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Mobile apps in ObGyn practice: Tools for enhancing women’s preventive health care
Evolutionary changes in ObGyn
Preventive medicine guidelines have evolved to reflect enhanced cervical cancer screening tests, longer-acting contraceptive options, and better data on the lack of utility of the annual pelvic exam that has changed the focus of the annual visit for both physicians and patients.1 These changes allow us to pivot and leverage the trust we build with our patients to make meaningful impacts in preventing chronic disease, improving prepregnancy health, reducing maternal mortality and morbidity, and improving the quality and longevity of our patients’ lives. New guidelines, coupled with the knowledge of the leading causes of morbidity for women, provide the chance to incorporate areas of screening and intervention that, while we are capable of addressing, we traditionally have not done so for various reasons.
The ACOG Presidential Task Force identified 5 areas of preventive health that significantly influence the long-term morbidity of women: obesity, cardiovascular disease, preconception counseling, diabetes, and cancer risk. ObGyns are uniquely positioned to identify and initiate the conversation and subsequently manage, treat, and address these critical health areas. To make this daunting task more manageable, the Task Force not only published webinars to address the clinical knowledge pertaining to these areas of health but also specifically looked at how to use technology to aid obstetrician-gynecologists in addressing them with patients.
Making use of technology in clinical practice
Technology is emerging as an influential player in health care. Major corporations, such as Amazon, Google, Apple, and Facebook, are making headlines in health care as they consider strategies (moves) to revolutionize technology and, in turn, patient visits like we have never seen before. Examples include incorporating artificial intelligence in a patient’s care and allowing better access for primary care.
The changes that we will see over the next 10 years, influenced by industry, will be more than those seen in our lifetime. To prepare for these changes, we need to incorporate technology into our daily practice. This encompasses much more than just the electronic medical record. Consequently, the Task Force intentionally looked at mobile medical apps to aid physicians in addressing the 5 specific areas of preventive health identified.
While a small step compared with what is to come, apps are a great resource to leverage in making this transition. However, with hundreds of thousands of medical apps available in app stores and the constant updates and iterations of each, it would be impossible to recommend any single app. There is much value in having a framework to use to efficiently measure the benefit of an app that you or your patient comes across in clinical practice. The objective of this series was to provide clinicians with an effective tool to evaluate a medical app that could be used, for example, when addressing obesity or optimizing prepregnancy health.
Continue to: The recommended rubric for evaluating apps...
The recommended rubric for evaluating apps
To evaluate mobile drug information apps, the Task Force members recommend a user-friendly, convenient rubric developed by the American Society of Health-System Pharmacists (ASHP) (see page 35). The rubric can help obstetrician-gynecologists evaluate and compare the value of various medical apps that specifically address obesity, diabetes mellitus, cardiovascular disease, improving maternal morbidity with enhanced preconception counseling, and cancer risk assessment.
The authors of this Task Force series have attempted to highlight the key features of an app as it pertains to a particular area of focus. It is important to keep in mind the primary user and the goal when choosing or recommending an app for practice or for patient use. The ASHP’s rubric is a tool meant to aid clinicians in evaluating medical apps, but it is ultimately the user’s decision to determine if the deficiencies of an app should deter its use. Although all the criteria are relevant and important, as medical experts it is incumbent on us to pay careful attention to the accuracy, authority, objectivity, timeliness, and security of any app we consider incorporating into clinical practice.
While integrating the use of medical apps into clinical practice will be novel for some, for others, junior Fellows in particular, it has become part of their practice and education. Dr. Eva Hoffmann, Chief Resident in the NYU Langone Health System, offers this perspective: “As medical trainees we use mobile apps to enhance our patient interaction and guide high-quality, continuous care. In today’s modern technological world, apps help keep us up to date with the ever-changing guidelines in pregnancy and routine gynecologic care as well as communicate directly and discreetly with a patient whenever the need arises. The most significant apps provide guidance on abnormal Pap results, indicated deliveries prior to 39 weeks, and the ability to respond to obstetrical emergencies. They also allow for quick society-endorsed references in seconds. Apps have changed the way that we practice by providing evidence-based medicine literally at our fingertips—in a shareable and communicable way—making the practice of medicine even more efficient and effective.”
