Purpose of App Review

Anyone who has been in a doctor’s office lately knows the doctor is (almost) always running behind.

The pressure to see many patients in a small amount of time can shortchange an important aspect of provider-patient interaction – education and addressing of questions, fears, and concerns.

This educational time is particularly important in obstetrics where each pregnancy takes its own path.

As a busy obstetrician/gynecology resident, when I am not able to address all of my patients concerns or provide a large amount of education, I refer my patients to trusted resources for them to read. In trying out the My Prognosis: Pregnancy app for the iPad, I evaluated it to see if this is an app to which I could and would refer my patients.

Introduction

The My Prognosis: Pregnancy app, developed by Medical Joyworks, is now available. It is part of a greater series of apps provided by Medical Joyworks; the developers claim the app will provide an in-depth understanding of a wide range of pregnancy-related issues in order to empower informed patient/family choice in the case of emergency. It is available for the iPhone and the iPad and only in English.

User Interface

The first screen brings you to early pregnancy issues, while the toolbar on the left allows you to navigate to late pregnancy and postpartum/miscellaneous issues. The app offers the user learning topics presented as a patient.


By clicking on the filter icon on the top right, you can specify what type of stories you want to see/choose from, including tummy pain, contractions, itching, and high blood pressure among others. Selecting a particular filter will allow to see only those stories with that particular issue, but you must navigate to the appropriate screen to find them. The filter is easily removed by selecting the “all stories” option.

Choosing a woman’s story brings you to an illustrated discussion of that individual woman and her story. Most panes are single choice (forward or back in the story by pressing the arrow radio buttons). You can also go back to the main menu (main menu button in the top left corner) or see and navigate through illustration panes you have already seen (show/hide function along bottom).

For each case, there is at last one “choose-your-own-adventure” aspect where you can choose a particular outcome to see. You can easily navigate to previous panes in the middle of the story or at the end.

Throughout the story, there are hyper-linked concepts or phrases offering a Question & Answer type of learning. Once the topic has been read about, you can go back to the main story and continuing reading. At the end of the woman’s story, a screen tells the user the story is completed, as well as how many outcomes and learning topics were viewed.

Based on the woman’s story, the application also makes recommendations for other stories the user may like. Other final window options are to play the story again (allowing you to choose other outcomes via navigating to decision panes), making comments on the story via Facebook, returning to the main menu, or sharing the story on Facebook. The bottom right area also contains a reference section indicating where the scientific information for the story can be found.

Once you have read a story, it is checked marked, but still available for you to read again.

Evidence to support use

At the end of each story, references from reliable sources are listed for patient reference. These are references such as practice bulletins from the American Congress of Obstetricians and Gynecologists – these are references to which I often refer. There are no hyperlinks to these resources, but a complete reference is listed, allowing for an easy Internet search.

No direct quoting of data is made in the story. The application description states that the case stories are also checked by a panel of expert obstetricians, but the panel list is not disclosed – I would like to see this available and feel that I cannot quit trust if or who has reviewed the cases without it.

Likes

  • Interactive application with ability to change the story and explore possibilities
  • Embedded learning topics related to the overall subject, as well as general important educational facts
  • End screen for each story offers a monitoring bar – you can see if you missed something
  • Ability to sort stories by type of problem
  • Discussion of postpartum depression and related issues
  • Use of trusted and reliable references for the scientific data

Dislikes

  • Does not include discussion on round ligament pain, which is a common reason for triage visits during pregnancy
  • Does not include statistics (or at least an idea) of how common certain outcomes are
  • Limited ability to convey how realistic each outcome is
  • Does not link to or directly quote references in the middle of the story
  • No discussion that this application is not a substitute for talking with your health care provider in the application itself– the sharing email claims that this app is just like having your own doctor
  • Pointing out of only some patient’s geographic/ethnic origin without explanation of why this is important. Most case stories are of Caucasian women.

Patients who would benefit from the app

  • This is a useful application for an interactive exploration of common and rare complications of pregnancy for patients and their families experiencing or even considering pregnancy. Patients who want to have a better idea of complications of pregnancy and possible warning signs of these complications could use it.
  • While the app provides useful information in the form of anticipatory guidance, it is not a substitute for patient-provider education, but can act as a useful supplement. I would recommend this to my patient who realizes that while many things can go wrong, they usually do not.
  • If my patient has one of the problems discussed in the application, I would rely more on my education and training to educate and discuss options than on this application.

Conclusions

  • The My Prognosis: Pregnancy app provides a fun, interactive, and patient-friendly way for patients to learn more about complications of pregnancy. Use of the application, like most patient-related applications, should not substitute for provider-based education for an individual patient’s medical complications.
  • This app covers a good variety of pregnancy-related complaints and discusses them in an inviting and memorable manner.

iMedicalApps recommended?

  • Yes

iTunes Link

Rating: (1 to 5 stars) 3.125
1. User Interface 3
2. Multimedia usage 3.5
3. Price – 2.75 ($4.99)
4. Real world applicability – 3.25

Disclaimer:
This post does not establish, nor is it intended to establish, a patient physician relationship with anyone. It does not substitute for professional advice, and does not substitute for an in-person evaluation with your health-care provider. It does not provide the definitive statement on the subject addressed. Before using these apps please consult with your own physician or health-care provider as to the apps validity and accuracy as this post is not intended to affirm the validity or accuracy of the apps in question. The app(s) mentioned in this post should not be used without discussing the app first with your health-care provider.