Using apps to enhance patient and family education

There are lots of medical apps available for smart phones and tablets, many of which are free or inexpensive. But how do you incorporate them into clinical practice?

The good news is you don’t have to invest in fancy equipment. If you’re asking about apps, you probably own a smart phone or tablet. Your patients who will benefit most from apps own the technology already, too. So the most efficient and effective way to start is to use the technology you have, and have learners use what they have.

Next step is to find the most appropriate resources. Do not start from “what apps are available?” That would not be patient-centered. Instead, ask: What conditions do my patients have? What do I teach about? What do my patients and their families need to learn? What questions do they have? What behaviors do they need help changing to optimize health?

There are 3 places apps might be used:
1. In the clinical encounter, as you explain something.
2. During a hospitalization, to engage the patient and family in the educational process.
3. At home, to provide information and support healthy behavior changes.

1. In the clinical encounter, as you explain something.

Often, when explaining the diagnosis or physiology, it is helpful to show anatomy. If you search Patient Education in the app store these will come up. There are many apps with clear illustrations and just the right amount of detail.

Show anatomy with illustrations, not graphic photos. Find out how much detail the learner wants. Watch your learner’s reactions to make sure the illustrations you choose are not frightening, which would impair learning. There is no need to show graphic details of a surgical procedure unless the learner asks to see them.

There are also apps to help you provide information handouts, like AAP Patient Education: HealthyGrowth. Ask your colleagues what apps they use.

2. During a hospitalization, to engage the patient and family in the educational process.

The goal of patient education in the hospital is to be sure the patient and family understand the diagnosis, what tests and treatments they are agreeing to (informed consent), have the self-care skills to function after discharge, and know how to recognize problems and how to respond. The degree of understanding is evaluated by teach back.

One free app that provides the cues for teach back of topics that must be understood for a safe discharge is Our Journey in the Hospital. It facilitates communication by encouraging the family of a hospitalized child to teach back their understanding of core information, so content can be reinforced or corrected. It presents teach back as the norm, and helps you find out if your teaching was clear. The family can use it throughout hospitalization to ask questions and keep track of situations they are comfortable and confident handling. It promotes patient engagement.

For the iPhone and iPad:
https://itunes.apple.com/us/app/our-journey-in-the-hospital/id586230947?mt=8

For Android:
https://play.google.com/store/apps/details?id=com.mediakube.pch.ourjourneyinthehospital

3. At home, to provide information and support healthy behavior changes.

Most patient education apps fall into this category. These are apps the patient and family can use to reinforce information, monitor symptoms or self-care activities, or get coaching to change behaviors. For example, there are many apps that remind the user to take medicine.

You need to know what good quality apps are available for your patient population. A great place to start is the website Webicina at http://www.webicina.com/?select=patient

This site offers curated resources chosen through crowdsourcing with medical professionals and e-patients. Choose the condition and look at the app recommendations. For example, the app Symple keeps track of symptoms and what influences them, and exports data to share. Pain Management apps include WebMD Pain Coach and the Simplyhealth Back Care app. To promote fitness there is GymGoal. There are many apps to support diabetes self-care, including Diamedic Diabetes Logbook, which can be used to record every glucose reading, insulin injection, lab result, carb intake, weight, medicine, and exercise. There’s even an app that acts as a pedometer for people with multiple sclerosis, Mobility Matters in MS. It doesn’t set target steps for the day, but records your average number of steps per hour, encouraging achievable activity.

Ask your patients what they find helpful, and review them yourself. Keep a list of useful apps you are willing to recommend to your patients and their families.

Apps are, obviously, only one patient education tool available to you. The old standbys like handouts and videos are still very important. The best patient and family education involves the learner in the process and individualizes teaching to the needs of the learner. If your patient is continuously interacting with a smart phone, apps may be the way to go. Assess and individualize.

©2013 Fran London, MS, RN

2 Responses to “Using apps to enhance patient and family education”

  1. marga vintges says:

    Hi Fran
    I work at a centre of expertise on health equity issues in the Netherlands. We get a lot of questions from professionals around communication and low health literacy, self management etc. So happy I have found your stuff on the web, please take my compliments on your work. We have also bought a number of copies of your book. It’s so useful, even though we are in another copuntry.

    Now, I have a question regarding apps and graphs, pictures etc. We think that effectiviness of materials should be measured on patients and effect should be proven positive, before we can advise them to professionals. We did some small research and found that our low literate patients came with real creative interpretations of graphs that we really had not meant and even thought of! However, there is not much of measurement done in this field, at least not in my country. And yes, it’s a lengthy proces indeed. So I am inclined to just go on and use the stuff that is available, while waching patients’ respond.
    What ‘s your view on this?
    Are there any overviews of stuff that has been positively evaluated?
    sincerely
    dr. marga vintges
    Pharos, the Netherlands

  2. Thank you for the question. There is a website that identifies health-related social media sites that have reliable information: Webicina.com However, they are not evaluated for use with patients with low health literacy skills. Regarding graphs, charts, and pictures, I have responded in my next blog post. Let me know if I was not clear or need to discuss anything in more detail.

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