Taridzo Chomutare*, University Hospital of North Norway, Tromsø, Norway Luis Fernandez-luque, Northern Research Institute, Tromsø, Norway Gunnar Hartvigsen*, University of Tromsø, Tromsø, Norway Eirik Ã…rsand, University Hospital of North Norway, Tromsø, Norway Track: Research Presentation Topic: Mobile & Tablet Health Applications Presentation Type: Oral presentation Submission Type: Single Presentation Building: LKSC Conference Center Stanford Room: Lower Auditorium 120 Date: 2011-09-18 03:00 PM – 04:30 PM Last modified: 2011-08-12

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Background
We are experiencing an increasing growth in interest for mobile health (mHealth) applications for self-management of blood glucose (SMBG). In spring 2009, we found 60 diabetes applications on iTunes for iPhone and as of February 2011 the number has grown over 400% to 260. Despite the growth, there still lacks research on diabetes mHealth applications. For example, the impact emergent technology such as social media has on further development of use cases is largely unexplored. Our objective is to study the salient characteristics of mobile applications for diabetes on the Norwegian market using a popular mobile platform: Apple’s iPhone.
Methods
We searched the Norwegian market iTunes Store for diabetes applications using search terms “diabetes” and “glucose”. The inclusion criterion was applications that featured a component for blood glucose tracking. We excluded applications for healthcare professionals and non-English applications. Search hits were 260, of which 49 met the selection criteria and were installed on an iPod for further analyses. The inclusion comprised 19 free and 30 paid applications, where the mean and modal price was the equivalent of €2 and €1.40, respectively. We studied the following features: (1) self-monitoring (blood glucose, physical activity, diet, weight, insulin and blood pressure), (2) functional integration of social media, (3) data export and (4) synchronization with Personal Health Records (PHR) or portals.
Results
Tools for tracking insulin injections were present in 33 of the 49 selected applications, although most neglected making references to Type 1 or Type 2 diabetes, or insulin pump technologies. Just over half of the applications had some form of diet management; either by tracking carbohydrates intake or making meal suggestions. Weight tracking and physical activity had each 20 and 19 applications, respectively. Only two of the eight applications with an educational module had personalized education or advice, 7 had reminders, while 11 had some form of integration with social media. Four applications had a component for synchronizing with PHRs or web portals. No application had visible effort towards patient privacy and safety beyond disclaimers and warnings about potential risks with using the application.
Conclusions
While there seem to be a wide selection of applications available for people with diabetes, this study shows the hype about social media has not yet translated to seamless functional linking of SMBG tools to the social Web in many applications. Web 2.0 tools can provide peer support and personalized education, both of which are recommended for SMBG, especially for people with Type 2 diabetes not using insulin. ZipHealth is a good an example of a functionally integrated application, where specialist functionality like PHR is interfaced with specialist providers such as Microsoft HealthVault or Google Health. Preliminary evidence seems to point to a future with increased use of wireless sensors, usage of PHR in augmenting social engagement with peers and personalizing health education, but this study has shown these concepts are still seldom recognized in iPhone SMBG applications in the Norwegian market.