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The App Gap: Why Baby Boomers Won’t Use Most Smart Phone Apps

Along with the invention of smart phones, an entire medical mobile application (app) industry has cropped up, promising patients enhanced connectivity, health data collection, and overall care quality at lower costs. Last year the FDA put a damper on the app industry’s quick-profit hopes by announcing that it intends to regulate certain medical apps as medical devices. In other words, if the app is used to connect with a medical device or to turn a smart phone into such a device (whether it can check your blood sugar, blood pressure, heart rhythm, etc. or suggest diagnoses), it must undergo safety and efficacy checks by the FDA before it can be brought to market. That process is likely to inflate app development costs exponentially, thus creating a chilling effect on the industry.

I actually think that FDA oversight is a good thing in this case, since it could protect patients from potentially misleading health information that they might use to make treatment or care decisions. But more importantly, I wonder if a lot of this fuss is moot for the largest, sickest, segment of the U.S. population?

For all the hype about robo-grannies, aging in place technologies, and how high tech solutions will reduce healthcare costs, the reality is that these hopes are unlikely to be achieved with the baby boomer generation. I believe that the generation that follows will be fully wired and interested in maximizing all that mobile health has to offer, but they’re not sick (yet) and they’re also not the proverbial “pig in the python” of today’s healthcare consumption.

I’m not saying that mobile health apps have no role in caring for America’s seniors – their physicians and care teams use tablets and smart phones, their kids do too, and a small percent of seniors may adopt these technologies, but I’m a realist when it comes to massive adoption by boomers themselves. Wireless connectivity, texting, personal digital health records, and asynchronous communication is just not in their DNA. Take away a teenager’s smart phone and he or she is likely to be completely flummoxed by reality. Now give that phone to a baby boomer and the flummoxing will be roughly equivalent, but centered upon the device. The teen can’t live without the constant phone/internet connection, and the senior is overwhelmed by the lack of human interface and unfamiliar menus.

What makes me so sure of my pronouncements? I just spent a month making house calls to almost 70 different Medicare Advantage members in rural parts of this country. And I can tell you that almost none of them used any sort of smart phone app to manage their health. These “odd creatures” actually enjoyed face-to-face human contact, they used their phones almost exclusively to talk to people (not surf the Internet), and they took hand-written notes when it was important for them to remember something. They even had paper calendars that they used to schedule their physician appointments and keep records of their medications and procedures. How “weird” is that?!

When I asked one of the seniors if she’d be interested in using a cell phone to check her blood pressure and have that automatically uploaded to her doctor’s office she replied,

“I’m too old to learn that stuff, dear. I’m lucky if I can find my slippers in the morning.”

The reality is that the average app user isn’t sick, and sick people don’t see a need for apps… yet.  So our challenge is to meet seniors where they are instead of trying to change their habits. House calls are the best way I know of to get a full appreciation for individual quirks, compliance challenges, and health practices. If we are really serious about reducing healthcare costs in our aging population, it may take some low-tech solutions. As un-sexy as that may be, it’s time that we put down the iPhone and practiced some good old-fashioned medicine.

Android, iPhone And iPad Being Tested For Medical Use On The Battlefield

I was always under the impression that medical documentation was reserved for the office and the hospital.  Not necessarily so — even in the battlefield, medics document medical care in real time.

Unfortunately, the tools they use to do this documentation consists of bulky Motorola hand held devices that are four years old.

Four years is an eternity in the tech world.  To put this in perspective, I was still rocking a Motorola RAZR back then.  So it shouldn’t come as a surprise that the Army is field testing the iPhone, iPad, and Android smartphones in the battlefield. Read more »

*This blog post was originally published at iMedicalApps*

More Specialty-Specific Apps Are Coming On The Market

The explosive growth of medical applications for smartphones, launched by the  debut of the innovative Apple iTunes App store in 2008, promises to fundamentally change the physician’s tool set. While many specialties have always been heavily dependent on technology, such as radiology and cardiology, the ubiquity of these small, interconnected computers means that every physician will soon have access to a broad array of software and hardware to help them perform their daily work.

At, we have been reviewing the most interesting medical apps on the market today as well as watching for trends in mobile medical technology. The most popular categories thus far have been clinical reference and utility apps.  Some of the largest download numbers have been for apps that provide drug and disease reference information, such as the encyclopedic Medscape app, or medical calculators.

However, more targeted apps that are specialty specific are slowly coming on the market. Some early ones, not surprisingly, Read more »

*This blog post was originally published at iMedicalApps*

Tired Of Needles? Measure Your Glucose Levels With An iPhone

skin_tattoo[1]Researchers at Northeastern University are using nanosensors implanted into the skin — similar to a tattoo — and a modified iPhone to measure sodium and glucose levels in patients. The implications for this could be tremendous, but first, here’s how it works:

“The team begins by injecting a solution containing carefully chosen nanoparticles into the skin. This leaves no visible mark, but the nanoparticles will fluoresce when exposed to a target molecule, such as sodium or glucose. A modified iPhone then tracks changes in the level of fluorescence, which indicates the amount of sodium or glucose present.”

For patients who are diabetics, Read more »

*This blog post was originally published at iMedicalApps*

Why Don’t More People Use Health Apps For iPhones And Droids?

Jessie GrumanI have been musing about why, despite our fascination with gadgets and timesaving devices, so few of us use the apps and tools that have been developed to help us take care of ourselves.

The range of options is staggering – my iPhone coughed up 52 applications for medication reminders just now – but most of us don’t make use of the (often free) high-tech help available to us.  There are hundreds of websites and portals to help us monitor our diets, physical activity and blood sugar, talk to our doctors by e-mail and understand our test results.  Apps can help us watch for drug interactions, unravel our test results, adjust our hearing aids and track our symptoms.  Devices can monitor whether our mom is moving around her house this morning or continuously monitor our vital signs.

Interesting ideas.  Modest pickup.

DSCF6172In an essay published in the May issue of the American Journal of Preventive Medicine supplement “Cyberinfrastructure for Consumer Health,” I make some observations about why this may be so, Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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