Posted July 27, 2009 by Jason Rothstein and Lygeia Ricciardi
The use of smartphones to host health applications is
compatible with the platform model Project
HealthDesign promotes for PHR applications generally. Blackberry, Symbian, Palm, and Apple devices,
among others, support application services, with an increasing number of health
applications.
While Project
HealthDesign doesn’t endorse smartphones over any other platform—or any
particular type of smartphone over others—the Apple iPhone is currently
leading the pack when it comes to apps.
There are now more than 60,000 iPhone apps, with the pace of development
accelerating. Google’s Android operating system has 5,000 apps, and Nokia and
Blackberry have roughly 1,000 each, according to Slate Magazine.
The iPhone may provide certain clues about where we’re headed in the mobile PHR space. And some of these clues may challenge our assumptions about how consumer use of personal health records (PHRs) will grow in the future.
The iPhone App store is full of apps that give users access to sophisticated online services: eBay auctions, Netflix rentals, Paypal transactions, banking, blogging, Facebooking… the list goes on. But curiously, the major PHRs don’t yet have much presence on the iPhone — or on any smartphone platform. Among the most common PHR platforms, only Google Health has a meaningful iPhone presence, through two third-party applications: 1.) Health Cloud, which delivers a view of the account holder’s PHR, somewhat optimized for the iPhone’s screen with limited functionality for users to add new information, and 2.) MotionPHR, which bills itself as a standalone mobile PHR that also integrates and syncs with Google Health.
A quick search through the iPhone app store suggests that most of the 1,500 or so health apps offered focus overwhelmingly on collecting, tracking, analyzing, and even sharing both traditional clinical measures of health and Observations of Daily Living (ODLs) — but not on integrating them with a more robust PHR. (ODLs are consumers’ or patients’ own measures of their health related to factors that they define as relevant. Examples of ODLs include sleep patterns, fluctuations in work-or home-related stress, and exercise/eating patterns. These observations differ from patient capture of physician directed data, for example, in that they are often uniquely meaningful to the individual.
By far, the most common health and ODL tracking applications in the app store concern weight and nutrition: weight trackers, BMI calculators, calorie counters, and exercise loggers, in almost endless combinations. While some, like the stylish Weight Bot, try to appeal though simplicity, others enhance user experience with added features.
For example, Health
Cubby combines weight tracking with exercise goals, simple nutrition
records, and the added ability to connect with other people using the same
system to provide reinforcement and incentive to stay on a program. Others,
like SparkPeople
Food & Fitness Tracker, and Livestrong.com’s
Calorie Tracker add an iPhone interface to existing social fitness web
sites. (It’s tempting to wonder if this social approach to weight loss and
exercise goals might have potential for disease management too.)
Just as weight looms large in the imaginations of iPhone app users, so too does one potential consequence of poor weight management: diabetes. One of the more popular programs, Diabetes Pilot, first appeared on the Palm platform many years ago, and also integrates with a Windows-only desktop tool. But the iPhone platform has spurred the development of new applications like Glucose Buddy, an app with a heavy emphasis on combining ODL input (such as exercise and diet) with blood sugar levels to produce easy-to-understand reports for the patient. In the future, smartphones could also link with glucose management hardware to collect data and offer patient feedback, like the system envisioned by the winners of the 2009 DiabetesMine Design Challenge.
Given the iPhone’s contribution
to the explosive
growth in smartphone use among women, it only makes sense that reproductive
health apps make up another sizeable category. The app store features more than
a dozen simple menstruation logs, including the popular iPeriod,
and Period
Tracker, which incorporate ODL fields to record indicators such as fatigue
and mood. Another several applications,
like FemCal,
expand on these features to emphasize ovulation timing and fertility, and track
pregnancy test results. Still others track pregnancies themselves, like Pregnancy
Calendar, which offers fields to record information both about maternal and
fetal health indicators. (And then of course, after nine months, Baby
Activity Logger helps new parents record ODLs on baby’s behalf. Can Fisher
Price’s My First PHR be far behind?)
TheCarrot.com, an app that integrates with a site of the same name somewhat blurs the line between a simple ODL app and what many would consider to be a full-fledged PHR. TheCarrot.com combines a comprehensive set of trackers for clinical health indicators and ODL indicators such as mood, energy level, sleep, and anything else that fits into its journal format. TheCarrot.com also has additional features for disease management, medication management, and some types of lab results. It also incorporates sharing functions both via the web and through simple printable information sheets that patients can take with them to a doctor’s office.
