In the last issue, we focused on pharmacists’ role as collaborators with patients to maximize health information technology innovations. Specifically, we explored mobile health (mHealth) apps, including approaches to evaluate apps for use by patients. We also explored specific characteristics that are critical to helping patients make desired behavior change. The relevance of these characteristics to mHealth apps was discussed, along with opportunities for pharmacists to support their patients’ use of these tools.
mHealth Requires Proficiency with Smartphones And Apps
From reviewing that article, however, it is apparent that a certain level of proficiency with smartphones and apps is assumed to be present as a baseline before mHealth apps are used. Data regarding the digital divide between older and younger adults demonstrates lower rates of internet and smartphone adoption among older adults.
Many ComputerTalk readers likely feel this is a logical finding. But what about actual proficiency of smartphone usage among older adults? Does having the latest Android or iOS device equate to knowing how to use it, beyond making a phone call, or sending the occasional text message? Our day-to-day experiences — especially those in a community pharmacy — provide a resounding “no” as we think of the people we routinely encounter who are barely scratching the surface of their device’s capabilities.
Given this reality, how might we help them? Before addressing the “how,” some readers might ask, “why” might we help them? Isn’t the smartphone a bit out of scope for pharmacists, and who has the time? Relationships are critical to community pharmacy practice. Patients value the stability provided through routine interactions with their pharmacists over time.
This trust extends beyond medications and can include the patient’s favorite mobile device, especially when the pharmacy wants to engage their patients through this device. The suggestion is not that the pharmacist becomes the smartphone tech support, but useful tips and tricks can be valuable to patients, and a patient with greater smartphone proficiency can engage the pharmacy in new ways, accessing resources the pharmacy has already made available online and/or in an app.
Some patients may have reached the point of needing to upgrade to a contemporary device with modern features like apps and video capability (for talking to family and friends). With the primary options being an iOS device from Apple, or an Android device, the choice may seem simple. We know, however, that the Android ecosystem is much different from that of Apple, in that there are literally hundreds of unique devices running Android. Most of the popular apps and services are found on both platforms. However, patients need to know that apps unique to Apple (e.g., FaceTime) do not work on Android. Screen size is also an important consideration in selecting a device.
Helpful Features for Smartphone App Use
Regardless of the platform, an obvious but critical consideration is the patient’s ability to read the screen. Fortunately, there are several features to help. First, both Android and iOS allow the font size to be adjusted for better readability. Similarly, both platforms include a magnification feature to zoom in on the entire screen. Closed captioning is also an option on both platforms. Lastly, both platforms include a screen reader that will read the screen aloud. While there is variability in menu structure, both within and across the two primary platforms, these features are generally found in an accessibility section of settings.
The Privacy Factor
Information privacy and security is a common focus among pharmacy and other health professions. Patients may not be as aware of the risks to their personal information, however. Fortunately, both platforms include strong security options that are also easy to use. At a minimum, patients should secure their device with a passcode. The number of digits in the passcode is influenced by the specific device’s operating system version. An additional layer of device security is provided through either facial or fingerprint recognition.
Once access to the device has been secured and screen legibility (or reading) is established, device organization is critical, both on the home screen (the launch screen on Android) and in the general listing of apps. The recommendation here is to keep it simple. Only the core, most frequently used apps should be found on the home/launch screen.
On both platforms, apps can be moved to a different location on the home screen, as well as moved to a different screen altogether. Alternatively, apps that are not needed can be deleted. Both moving and deleting apps can be accomplished by tapping and holding on the desired app. Because app management is an ongoing activity, patients should be taught how to perform these functions.
Once the core apps (like your pharmacy’s app) are on the home screen, the next task is to place useful shortcuts (or favorites) on the home screen. This generally includes functions like calling, texting, or video chatting with specific people. For patients, useful calls could include your pharmacy, their doctor(s), and their closet neighbor or friend in the event they need medical help.
Related, smartphone platforms provide a useful means to store pertinent medical information. On iOS devices, this information is stored in the Health app. On Android devices, medical information can be stored in the Emergency Information section found in About. Both platforms include a built-in emergency call feature that calls 911 if a certain set of trigger steps occur. Find the Emergency SOS function on either platform to identify the 911 trigger steps.
The last group of tips relates to ringtones and notifications. Tips for using the phone’s calendar to provide medication adherence alerts have been around for literally decades. Calendars have gotten smarter, however, and support more complex medication regimens. In many cases, an app devoted to medication adherence may prove more useful due to tracking and other capabilities.
Other types of notification and ringtone tips focus on ensuring that ringtones/notifications can be heard. Additionally, some patients may find value in setting up specific sounds to alert them when designated individuals are calling (e.g., your pharmacy, their spouse or children, etc.).
So, we addressed “why” a pharmacy may assist patients in their smartphone use. We also addressed the “what” — specific topics to cover with patients. But how can this be implemented? Again, the pharmacist is most likely not going to have time during a typical day to walk through these functions with patients. One approach includes creating a flyer that includes core tips, instructions, and where appropriate, links to demonstrations for each platform.
A similar approach is to identify instructional videos online and link to them from your pharmacy’s website. For those pharmacies that serve as rotation sites, pharmacy students can help patients with these functions in the pharmacy. Regardless of the extent to which a pharmacy helps a patient with his or her smartphone, something as simple as showing a patient how to make the pharmacy a “favorite” in the phone’s contact list can go a long way to strengthening the patient’s relationship with their pharmacy. I would be interested in your comments. CT
Brent I. Fox, Pharm.D., Ph.D., is a professor in the Department of Health Outcomes Research and Policy, Harrison School of Pharmacy, Auburn University. He can be reached at foxbren@auburn.edu.