Have a Concussion? There’s an App for That

<sup>If my best friend’s daughters weren’t finished with the high-level soccer they used to play, I’d know exactly what to get her for Christmas—the concussion app I saw yesterday here at the mHealth Summit in Washington, D.C. 

The app, one of hundreds being demonstrated at the mobile health conference, is marketed by the psychological assessment company Par Inc. It is targeted toward parents and coaches of youth soccer teams who, it turns out, are often the “first responders” when a child is injured. They have to be: many youth teams do not have athletic trainers at the field. 

Yet, between 100,000 and 140,000 children and adolescents are treated in emergency departments each year for concussions, with an estimated 2.5 concussions occurring for every 10,000 athletic exposures in this age group. Today we know that concussions are far from benign. Indeed, left untreated, the child can suffer significant cognitive deficits.

The app leads users through a series of prompts describing the child’s symptoms (what the parent/coach observes) and signs (what the child describes), runs the results through an evidence-based algorithm, then delivers a recommendation. In some cases, the message is “call 911!” and touching the “911” on the screen immediately connects you to emergency services. Other results advise taking the child to the emergency room, contacting your healthcare provider or simply providing rest. It will also tell you if you’re worrying too much and your kid is just fine. 

But the app goes further. Since the first 48 hours after a concussion are critical, it also provides a “diary” to track any other signs or symptoms, information you can then e-mail or text to your child’s doctor. You can even take a picture of your child to send to your doctor. Plus, there is background information about concussion to send to your child’s teacher or school nurse so they, too, can be aware of any changes. 

This is just one of dozens of “way cool” applications of mobile health technology I’ve seen in the past two days. Among them: 

— A suite of apps from the U.S. Department of Veterans Affairs for caregivers of seriously injured veterans. The interlinked apps enable the family member to, among other things, track their loved one’s pain, maintain a daily diary of activities and even meditate to relieve stress. There is an app to provide legal surrogacy to the caregiver and one that enables a caregiver to make appointments with providers, then automatically puts those appointments on the caregiver’s calendar. Caregivers are also linked directly to the patients’ medical records so they can receive information on all lab tests, radiology results and even progress notes from providers. 

The VA is rolling out a pilot program on the system in January, providing iPads to 1,200 family caregivers.

— A game for teenagers with type 1 diabetes. Like the video games my son plays ad nauseam, kids get points and advance through increasingly difficult levels, but their advancement is based on demonstrating that they tested their blood glucose at least five times a day. If those levels are in a danger zone, an alert goes out to their caregiver.

I saw pill bottles with sensors that track adherence and wirelessly transmit that data to a caregiver or provider; bandage-sized, stick-on sensors that track every vital sign in your body and wirelessly transmit that to providers; and dozens of apps for providers designed to improve their diagnosis and management skills. 

It all sounds wonderful, doesn’t it? But we are far from Nirvana. As I’ve learned here the past two days, we have numerous hurdles to overcome before we can recognize the reality of mHealth. These include privacy and security concerns; consumer and provider engagement with the apps; ease of use; and interoperability. 

I’ll be covering all these in the book I’ve been commissioned to write on mHealth. Send me an e-mail or leave a comment below, and I’ll make sure you’re on the list to receive an announcement when it’s published.</sup>