Which of the following personal safety features of mobile devices was not described in the textbook?

Securing mobile devices requires a multi-layered approach and investment in enterprise solutions. While there are key elements to mobile device security, each organization needs to find what best fits its network.

To get started, here are some mobile security best practices:

• Establish, share, and enforce clear policies and processes

Mobile device rules are only as effective as a company’s ability to properly communicate those policies to employees. Mobile device security should include clear rules about:

1. What devices can be used
2. Allowed OS levels
3. What the company can and cannot access on a personal phone
4. Whether IT can remote wipe a device
5. Password requirements and frequency for updating passwords

One of the most basic ways to prevent unauthorized access to a mobile device is to create a strong password, and yet weak passwords are still a persistent problem that contributes to the majority of data hacks. Another common security problem is workers using the same password for their mobile device, email, and every work-related account. It is critical that employees create strong, unique passwords (of at least eight characters) and create different passwords for different accounts.

Instead of relying on traditional methods of mobile access security, such as passwords, some companies are looking to biometrics as a safer alternative. Biometric authentication is when a computer uses measurable biological characteristics, such as face, fingerprint, voice, or iris recognition for identification and access. Multiple biometric authentication methods are now available on smartphones and are easy for workers to set up and use.

A mobile device is only as secure as the network through which it transmits data. Companies need to educate employees about the dangers of using public Wi-Fi networks, which are vulnerable to attacks from hackers who can easily breach a device, access the network, and steal data. The best defense is to encourage smart user behavior and prohibit the use of open Wi-Fi networks, no matter the convenience.

Malicious apps are some of the fastest growing threats to mobile devices. When an employee unknowingly downloads one, either for work or personal reasons, it provides unauthorized access to the company’s network and data. To combat this rising threat, companies have two options: instruct employees about the dangers of downloading unapproved apps, or ban employees from downloading certain apps on their phones altogether.

• Mobile device encryption:

Most mobile devices are bundled with a built-in encryption feature. Users need to locate this feature on their device and enter a password to encrypt their device. With this method, data is converted into a code that can only be accessed by authorized users. This is important in case of theft, and it prevents unauthorized access.

Clinical Decision-Making

Mobile devices provide HCPs with convenient and rapid access to evidence-based information, supporting clinical decision-making at the point of care.8 HCPs’ increased reliance on electronic resources for this purpose was identified in the Manhattan Research/Physician Channel Adoption Study, which reported that physicians spend the majority (64%) of their online time looking for information to make or support clinical decisions, double the time spent reviewing print resources.13

Many evidence-based software apps serve as useful bedside clinical decision-making tools.7 Printed medical references often used in disease diagnosis are now available as mobile device apps that provide information on diagnosis, treatment, differential diagnosis, infectious diseases, pathogens, and other topics.7 Such apps include: Johns Hopkins Antibiotic Guide (JHABx), Dynamed, UpToDate, 5-Minute Clinical Consult (5MCC), 5-Minute Infectious Diseases Consult (5MIDC), Sanford Guide to Antimicrobial Therapy (SG), ePocrates ID, Infectious Disease Notes (ID Notes), Pocket Medicine Infectious Diseases (PMID), and IDdx.2,7

Diagnosaurus, a popular, low-cost mobile differential diagnosis app for the iPhone, iPad, and iTouch, can help ensure that alternative diagnoses are not overlooked.4 Flowcharts to help physicians identify diagnostic possibilities are included in the apps 5MCC and Pocket Guide to Diagnostic Tests.7 Other diagnostic mobile apps apply clinical algorithms to aid physicians in determining a disease diagnosis.7 Mobile devices can also be used to access CDSSs installed on desktop computers in clinical settings to aid in diagnosis and treatment decisions.8

Mobile apps can also help clinicians identify the appropriate scans or tests to order, decreasing unnecessary procedures and reducing cost of care.7 Lab test apps provide information such as: reference values and interpretation, causes for abnormal values, and laboratory unit conversions.7 They include: Pocket Lab Values, Lab Pro Values, Palm LabDX, Normal Lab Values, Lab Unit Converter, Labs 360, Davis’s Laboratory and Diagnostic Tests, and Pocket Guide to Diagnostic Tests.2,7

Mobile apps can also be used directly to conduct simple examinations for visual acuity or color blindness, as well as blood pressure or glucose level.3,5,7 The iPhone iSeismometer app, which is used to measure tremor frequency, has been reported to match more sophisticated and expensive devices used for electromyogram analysis.3 The iMurmur app provides recordings of 20 types of heart murmurs, allowing a physician to match and identify what she or he hears.3 Many apps are available to determine pregnancy due dates by using a patient’s sonogram and date of last period, such as “Perfect OB Wheel.” 3 These apps have been said to predict pregnancy due dates more accurately than the paper wheels that had previously been the standard.3

