V. O’Reilly-Shah1,2, S. Gillespie1, G. Easton1 1Emory University School Of Medicine,Anesthesiology,Atlanta, GA, USA 2Children’s Healthcare Of Atlanta,Pediatric Anesthesiology,Atlanta, GA, USA
Introduction: The rapid global adoption of mobile health (mHealth) smartphone apps by healthcare providers presents challenges and opportunities in medicine. Ensuring the delivery of high-quality, up-to-date, and optimized information is the obligation of authors, regulatory bodies, and the biomedical community itself. Studying apps to achieve these goals carries accompanying opportunities to study medical practice patterns, access to medical and surgical care, and continuing medical education needs on a large scale.
Methods: We studied users of Anesthesiologist, a free Android app providing age and weight based guidelines for airway equipment, physiological reference data, and drug dosing. It is installed on ~100,000 devices globally. We combined traditional app analytics with basic app user demographics collected via in-app surveys.
Results: 39,181 users updated the app to the study version, 22,572 (58%) subjects consented to enrollment. Users were from 192 countries and included all levels of healthcare providers. Individuals from low-, middle-, and high-income countries (as defined by the World Bank) represented 3%, 63%, and 33% of users, respectively. Users from lower income countries had significantly greater rates of app use and higher ratings for the importance of the app to their practice (p<0.01). Significant differences were also found in the rate of app use and app importance based on provider type (p<0.01), with less training generally correlating with higher rates of app use and higher scoring of app importance. App importance itself was significantly correlated with greater app use (p<0.01). 72% of users report having used the app in an emergency, supported by data indicating app activations during evenings and weekends. Time of app use peaks in the morning, indicating a high level of use for routine cases as well. The app was primarily used for pediatric cases, with 71% of uses involving patients less than 12 years old, and 28% under 12 months. Mining 482,975 app uses, we detected rare events such as interest in intralipid (n=287 clicks) and dantrolene (n=162). The most common searches, however, were related to commonly used drugs such as succinylcholine (n=1191 clicks), fentanyl (n=1250) and propofol (n=1293).
Conclusions: Combined demographics and app analytics collected from this widely used mHealth app provided a window into the detailed app usage habits of global anesthesia healthcare providers. These findings demonstrate that this mHealth app is a valuable decision support tool for global healthcare providers in both routine and emergency patient management, particularly those in more resource-limited settings and with less training. Current usage indicates that the app supports decision-making in pediatrics far better than in adults, indicating an opportunity for feature expansion to meet the needs of adult physicians and providers.