Smartphone applications with sensors used in a tertiary hospital-current status and future challenges

Abstract

Smartphones have been widely used recently to monitor heart rate and activity, since they have the necessary processing power, non-invasive and cost-effective sensors, and wireless communication capabilities. Consequently, healthcare applications (apps) using smartphone-based sensors have been highlighted for non-invasive physiological monitoring. In addition, several healthcare apps have received FDA clearance. However, in spite of their potential, healthcare apps with smartphone-based sensors are mostly used outside of hospitals and have not been widely adopted for patient care in hospitals until recently. In this paper, we describe the experience of using smartphone apps with sensors in a large medical center in Korea. Among >20 apps developed in our medical center, four were extensively analyzed ("My Cancer Diary", "Point-of-Care HIV Check", "Blood Culture" and "mAMIS"), since they use smartphone-based sensors such as the camera and barcode reader to enter data into the electronic health record system. By analyzing the usage patterns of these apps for data entry with sensors, the current limitations of smartphone-based sensors in a clinical setting, hurdles against adoption in the medical center, benefits of smartphone-based sensors and potential future research directions could be evaluated.

Figure 1

My Cancer Diary application (A) Patient barcode sample (B) Screenshot of main menu.

Figure 2

“Point-of-care HIV Check” application. (A) Screenshot of main menu; (B) Screenshot of barcode reading phase.

Figure 3

“Blood Culture” application. (A) Barcode reading menu; (B) Barcode reading phase; (C) Reading results and entering additional data such as the sample site and volume; (D) Saving data. In this figure, pseudonymized ID and patient name were used.

Figure 3

“Blood Culture” application. (A) Barcode reading menu; (B) Barcode reading phase; (C) Reading results and entering additional data such as the sample site and volume; (D) Saving data. In this figure, pseudonymized ID and patient name were used.

Figure 4

mAMIS application. (A) mAMIS login menu; (B) Medication information for the chosen patient; (C) Admission note; (D) PACS image.

Figure 4

mAMIS application. (A) mAMIS login menu; (B) Medication information for the chosen patient; (C) Admission note; (D) PACS image.

Figure 5

Technical architecture of mobile sensor applications. JSON: JavaScript Object Notation, SSL: Secure Socket Layer, TLS: Transport Layer Security, IIS: Internet Information Services, HIS: Hospital Information System, EMR: Electronic Medical Record, CPOE: Computerized Physician Order Entry, LIMS: Laboratory Information Management System, RIS: Radiology Information System, PACS: Picture Archiving Communication System, ERP: Enterprise Resource Planning.

Figure 6

Frequency of sensor usage in “My Cancer Diary” by month.

Figure 7

Usage pattern of Point-of-Care HIV check app by month.

Figure 8

Frequency of usage of the “Blood Culture” app by month.

Figure 9

Frequency of usage in mAMIS app by month.

Figure 10

The conflicting requests of healthcare app users. Arrows indicate the trade-off relationships.