Current treatment guidelines available at the point of care via mobile apps also provide a valuable resource for HCPs.6 Several guidelines are accessible on mobile platforms, including the National Comprehensive Cancer Network guidelines for cancer care available through the Epocrates app, and the American College of Chest Physicians antithrombotic therapy guidelines available via the CHEST app.6 The Johns Hopkins ABX Guide app provides an impressive compilation of antimicrobial recommendations and guidelines, including some for surgical prophylaxis and surgical site infection treatment.6

Other mobile apps, such as medical calculators, use standard formulas to make calculations to determine risk scores and other measures, such as body mass index (BMI), body surface area (BSA), and proper drug doses.4,7 Calculation of clinical scores or indices typically involves utilizing complex formulas that require several input parameters.7 Even if a HCP knows the formula, performing even simple clinical score calculations manually can be surprisingly time consuming and error prone in a fast-paced clinical environment.7 In contrast, HCPs who use medical calculators do not necessarily need to know the formula for calculating a clinical score or index; they only need to enter the parameters to quickly produce a reliable result.7

Popular medical calculators include: Epocrates MedMath, MedCalc, Mediquations, Calculate, Medical Calculator, Archimedes, uBurn Lite, Softforce’s Antibiotic Dosage Calculator, and Paeds ED.2,6 Others that are available are: Vancomycin ClinCalc Full, Softforces’s Antibiotic Dosage Calculator, and MedCalc 3000 Pharmacology.5 Calculate by QxMD is a free app that calculates heart disease and stroke risk based on various patient variables.3 Since the results are visual, this app can be very effective in communicating risks to patients during discussions about potential behavior change.3 Another free medical calculator called Archimedes is available through Skyscape.4

The Agency for Healthcare Research and Quality (AHRQ), part of the U.S. Department of Health and Human Services, provides the free Electronic Preventive Services Selector (AHRQ ePSS) app.3,4 This app is designed to assist primary care physicians in screening, counseling, and identifying preventive measures, based on a patient’s age, gender, sexual activity, tobacco use, and other risk factors.3,4 Surgical risk calculators are also available, such as the euroSCORE calculator, which uses recommendations from the Society of Thoracic Surgeons to calculate operative risk at the point of care.6 The American Cancer Society National Surgical Quality Improvement Program is also developing a surgical risk calculator.6

Patient Monitoring

The use of mobile devices to remotely monitor the health or location of patients with chronic diseases or conditions has already become a viable option.7 Mobile device apps can provide public health surveillance, aid in community data collection, or assist disabled persons with independent living.12 In one study, a single-lead electrocardiograph (ECG) was connected to a smartphone to diagnose and follow treatment of patients with sleep apnea, providing a possible alternative to costly and labor-intensive polysomnography.4 Sensors attached to garments that communicate with mobile devices have also been used to remotely monitor and collect medical data regarding chronically ill elderly patients.4

A clinical monitoring system was developed to monitor an entire unit or one bed in intensive care via smartphone; it displays an alarm, color-coded according to severity, based on patient vital signs.7 The app iWander for Android was developed to monitor and track patients with early Alzheimer’s disease who are prone to wandering by using the mobile device GPS.4 HanDBase, a HIPAA-compliant relational database software program, can be used on mobile devices to track hospitalized patients according to their locations, diagnosis, tests, treatments, and billing information.3 Smartphone apps have also been used to monitor patients during rehabilitation.4 For example, a smartphone connected via Bluetooth to a single-lead ECG device enabled the monitoring of patients in their own neighborhoods when they were unable to reach traditional hospital-based rehabilitation.4 Although potentially useful, patient monitoring apps can be limited by factors such as Internet and GPS reliability, as well as the patient’s ability to use the device.4

Mobile apps that supplement medical devices are being developed.5 One example is iStethoscope, which uses the microphone function of the iPhone to auscultate and record.5 While this app isn’t officially intended for use as a medical device, it is significant in that its existence suggests that mobile devices can eventually replace medical devices.5 Mobile devices have also been used to accurately track heart rate and heart-rate variability.4 In January 2011, MobiSante became the first company to receive FDA approval for a smartphone-based medical diagnostic tool that uses an ultrasound probe for echocardiography.4 Work has also already been initiated to develop ECG recording devices that work with smartphones.4

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Uses for Mobile Devices and Apps by Health Care Professionals