Doctors who prescribe apps. Interview with Sergio Vañó MD from Hospital Ramón y Cajal

From getting over a phobia to being a real support during depression. Mobile devices are increasingly used in the field of healthcare, to diagnose or as a way to prevent diseases.

The business figures and the number of projects in this niche leave no doubts: it has a strong future. There are even various medical experts whoare betting on applications as a way to help their patients.

One of the most notable cases was the Secretary of Health in the United Kingdom Andrew Lansley, who created a list of applications to recommend to British doctors, for them to recommend to their patients. This is happening in well known hospitals around the world, from the Vancouver General Hospital to the Hospital Ramón y Cajal from Madrid, where Doctor Sergio Vañó works, who we had the chance to ask first hand.

Sergio Vañó is a dermatologist and coordinator of the group Innovation in Medical Technologies from the Hospital Ramón y Cajal, among other roles. Sergio has kindly answered our questions.

”Technology is not a replacement for medicine, but a complement.”

As you are behind the development of DermoApp and FotoSkin, what can a mobile application do that traditional methods do not?

The main advantages: portability, speed and ease of use. The availability of a tool to help a patient in his own pocket, in a quick and fast way, is one of the great potentials of apps.

Are you afraid that this could increase self-diagnoses and patients won’t visit their general practitioners?

Far from it. Of course, you should handle with caution the medical information you find on apps, in the same way that you should be careful with the medical information you find on the internet or even some books. Technology is not a substitute for medicine, but a complement.

It´s not always easy to introduce innovations, and medicine, as much as it is used to it, might not be an exception. Do you consider that the sector is conscious of the potential of apps or are they more skeptical?

The app world is just getting starting in medicine. It still isn´t institutionalized, although a significant percentage of doctors and other healthcare professional (including patients) use them daily. Now we are starting to see how the doctors “prescribe apps” that could improve patient adherence, self-monitoring, or could provide useful information for a patient about their own illness.

Doctors who prescribe apps. Interview with Sergio Vañó MD from Hospital Ramón y Cajal

We have several successful examples of mobile applications that reduce costs of some procedures. Is this the way to improve sanitary services in developing countries?

The value of new technologies to improve the efficiency of the sanitary processes is undoubtable, especially in regard to telemedicine. This is of course highly relevant for developing countries.

On a personal level, we just completed a study with a smartphone app that will allow primary care doctors to connect with a dermatologist, and we have seen how they avoided unnecessary referrals and optimized and prioritized skin cancer referrals.

Other than the projects that you work on, what do you think are the most interesting apps for mobile devices right now?

There are many apps useful for clinical practice. At a personal level, I could recommend I-Doctus, Google Drive and Evernote. They allow me to organize my time, and in the case of I-Doctus, it offers updated medical information (medications, protocols) and contributes to improving health care practices, avoiding prescription errors and providing useful medical information.

Lastly, how do you imagine the future of medicine, let´s say in 10 years? Will it be common to see doctors working with Google Glass and other wearables, such as tablets and smartphones?

I have no doubt. In the same way that 20 years ago it was unthinkable to imagine that a patient could arrive at a hospital and you could see his medical history on the computer, as it is today; in the future we will be speaking of new ways for the doctor-patient to communicate (telemedicine), monitoring services for diseases and vital signs (wearables) and the use of the smartphones, tablets and other devices, such as the social networks, in the doctor-patient communication, medical training and search of illnesses by the patients themselves.

Image | NEC Corporation of America

The dark side of prescribing apps

Although there are increasingly better options that are being used by doctors all over the world and in diverse uses, the fact is there are still some impediments for its extended use.

The first is to jump the technology gap that has affected other sectors. Although prescribing apps could lead to significant savings in medical costs, the truth is that it forces you to rely on an important development and manage technology that does not exist in the current healthcare systems. It is not only that these applications are qualified for use with patients, but the doctors themselves and especially that the patients know and can use them.

There are certain sections of society who simply feel more comfortable with paper and pen; in medicine a similar process occurs. This as well, has a solution. The British National Health Service (NHS) already has a plan to improve the digital education of their professionals. It´s only a matter of time until the barriers become smaller.

Secondly, there are more complicated bureaucratic problems. Just as you cannot prescribe medicines without the corresponding health validation, the same happens with apps. The problem is that in the case of apps, it is difficult to control, as we can find dozens of cancer applications that do not have any type of scientific backing.

Until policy makers evaluate which ones are accepted and which are not, there is a significant and dangerous legal loophole. What would happen if you are prescribed medicine without checking from a software, that´s dangerous for the health? Until all of this is cleared, the process could be slow.