Opportunity to reaffirm expertise
Dr. Chalas’ initiative was meant to shed light on the opportunity obstetrician-gynecologists have to reassert themselves as women’s health experts, to consider redefining their practice by incorporating new preventive guidelines, and to leverage medical apps for achieving better health outcomes for women across their lifetime. We hope that by opening a dialogue about how ubiquitous medical apps are (for both physicians and patients) in today’s health arena, how many apps are inaccurate and/or misused, and how a simple rubric can be used to assess an app’s value, you are inspired and feel more comfortable to incorporate medical apps into your practice.
Health care will continually undergo advancements, and as a specialty we must evolve to address women’s needs. Obstetrician-gynecologists are well suited to contribute significantly to the well-being of women and mothers. We can leverage technology-based apps to help us redefine our roles and priorities at the patient’s annual visit. We can reaffirm ourselves as the leading women’s health care physicians.
An additional resource
To enhance your understanding of apps and how to evaluate them, Dr. Katherine Chen’s App Review series in
In appreciation
The members of this Task Force want to thank the Editorial Board and staff of
- Women’s Preventive Services Initiative website. Recommendations for well-woman care: a well-woman chart. https:// www.womenspreventivehealth.org/wellwomanchart/. Accessed June 11, 2021.
- Chyjek K, Farag S, Chen KT. Rating pregnancy wheel applications using the APPLICATIONS scoring system. Obstet Gynecol. 2015;125:1478-1483.
Hartaj K. Powell, MD, MPH
Dr. Powell is OB Hospitalist, Ascension Saint Agnes Hospital, Baltimore, Maryland.
Matthew Wells, MD, MBA
Dr. Wells is Attending Physician, Women and Children’s Services, NYU Langone Health Hospital, and Unified Women’s Healthcare, Mineola, New York
Eva Hoffmann, MD
Dr. Hoffmann is Resident Physician, Department of Obstetrics and Gynecology, NYU Langone Hospital–Long Island, Long Island School of Medicine, Mineola, New York.
The authors report no financial relationships relevant to this article.
Hartaj K. Powell, MD, MPH
Dr. Powell is OB Hospitalist, Ascension Saint Agnes Hospital, Baltimore, Maryland.
Matthew Wells, MD, MBA
Dr. Wells is Attending Physician, Women and Children’s Services, NYU Langone Health Hospital, and Unified Women’s Healthcare, Mineola, New York
Eva Hoffmann, MD
Dr. Hoffmann is Resident Physician, Department of Obstetrics and Gynecology, NYU Langone Hospital–Long Island, Long Island School of Medicine, Mineola, New York.
The authors report no financial relationships relevant to this article.
Hartaj K. Powell, MD, MPH
Dr. Powell is OB Hospitalist, Ascension Saint Agnes Hospital, Baltimore, Maryland.
Matthew Wells, MD, MBA
Dr. Wells is Attending Physician, Women and Children’s Services, NYU Langone Health Hospital, and Unified Women’s Healthcare, Mineola, New York
Eva Hoffmann, MD
Dr. Hoffmann is Resident Physician, Department of Obstetrics and Gynecology, NYU Langone Hospital–Long Island, Long Island School of Medicine, Mineola, New York.
The authors report no financial relationships relevant to this article.
Evolutionary changes in ObGyn
Preventive medicine guidelines have evolved to reflect enhanced cervical cancer screening tests, longer-acting contraceptive options, and better data on the lack of utility of the annual pelvic exam that has changed the focus of the annual visit for both physicians and patients.1 These changes allow us to pivot and leverage the trust we build with our patients to make meaningful impacts in preventing chronic disease, improving prepregnancy health, reducing maternal mortality and morbidity, and improving the quality and longevity of our patients’ lives. New guidelines, coupled with the knowledge of the leading causes of morbidity for women, provide the chance to incorporate areas of screening and intervention that, while we are capable of addressing, we traditionally have not done so for various reasons.
