Smartphone apps for Orthopedicians

… be smart !!Dr.P.Jeya Venkatesh MS Ortho., Dip SICOT (Guangzhou)Senior resident,All India Institute of Medical Sciences (AIIMS) New Delhi.

Why this talk?

05/03/23

05/03/23

Why this talk?

Why this talk?

05/03/23

Smartphones and mHealth mHealth market - Rapidly expanding. 3 billion downloads of 1,65,000 mHealth

apps in 2015 Different studies have recorded the

usage between 84 to 90 %. But only 53 % using it in clinical practice

Dr. Neelesh bhandari. 10 Things You Need To Know About mHealth Apps in 2015. Digital Medicine, dated 02.12.2015

Educational/reference apps

AO TRAUMA. PUBMED. MEDSCAPE.

Journals in app AAOS BJJ JBJS (Am). CORR.

Insights orthopedics OrthoEvidence Orthopaedics 365

Wong et al. BMC Sports Science, Medicine, and Rehabilitation (2015) 7:23.

Summary of recent articles

Apps for clinical practice

Corporate Hospital apps Home> Specialties > Facilities > Doctors > Appointment

Clinical appointments & marketing

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mHealth apps will have the highest impact on

Patient Follow up monitoring  during the next 5 years.

Pre op planning Measure angle in x rays Measure scoliosis curve using inclinometer Measure joint movements accurately

Shaw M et al. Use of the iPhone for Cobb angle measurement in scoliosis. Eur Spine J. 2011 Nov 9;21(6):1062–8.

Walter R, et al. Inter- and intra-observer reliability of a smartphone application for measuring hallux valgus angles. Foot Ankle Surg. 2013 Mar 1;19(1):18–21.

Milani P et al. Mobile Smartphone Applications for Body Position Measurement in Rehabilitation: A Review of Goniometric Tools. PM&R. 2014 Nov;6(11):1038–43

PACS viewerKirk M et al. “The role of smartphones in the recording and dissemination of medical images.”

J Mob Technol Med. 2014 Jul 28;3(2):40–5.

CCTV monitoring

CPRS Tele ICU

Documentation..

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Patient education apps

Educational apps for patients Provide information, images, and videos to

better understand the pathology. provide pre and post operative information.

Teach how to perform sets of exercises Contains animated rehabilitation exercises for

patients

Reijen Mv et al . Increasing compliance with neuromuscular training to prevent ankle sprain in sport: does the “Strengthen your ankle” mobile App make a difference? A randomised controlled trial. Br J Sports Med. 2016 Jan 18

Algar L, Valdes K. Using smartphone applications as hand therapy interventions. J Hand Ther. 2014 Jul;27(3):254–7.

Patient apps Anterior Cruciate Ligament app

Contains strengthening exercises, balancing exercises

Meniscal Tear app

https://play.google.com/store/apps/details?id=com.canny.LigamentInjuries&hl=en

Patient apps My Knee Guide

Resource for patients considering knee replacement surgery

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Spine MD Videos, and peri-

operative as well as post-operative rehabilitation education.

Apps using sensors

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Lumo liftPosture zoneOsteo alarm

Avoiding pressure sores in Paraplegics

Prevention of foot ulcers in diabetics

Fall prevention in elderly

Compliance monitoring

*Andrawis JP, Muzykewicz DA, Franko OI. Mobile Device Trends in Orthopedic Surgery: Rapid Change and Future Implications. Orthopedics. 2016 Jan 1;39(1):e51–6.

Apps for Postgraduates

Simulation apps Touch Surgery

3-D surgical simulation app to help surgeons become more familiar with surgical procedures.

https://play.google.com/store/apps/details?id=com.touchsurgery&hl=en

Learning

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Anatomy Fracture classification Scoring systems Ready reconers

Neve whiz Sports Injury Clinic iShoulder

Reference manager

Al-Hadithy N, Gikas PD, Al-Nammari SS. Smartphones in orthopaedics. Int Orthop. 2012;36(8):1543–7.

eLog book

Improve your presentation

Vs

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Caution

Safety

Potential danger : Dissemination of inaccurate medical information

App developers are not obligated to reveal the sources, guidelines, or limitations of their tools.

Ultimately the responsibility of the user/physician to decide the safety of the app.

Buijink AW et al Medical apps for smartphones: lack of evidence undermines quality and safety. Evid Based Med. 2013;18(3):90–92.

Lack of doctors involvement in app development is of continued concern.

Security Any patient information that is shared on

mobile devices is at risk of a security breach.

All the apps require a amount of information for logging in.

No specific guidelines for software security.

Sherwin-Smith J, Pritchard-Jones R. Medical Applications: The Future of Regulation. Bull R Coll Surg Engl. 2012 Jan 1;94(1):12–3.

What does FDA say??

Mike Mitka, FDA Lays Out Rules for Regulating Mobile Medical Apps, JAMA. 2013;310(17):1783-1784.

FDA approval - mandatory for apps that use sensors/ leads

connected to patient like ECG, Oximeter .

Summary

Summary Apps provide significant benefit and

diverse functionality at your fingertips. They are educational for the patients Medical personnel involvement is

remains low. Recent advances and surgical

techniques can be conveniently viewed. Implementation of a validation stamp

is necessary.

references www.imedicalapps.com www.toporthoapps.com

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Thank you