Personal Health Record app underscores importance of using patient friendly medical terms

Part of the new iMedicalApps Patient Centered App Series 

By: Kathy A Nieder, MD

PocketHealth is a patient app developed by Cognovant as a mobile Personal Health Record (mPHR) available for the iPhone, iPad and Android platforms.

This is an ambitious and comprehensive app based on Electronic Health Record features for individual use. It’s stated purpose by the developer is to allow consumers to take control of their health data. It is encrypted and stored solely on the device.

There are future disease specific modules in development. Also planned is the ability to sync the app across devices. Cognovant includes a lengthy disclaimer that explains how they collect information specific to the app’s usage but no confidential information that is entered into the app.

The analysis of this app revealed how critical it is for app developers targeting patients to use medical terminology patients can understand. We will explain further in this review.

Some information can be entered both by tapping on the left side of the screen or one can tap on Main which will allow the user to add more specific facts, such as Medical conditions, allergies, immunizations, etc.

Appointments include a map link and a nice feature option of adding the appointment to the native calendar app on your device. There is a customizable area on for putting notes that could be used for asking questions of one’s physician.

The medication list is not customizable but very extensive, perhaps too extensive for the average home user. For example “fish oil” is not in the list but “Omega-3 Acid Ethyl Esters” is. However, the fish oil bottle may mention eicosapentaenoic acid or EPA and docosahexaenoic acid or DHA.

It will probably mention Omega-3 acids but how will a patient know which one to pick? There are similar issues in the medical condition screen where all cancer choices were very specific (adenocarcinoma of the prostrate) but there were no breast cancer choices at all, even specific ones such as ductal cancer.

If “cancer” was typed in a similar issue occurred. A physician would have trouble with this list, much less the ordinary user. If “Other” is chosen, the next screen will allow the user to write breast cancer in the notes.

The app is password protected but there is an emergency button available that can be pressed for basic healthcare facts without accessing the rest of the recorded information.

Pressing the red emergency button brings up the following screen:

Is there Medical Literature to Support Personal Health Record app use?

While there is evidence that Electronic Medical Records (EMR) improve healthcare quality and efficiency, PHRs have not been specifically studied sufficiently to offer conclusive data. Multiple entities, such as the Mayo Clinic, Veteran’s Administration and HIMMS are supporting efforts to encourage patient use of these records.

Price:

  • Free, with conditions
  • $0.99 for PHR version which includes the ability to track radiology results, lab results, procedures, and daily glucose with graphing
  • $3.99 for the Family version which includes all the features of PHR and the ability to document multiple individuals’ health information

Likes:

  • Interface is easy to work with
  • Data is encrypted
  • Data is potentially sharable using XML file format which providers could download into their systems (potentially)
  • Information is easily imported from the address book and to calendar
  • Linked resources are comprehensive

Dislikes:

  • Does not (yet) sync across devices
  • Medications and Immunizations are not customizable, forcing patients to use pick lists that are too technical. There appear to be common medical conditions lacking from the pick lists.
  • All immunizations are in “medical-ese”. Patients may not understand the difference between a Td, Tdap, or tetanus toxoid.

Conclusion:

Ambitious app that allows patients to securely record and track all aspects of one’s personal health record including, but not limited to, immunizations, medications, diagnoses, allergies, side effects, family and social history, heath insurance, providers and appointments with the potential to share information via XML with providers. With the upgraded version the entire family’s information can be kept in one place and upgraded as time goes by.

As a clinician it is obvious the interface was built from an electronic medical record platform and very easy to use but unless the end-user has some background in medicine the more specific components of the app may be difficult to understand. It utilizes medical language in those sections where patients must choose medications, immunizations and medical conditions from drop-down lists (detailed in the above screen shots).