The ACOG Presidential Task Force identified 5 areas of preventive health that significantly influence the long-term morbidity of women: obesity, cardiovascular disease, preconception counseling, diabetes, and cancer risk. ObGyns are uniquely positioned to identify and initiate the conversation and subsequently manage, treat, and address these critical health areas. To make this daunting task more manageable, the Task Force not only published webinars to address the clinical knowledge pertaining to these areas of health but also specifically looked at how to use technology to aid obstetrician-gynecologists in addressing them with patients.
Making use of technology in clinical practice
Technology is emerging as an influential player in health care. Major corporations, such as Amazon, Google, Apple, and Facebook, are making headlines in health care as they consider strategies (moves) to revolutionize technology and, in turn, patient visits like we have never seen before. Examples include incorporating artificial intelligence in a patient’s care and allowing better access for primary care.
The changes that we will see over the next 10 years, influenced by industry, will be more than those seen in our lifetime. To prepare for these changes, we need to incorporate technology into our daily practice. This encompasses much more than just the electronic medical record. Consequently, the Task Force intentionally looked at mobile medical apps to aid physicians in addressing the 5 specific areas of preventive health identified.
While a small step compared with what is to come, apps are a great resource to leverage in making this transition. However, with hundreds of thousands of medical apps available in app stores and the constant updates and iterations of each, it would be impossible to recommend any single app. There is much value in having a framework to use to efficiently measure the benefit of an app that you or your patient comes across in clinical practice. The objective of this series was to provide clinicians with an effective tool to evaluate a medical app that could be used, for example, when addressing obesity or optimizing prepregnancy health.
Continue to: The recommended rubric for evaluating apps...
The recommended rubric for evaluating apps
To evaluate mobile drug information apps, the Task Force members recommend a user-friendly, convenient rubric developed by the American Society of Health-System Pharmacists (ASHP) (see page 35). The rubric can help obstetrician-gynecologists evaluate and compare the value of various medical apps that specifically address obesity, diabetes mellitus, cardiovascular disease, improving maternal morbidity with enhanced preconception counseling, and cancer risk assessment.
The authors of this Task Force series have attempted to highlight the key features of an app as it pertains to a particular area of focus. It is important to keep in mind the primary user and the goal when choosing or recommending an app for practice or for patient use. The ASHP’s rubric is a tool meant to aid clinicians in evaluating medical apps, but it is ultimately the user’s decision to determine if the deficiencies of an app should deter its use. Although all the criteria are relevant and important, as medical experts it is incumbent on us to pay careful attention to the accuracy, authority, objectivity, timeliness, and security of any app we consider incorporating into clinical practice.
While integrating the use of medical apps into clinical practice will be novel for some, for others, junior Fellows in particular, it has become part of their practice and education. Dr. Eva Hoffmann, Chief Resident in the NYU Langone Health System, offers this perspective: “As medical trainees we use mobile apps to enhance our patient interaction and guide high-quality, continuous care. In today’s modern technological world, apps help keep us up to date with the ever-changing guidelines in pregnancy and routine gynecologic care as well as communicate directly and discreetly with a patient whenever the need arises. The most significant apps provide guidance on abnormal Pap results, indicated deliveries prior to 39 weeks, and the ability to respond to obstetrical emergencies. They also allow for quick society-endorsed references in seconds. Apps have changed the way that we practice by providing evidence-based medicine literally at our fingertips—in a shareable and communicable way—making the practice of medicine even more efficient and effective.”
Opportunity to reaffirm expertise
Dr. Chalas’ initiative was meant to shed light on the opportunity obstetrician-gynecologists have to reassert themselves as women’s health experts, to consider redefining their practice by incorporating new preventive guidelines, and to leverage medical apps for achieving better health outcomes for women across their lifetime. We hope that by opening a dialogue about how ubiquitous medical apps are (for both physicians and patients) in today’s health arena, how many apps are inaccurate and/or misused, and how a simple rubric can be used to assess an app’s value, you are inspired and feel more comfortable to incorporate medical apps into your practice.
Health care will continually undergo advancements, and as a specialty we must evolve to address women’s needs. Obstetrician-gynecologists are well suited to contribute significantly to the well-being of women and mothers. We can leverage technology-based apps to help us redefine our roles and priorities at the patient’s annual visit. We can reaffirm ourselves as the leading women’s health care physicians.
