or caregiver. They can save precious time, hold medical records, guide patient and inform them about medications and drugs, and even help the doctors to follow up with their patients even when they are faraway. However, some issues arise with the use of these applications such as the privacy and security of the user s information. Thus, I believe that strict regulations and rules has to be maid in order to control and assure the user s privacy and the security of his records if they are present in an application, because these applications has many benefits and can have a positive influence on the medical services.

SMARTPHONE APPLICATIONS FOR MEDICAL SERVICES 7 References Gross, T., Marcin, J., Auerbach, M., Middlebrooks, L., Putzier, P. M., Jaeger, M. W., & Abramo, T. (2014). New technologies in emergency medical services for children. Clinical Pediatric Emergency Medicine, 15(1), 67-78. doi: http://dx.doi.org/10.1016/j.cpem.2014.01.009 The paper is about new technologies to enhance the medical services in different ways. It provides different details on communication technologies with details and examples of smartphones medical applications. It also has many sections including advances in patient monitoring, patient treatment technologies, and disaster management. This paper is reliable since it includes reliable references sources such as papers, institutions, and organizations. Epstein, J., & Bequette, A. W. (2013). Smart phone applications in clinical practice. Journal of Mental Health Counseling, 35(4), 283-295. Retrieved from http://search.proquest.com/docview/1448231680?accountid=14541 This paper discusses some of the advantages and disadvantages of using smartphone applications in medical services and clinics. It covers different sections such as research on smartphone apps, research limitations, and caveats of using cell phones in clinical practice. The paper is reliable since it references different trustworthy research papers. Licht, C. (Producer). (2014, August 8). CBS This Morning [Television broadcast]. New York, NY: CBS Broadcast Center. Retrieved from http://www.cbsnews.com/news/medical-apps-let-doctors-diagnose-by-smartphone/

SMARTPHONE APPLICATIONS FOR MEDICAL SERVICES 8 This reference is a video of an interview on the CBS news channel with Dr. Holly Philips, a CBS News medical contributor. Dr. Philips explains different smartphone applications in the medical practice and their advantages and disadvantages. This is a good source since a doctor provides the information without any bias to the subject. Zimmerman, E. (2012, April 11). Vital signs by phone, then, with a click, a doctor s Appointment. New York Times. Retrieved from http://www.nytimes.com/2012/04/12/business/smallbusiness/start-ups-use-technology-inpatient-doctor-interaction.html This reference is an online newspaper article published on the New York Times. It discusses different mobile applications for medical practice usage and the initial idea behind each application. This is a reliable source since it provides information about different applications in the market. Cushman, R., Froomkin, A. M., Cava, A., Abril, P., Goodman, K. W., & Project HealthDesign. (October 01, 2010). Ethical, legal and social issues for personal health records and applications. Journal of Biomedical Informatics, 43, 5 This paper investigates the ethical, legal and social issues with using applications to hold personal health records. It has different sections such as Privacy and confidentiality, Social networking, Legal uncertainty, and Data security. It is a reliable paper since it has references of different trustworthy research papers, as well as the fact that it is funded and completed by the Robert Wood Johnson Foundation s Project HealthDesign. Eisenberg, A. (2011, October 15). Those scan results are just an app away. New York Times. Retrieved from http://www.nytimes.com/2011/10/16/business/medical-apps-to-assistwith-diagnoses-cleared-by-fda.html?_r=0

SMARTPHONE APPLICATIONS FOR MEDICAL SERVICES 9 This reference is an online newspaper article published on the New York Times. It discusses some smartphone applications for medical services such as the Mobile MIM which allows physicians to examine scans such as x-rays and MRI images if they are not at their workstation. It also describes some future ideas of applications. This is a reliable source since it provides information from a radiation oncologist Dr. Gagnon.