F E AT URE T E C HN O L O G Y


MAKING A MED T


What goes into the development and testing of a medical app? Here Matt Wickenden describes how one innovative app was custom created for use by respiratory specialists


HE list of things that smartphones can do is constantly growing – and their role in assisting healthcare professionals on the ward and in practices is also expanding almost daily. Apps in particular have the potential to offer quick and simple answers to some of the key questions doctors face every day. But they need to be reliable and effective.


Recently Cancer Research UK has been involved in


developing an app for iPhone and iPads in partnership with the British Thoracic Society (BTS). Our goal is to make it easy for health professionals to access comprehensive guidelines published in 2015 by the Society on how to manage patients with small tissue growths – called pulmonary nodules – that can appear on lung scans. These nodules can be harmless, but they can also be cancerous and need treatment. The guidelines have been very popular with doctors and the teams they work with, offering information to help diagnose patients with lung cancer as quickly as possible – and without carrying out unnecessary tests on people who don’t need them. But the different hospital staff who use the guidelines are almost always on the move. When we spoke to them it was clear they want the information they


need to move with them. Our app is designed to make that possible.


WHAT ARE THE GUIDELINES FOR? When a nodule is found on a scan, doctors must quickly decide if it needs further investigation. They have to balance this with avoiding unnecessary tests and worry for patients who may have harmless (benign) nodules. The guidelines help doctors decide these next steps – whether to discharge the patient, bring them back for monitoring, or offer further tests that may lead to a lung cancer diagnosis followed by treatment. The guidelines recommend using three different mathematical calculations to assess the risk that the nodule is cancerous and how quickly it’s growing. These have been turned into online calculators which


are available on the BTS website (tinyurl.com/ h6cpemn).


The guidelines and online calculators have been really


popular. Since the start of 2016, the online calculators have been used over 18,700 times, helping doctors make vital decisions around the care of thousands of patients. But there’s a problem.


HOW CAN AN APP HELP? As is often the case in medicine, the lung nodule guidelines contain a huge amount of information. The detail is vital but not something a doctor can quickly refer back to while they’re in the clinic or in a multidisciplinary team meeting (MDT) planning how best to care for their patients. Also, while the calculators are available online, it’s


awkward for doctors and their teams to access them when they’re on the wards or in MDTs. Simply using their phone isn’t easy either because they often can’t reliably get Wi-Fi or a mobile signal in hospitals. Our app gets around both these problems. Summaries


of the key information are already downloaded onto their phone, purpose built for handling the maths and available whenever clinicians need it.


“From the start we wanted to ensure that the design and functionality of the app did exactly what the doctors needed it to”


12 / MDDUS INSIGHT / Q1 2017


DOCTORS HELPED DESIGN THE APP TOO From the start we wanted to ensure that the design and functionality of the app did exactly what the doctors needed it to. First we collected feedback from 18 health professionals. We found that 11 were already using smartphone apps for their work at least several times a month, with three using them several times a day. The feedback also showed that 11 were very likely to use an app version of the guidelines and calculators. We then worked with our in-house digital experts to develop a prototype app that we took to hospitals in Leeds


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