An additional resource
To enhance your understanding of apps and how to evaluate them, Dr. Katherine Chen’s App Review series in
In appreciation
The members of this Task Force want to thank the Editorial Board and staff of
Evolutionary changes in ObGyn
Preventive medicine guidelines have evolved to reflect enhanced cervical cancer screening tests, longer-acting contraceptive options, and better data on the lack of utility of the annual pelvic exam that has changed the focus of the annual visit for both physicians and patients.1 These changes allow us to pivot and leverage the trust we build with our patients to make meaningful impacts in preventing chronic disease, improving prepregnancy health, reducing maternal mortality and morbidity, and improving the quality and longevity of our patients’ lives. New guidelines, coupled with the knowledge of the leading causes of morbidity for women, provide the chance to incorporate areas of screening and intervention that, while we are capable of addressing, we traditionally have not done so for various reasons.
The ACOG Presidential Task Force identified 5 areas of preventive health that significantly influence the long-term morbidity of women: obesity, cardiovascular disease, preconception counseling, diabetes, and cancer risk. ObGyns are uniquely positioned to identify and initiate the conversation and subsequently manage, treat, and address these critical health areas. To make this daunting task more manageable, the Task Force not only published webinars to address the clinical knowledge pertaining to these areas of health but also specifically looked at how to use technology to aid obstetrician-gynecologists in addressing them with patients.
Making use of technology in clinical practice
Technology is emerging as an influential player in health care. Major corporations, such as Amazon, Google, Apple, and Facebook, are making headlines in health care as they consider strategies (moves) to revolutionize technology and, in turn, patient visits like we have never seen before. Examples include incorporating artificial intelligence in a patient’s care and allowing better access for primary care.
The changes that we will see over the next 10 years, influenced by industry, will be more than those seen in our lifetime. To prepare for these changes, we need to incorporate technology into our daily practice. This encompasses much more than just the electronic medical record. Consequently, the Task Force intentionally looked at mobile medical apps to aid physicians in addressing the 5 specific areas of preventive health identified.
While a small step compared with what is to come, apps are a great resource to leverage in making this transition. However, with hundreds of thousands of medical apps available in app stores and the constant updates and iterations of each, it would be impossible to recommend any single app. There is much value in having a framework to use to efficiently measure the benefit of an app that you or your patient comes across in clinical practice. The objective of this series was to provide clinicians with an effective tool to evaluate a medical app that could be used, for example, when addressing obesity or optimizing prepregnancy health.
Continue to: The recommended rubric for evaluating apps...
The recommended rubric for evaluating apps
To evaluate mobile drug information apps, the Task Force members recommend a user-friendly, convenient rubric developed by the American Society of Health-System Pharmacists (ASHP) (see page 35). The rubric can help obstetrician-gynecologists evaluate and compare the value of various medical apps that specifically address obesity, diabetes mellitus, cardiovascular disease, improving maternal morbidity with enhanced preconception counseling, and cancer risk assessment.
The authors of this Task Force series have attempted to highlight the key features of an app as it pertains to a particular area of focus. It is important to keep in mind the primary user and the goal when choosing or recommending an app for practice or for patient use. The ASHP’s rubric is a tool meant to aid clinicians in evaluating medical apps, but it is ultimately the user’s decision to determine if the deficiencies of an app should deter its use. Although all the criteria are relevant and important, as medical experts it is incumbent on us to pay careful attention to the accuracy, authority, objectivity, timeliness, and security of any app we consider incorporating into clinical practice.
While integrating the use of medical apps into clinical practice will be novel for some, for others, junior Fellows in particular, it has become part of their practice and education. Dr. Eva Hoffmann, Chief Resident in the NYU Langone Health System, offers this perspective: “As medical trainees we use mobile apps to enhance our patient interaction and guide high-quality, continuous care. In today’s modern technological world, apps help keep us up to date with the ever-changing guidelines in pregnancy and routine gynecologic care as well as communicate directly and discreetly with a patient whenever the need arises. The most significant apps provide guidance on abnormal Pap results, indicated deliveries prior to 39 weeks, and the ability to respond to obstetrical emergencies. They also allow for quick society-endorsed references in seconds. Apps have changed the way that we practice by providing evidence-based medicine literally at our fingertips—in a shareable and communicable way—making the practice of medicine even more efficient and effective.”