This app would be difficult to use by the ordinary consumer with no medical background. The choices in the medical condition, medication and immunization sections need to be simplified for all but the most sophisticated of patients. Hopefully future versions will be less technical in these essential areas because this app has potential.

iTunes Link

Kathy Nieder is a Family Medicine doctor in Louisville, KY. She has utilized mobile health technologies beginning with the earliest versions of Epocrates for the Palm Pilot to today’s robust mobile apps for both patient and physician. She believes the use of mobile technology and social media can greatly enhance patient engagement in medical care and improve outcomes.

When not practicing medicine traditionally or socially, Kathy enjoys improving her French and Spanish speaking skills and spending time with her two dynamic adult daughters and long-suffering (28 years) husband.

Author:

iMedicalApps Team

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6 Responses to Personal Health Record app underscores importance of using patient friendly medical terms

  1. Joe Ketcherside, MD June 11, 2012 at 6:33 pm #

    Thanks for the thorough review of PocketHealth. You have captured many of the key things we are trying to achieve. And I completely agree with the challenges in using medical vocabularies.

    One of the key strengths of PocketHealth is that all of the data entered is captured in a structured manner in the database, and it all contains standard vocabulary identifiers. As you so rightly point out, that is a double-edged sword. However, since our ultimate goal is to facilitate the exchange of health information between care providers and consumers (via your personal health record), we need to use a common language between the systems. This also allows us to build in quality dashboards and tools to help improve care.

    The downside is that users can’t just change the terms or add things on the fly. And sometimes this makes it harder to find what you’re looking for—and we realize that. But our real goal is the best, most accurate information in consumers’ hands and control – so that’s what we’re working toward.

    The best thing? We’re not done! We’re working steadily to improve the ease of use for the PocketHealth app, add and simplify terms, and fill in the gaps as we get feedback from our early users. And that includes information like what you’ve shared here. We hope that taking care to get the information in accurately up front and building the best foundation possible pays off for our users in a more useful tool in the long run.

    We have been fortunate to have many engaged users who are making suggestions for improvements and new features. We value your feedback (always) and very much appreciate your time in reviewing the app. As you use it, please do let us know any other suggestions you have—we’d love to continue to hear your feedback!

    Thanks again!

    • Kathy Nieder, MD July 18, 2012 at 2:01 pm #

      Dr. Ketcherside,
      Thanks for your response (I apologize for my delay in responding). I’ll put a note in my calendar and try to re-review in another six months or so.

      • Joe Ketcherside, MD December 13, 2012 at 10:11 am #

        @Dr. Nieder, wanted to post an update on PocketHealth. We’ve made a lot of changes in the last 6 months, with significant improvements to the search functions and overall user interface. We have added Infobutton to conditions, meds and labs to link directly to consumer-friendly information on Medline. We’ve enhanced the export and added features to share data across devices. I hope you will find these and our other updates to add value.

        Next up is to implement the ability to import the new CCD-based Blue Button export files, and to build out and enhance medication manager for patients with multiple or complex medications.

        Thanks!

        • Miguel Flores, MD December 22, 2012 at 11:28 am #

          @Dr. Ketcherside,

          I recently came across this app and have a few questions:

          1) Is there an option to fill out the PHR online and have it sync across multiple devices (i.e iPhone, iPad) -Such a function would facilitate data entry and data access.

          2) I recall Google Health a few years back offered a function where a unique ID could be provided to the doctor ordering labs and the results would be electronically tied to the Google Health record when the results became available (for patient availability and plotting purposes). Is this/will this be a possibility with the app?

          3) Can I scan health documents and import them into the app as a PDF to have instant access wherever I am?

          Definitely believe apps like these to be the future of medicine. Strong work.

  2. Beryn Hammil June 13, 2012 at 1:24 pm #

    Absolutely! Filling out an on-line form, or any other kind for that matter, that has as a multiple choice question that looks like this just doesn’t cut it: “>3, <3, or other." Most people don't know what refer to and are confused. How about just saying “more than 3″ and “less than 3″>?

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