12 • Technology


MEDICINE AT YOU T


With so many medical apps on the market, doctors have to be increasingly careful in deciding which ones are worth downloading


HE world of medical apps is an ever-expanding one populated by both the ingeniously innovative and the downright dodgy. Who knew you could cure acne using the light from a mobile


phone or augment breast size by blaring baby cries out of your device 20 times a day? Others claim to allow users to select the sex of their baby by entering certain times, dates and phases of the moon. While the market is awash with apps making all manner of dubious medical claims, there are many that have proved popular with clinicians. There are tools to assist diagnosis, staging or treatment (such as calculating fluid requirements for burns patients), as well as countless others that can help monitor and promote general health and wellbeing.


Quality markers With so much choice, it is important that doctors take a cautious approach, researching as much as possible the app’s origins and reliability and looking out for positive/negative reviews by fellow healthcare professionals.


Health secretary Jeremy Hunt recently


announced a multi-million pound package of measures to “fast track digital excellence and improve the digital skills of the NHS workforce”. As part of this new campaign, NHS England has pledged to launch a library of NHS-assessed apps which aims to make selection easier. Another helpful guide is to look out for the CE mark, indicating it complies with essential criteria set out under European law. This applies specifically to apps with a medical purpose (i.e. those supporting diagnosis or clinical decisions) which are defined by law as “medical devices” and regulated in the UK by the MHRA. The first app to be officially registered by the


MHRA was Mersey Burns. It is a popular clinical tool for estimating burn area percentages, prescribing fluids using the Parkland formula, and recording patients’ details (being mindful of confidentiality). It was developed by plastic surgeons at St Helen’s and Knowsley NHS Trust and has won a number of innovation awards as well as favourable reviews. In its April 2015 guidance Using apps in


clinical practice, the Royal College of Physicians of London says doctors should not use medical


apps, including web apps, that do not have a CE mark. It is worth ensuring that the specific version of the app you are using is CE marked, rather than relying on the general information in the online app store. Apps which do not require a CE mark are those which do not use patient-specific information and only perform administrative functions. This might include those offering general guidance or supporting training. While it is a useful indicator, the RCP goes on to state: “Unfortunately, even if an app has a CE mark, that does not mean that it meets best practice, has been tested for accuracy or benefits in clinical use, or is applicable to the patient/ decision for which it is being used.” Most importantly, the College adds: “Always


exercise professional judgement before relying on information from an app.”


Popular apps So what are some of the commonly used apps for doctors on the market? Those listed below have received positive reviews but doctors are advised to carefully consider any app used in clinical practice. And if you access a smartphone app in front of a patient, it may be worthwhile quickly acknowledging this – MDDUS has dealt with a number of complaints from patients who wrongly assumed their doctor was rudely texting mid-consultation. The following are in no particular order (and MDDUS doesn’t endorse or approve any app):


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