Opportunity to reaffirm expertise
Dr. Chalas’ initiative was meant to shed light on the opportunity obstetrician-gynecologists have to reassert themselves as women’s health experts, to consider redefining their practice by incorporating new preventive guidelines, and to leverage medical apps for achieving better health outcomes for women across their lifetime. We hope that by opening a dialogue about how ubiquitous medical apps are (for both physicians and patients) in today’s health arena, how many apps are inaccurate and/or misused, and how a simple rubric can be used to assess an app’s value, you are inspired and feel more comfortable to incorporate medical apps into your practice.
Health care will continually undergo advancements, and as a specialty we must evolve to address women’s needs. Obstetrician-gynecologists are well suited to contribute significantly to the well-being of women and mothers. We can leverage technology-based apps to help us redefine our roles and priorities at the patient’s annual visit. We can reaffirm ourselves as the leading women’s health care physicians.
An additional resource
To enhance your understanding of apps and how to evaluate them, Dr. Katherine Chen’s App Review series in
In appreciation
The members of this Task Force want to thank the Editorial Board and staff of
- Women’s Preventive Services Initiative website. Recommendations for well-woman care: a well-woman chart. https:// www.womenspreventivehealth.org/wellwomanchart/. Accessed June 11, 2021.
- Chyjek K, Farag S, Chen KT. Rating pregnancy wheel applications using the APPLICATIONS scoring system. Obstet Gynecol. 2015;125:1478-1483.
- Women’s Preventive Services Initiative website. Recommendations for well-woman care: a well-woman chart. https:// www.womenspreventivehealth.org/wellwomanchart/. Accessed June 11, 2021.
- Chyjek K, Farag S, Chen KT. Rating pregnancy wheel applications using the APPLICATIONS scoring system. Obstet Gynecol. 2015;125:1478-1483.
Focus on cardiovascular disease
Cardiovascular disease is the leading cause of women’s death in the United States, accounting for 1 in every 5 female deaths per year according to the Centers for Disease Control and Prevention. Most risk factors for cardiovascular disease are modifiable. With a disease so prevalent in women’s health, obstetricians and gynecologists can assist patients in modifying these risk factors. This, however, is easier said than done.
One of the rate-limiting steps in assisting patients is the process of identifying an individual’s risk factors. This can be a time-consuming task in a women’s health appointment that is already busy with ObGyn-specific concerns, but technology can assist us.
Cardiovascular health app considerations
Many smartphone applications and websites are available that can alleviate the time constraints for identifying these individual modifiable risk factors. When evaluating cardiovascular risk factor apps for patients, keep these qualities (as outlined in the ACOG-recommended rubric) in mind: design, functionality, usefulness, and accuracy.
The patient-centered resources that assist women in identifying cardiovascular risk factors and that provide tools to positively impact these risk factors through lifestyle changes can help women achieve improved cardiovascular health. Recommendations include 1) manage blood pressure, 2) control cholesterol, 3) reduce blood sugar, 4) get active, 5) eat better, 6) lose weight, and 7) stop smoking.
National organizations’ smartphone apps guide the patient through a handful of questions about their current lifestyle, gender, age, and basic laboratory values. Their individual “heart health” results of these questions distribute the 7 risk factors to 3 categories based on the need to focus, improve, or celebrate. Through nonthreatening videos, patients can improve their scores themselves and bring the areas they need to focus, or improve, to their ObGyn’s attention for further assistance.
While adding one more task to an already busy practice can seem daunting, there are great technology resources that can be leveraged to successfully address this important health metric. By using the ACOG-recommended rubric and focusing on the app characteristics identified above, you can find one that works best for you and your patients and incorporate it into your practice today. ●
Matthew Wells, MD, MBA
Dr. Wells is Attending Physician, Women and Children’s Services, NYU Langone Health Hospital, and Unified Women’s Healthcare, Mineola, New York.
The author reports no financial relationships relevant to this article.
