Popularity and impact of using smart devices in medicine: experiences in Saudi Arabia

The use of smart device applications (apps) in the medical setting has been steadily increasing in recent years [1, 2]. This is generally beneficial because smart device medical app use has been shown to increase physician productivity [1‐4], efficiency [3, 5‐7], and accuracy [3, 6, 8, 9] and to improve patient access to medical care [3, 10]. However, medical apps have received both positive and negative reviews from practicing physicians [10]. Therefore, identifying the best app was important. Medscape, UpToDate, Lexicomp, and Epocrates have received positive ratings and are most commonly used by healthcare workers [11]. In contrast, other applications were poorly rated because of low performance that did not meet healthcare workers’ needs. Some issues raised include app reliability [12, 13] and diagnostic accuracy [12‐17], along with patient health disparities and poor health knowledge [18].

Smart phone medical apps are considered a major improvement to medicine, particularly in heavily populated countries [1, 3], which can be socioeconomically diverse. Saudi Arabia’s population is also socioeconomically diverse and many people cannot afford medical insurance or to pay for their medical care directly. Because medical apps improve physician efficiency [3, 5, 6] and productivity [1‐4], they may help reduce hospital congestion, improve access to medical care, and reduce medical care costs. Therefore, it is important to understand how medical apps can improve patient healthcare and which apps will be most useful to specific healthcare systems. Here, we examine current physician use of smart device medical apps in Saudi Arabia and their perceived impact on patient care.

This study examined the use and perceived impact of smart device medical apps in Saudi Arabia. In agreement with studies in other parts of the world [1, 5, 7, 21], we found that medical apps are generally well perceived and are reported by care providers to improve efficiency, accuracy, and education in the clinical setting. The medical apps that are most relied upon in Saudi Arabia (63.3%–79.0% use) were Medscape, Gray’s Anatomy, UpToDate, and Oxford mobile dictionary. These apps were designed to provide medical definitions, review anatomy, and assist clinicians by providing evidence-based answers to clinical questions. This was similar to trends in the United Kingdom, where 86.2% of surgeons reported using medical apps to access online medical resources [22, 23]. These findings indicate that Saudi Arabian physicians believe that medical app use directly improves patient care.

Medical practitioners in Saudi Arabia also agreed or strongly agreed that medical apps are important for medical educations of students, resident physicians, and more experienced practitioners. This is in agreement with several studies that examined the use of medical apps specifically designed for resident training [1, 3, 24‐26], continuing medical education [1, 3], and textbook access [1, 3]. Additionally, fast access to medical information was the number one benefit of medical apps reported by students [27], residents [28], and practicing physicians [27]. Resident physicians also commonly use apps to perform medical calculations [28].

The study found that hospitals are also recommending the usage of the medical applications. The finding is similar to Lewis and Wyatt [17, 29] who reported that hospitals are looking for solutions that will aid efficiency both the clinical care and research. The implication of the hospitals recommending use of medical apps is that will increase access to patient records since there are limited desktops at the health care facilities. [30] The study found that there is a significant difference between gender, age, medical rank and frequency of use of installed medical apps. The finding is supported by Rikesh et al., who found that juniors frequently use the medical apps as compared to their seniors and are able to access more information in the medical apps [30]. Medical apps were also accessed by several practitioners for various purposes. The finding is also supported by Rikesh et al. [30], who reported that medical apps are used to access more information related to medicine by health care practitioners.

Our study had several limitations. First, our sample size was relatively small and a study that examines medical app use in a larger group of Saudi Arabian medical practitioners is needed to confirm our findings. Still, our results are in agreement with those found in other regions and provide preliminary information on the benefits of medical apps in Saudi Arabia. Second, our study only examined provider perception of medical apps. Future studies examining regional patient use and perception of medical apps are needed to more completely examine how medical apps impact healthcare. Third, we did not examine differences between urban and rural locations. Because medical apps make care more accessible to patients in rural locations, it would be interesting to examine similarities in and differences between medical app use in urban and rural healthcare locations. Fourth, since temporality of association is a strong criterion for causality, cross-sectional studies cannot prove causality but help to generate causal hypotheses. Lastly, our study did not examine potentially negative impacts of medical app use. Concerns regarding patient safety and confidentiality have been raised [2, 31] and require further investigation.

In conclusion, the use of medical apps seems to be most beneficial to healthcare practitioners in Saudi Arabia because they make up-to-date medical information more readily available. This information may have a direct impact on patient care, largely because of influences on confirming/assigning diagnoses and determining treatment options. Future studies are needed to better quantify the impact of medical app use on patient care (e.g., correct diagnosis rates, time from diagnosis to treatment, and patient care costs). Studies that examine the impact of medical apps on the patient side in Saudi Arabia are also needed.