Matthew Wells, MD, MBA
Dr. Wells is Attending Physician, Women and Children’s Services, NYU Langone Health Hospital, and Unified Women’s Healthcare, Mineola, New York.
The author reports no financial relationships relevant to this article.
Matthew Wells, MD, MBA
Dr. Wells is Attending Physician, Women and Children’s Services, NYU Langone Health Hospital, and Unified Women’s Healthcare, Mineola, New York.
The author reports no financial relationships relevant to this article.
Cardiovascular disease is the leading cause of women’s death in the United States, accounting for 1 in every 5 female deaths per year according to the Centers for Disease Control and Prevention. Most risk factors for cardiovascular disease are modifiable. With a disease so prevalent in women’s health, obstetricians and gynecologists can assist patients in modifying these risk factors. This, however, is easier said than done.
One of the rate-limiting steps in assisting patients is the process of identifying an individual’s risk factors. This can be a time-consuming task in a women’s health appointment that is already busy with ObGyn-specific concerns, but technology can assist us.
Cardiovascular health app considerations
Many smartphone applications and websites are available that can alleviate the time constraints for identifying these individual modifiable risk factors. When evaluating cardiovascular risk factor apps for patients, keep these qualities (as outlined in the ACOG-recommended rubric) in mind: design, functionality, usefulness, and accuracy.
The patient-centered resources that assist women in identifying cardiovascular risk factors and that provide tools to positively impact these risk factors through lifestyle changes can help women achieve improved cardiovascular health. Recommendations include 1) manage blood pressure, 2) control cholesterol, 3) reduce blood sugar, 4) get active, 5) eat better, 6) lose weight, and 7) stop smoking.
National organizations’ smartphone apps guide the patient through a handful of questions about their current lifestyle, gender, age, and basic laboratory values. Their individual “heart health” results of these questions distribute the 7 risk factors to 3 categories based on the need to focus, improve, or celebrate. Through nonthreatening videos, patients can improve their scores themselves and bring the areas they need to focus, or improve, to their ObGyn’s attention for further assistance.
While adding one more task to an already busy practice can seem daunting, there are great technology resources that can be leveraged to successfully address this important health metric. By using the ACOG-recommended rubric and focusing on the app characteristics identified above, you can find one that works best for you and your patients and incorporate it into your practice today. ●
Cardiovascular disease is the leading cause of women’s death in the United States, accounting for 1 in every 5 female deaths per year according to the Centers for Disease Control and Prevention. Most risk factors for cardiovascular disease are modifiable. With a disease so prevalent in women’s health, obstetricians and gynecologists can assist patients in modifying these risk factors. This, however, is easier said than done.
One of the rate-limiting steps in assisting patients is the process of identifying an individual’s risk factors. This can be a time-consuming task in a women’s health appointment that is already busy with ObGyn-specific concerns, but technology can assist us.
Cardiovascular health app considerations
Many smartphone applications and websites are available that can alleviate the time constraints for identifying these individual modifiable risk factors. When evaluating cardiovascular risk factor apps for patients, keep these qualities (as outlined in the ACOG-recommended rubric) in mind: design, functionality, usefulness, and accuracy.
The patient-centered resources that assist women in identifying cardiovascular risk factors and that provide tools to positively impact these risk factors through lifestyle changes can help women achieve improved cardiovascular health. Recommendations include 1) manage blood pressure, 2) control cholesterol, 3) reduce blood sugar, 4) get active, 5) eat better, 6) lose weight, and 7) stop smoking.
National organizations’ smartphone apps guide the patient through a handful of questions about their current lifestyle, gender, age, and basic laboratory values. Their individual “heart health” results of these questions distribute the 7 risk factors to 3 categories based on the need to focus, improve, or celebrate. Through nonthreatening videos, patients can improve their scores themselves and bring the areas they need to focus, or improve, to their ObGyn’s attention for further assistance.
While adding one more task to an already busy practice can seem daunting, there are great technology resources that can be leveraged to successfully address this important health metric. By using the ACOG-recommended rubric and focusing on the app characteristics identified above, you can find one that works best for you and your patients and incorporate it into your practice today. ●