Anaesthetists and apps: content and contamination concerns

Abstract

We thank Dasari et al. [1] for highlighting the popularity and putative benefits of iPhone (Apple Inc., Cupertino, CA, USA) medical applications (apps) in anaesthetic practice. However, two issues warrant further attention. Firstly, accessing apps requires the presence of mobile communication devices (MCDs) in the operative environment and secondly, the validity and reliability of some unregulated medical apps may be questionable. In the clinical environment, MCDs are a reservoir of bacteria known to cause nosocomial infections and can cause contamination of user’s hands [2, 3]. In a previous study, 11.5% of healthcare workers’ MCDs in operating theatres were contaminated by pathogenic bacteria, and 84.8% of healthcare workers had never cleaned their MCD [4]. Jeske et al. [3] reported the high rate of bacterial contamination of anaesthetists’ hands after a 1-min telephone call using a MCD in the operating theatre. Furthermore, doctors using medical apps during patient care may be less likely to perform hand hygiene before contact with the patient, thereby increasing the risk of bacterial transmission. Given the widespread use of MCDs in the clinical environment, restricting their use in operating theatres and intensive care units is unlikely to be practical. However, education regarding hand hygiene and the use and effective decontamination of MCDs (e.g. 0.5% chlorhexidine/70% isopropyl alcohol wipes) could assist risk reduction [4]. Secondly, in a recent review of 111 apps related to pain control, there was a low level of healthcare worker involvement in their development and content. Whilst many apps promised assistance with pain relief, many had no concern for the product’s effectiveness or adverse effects [5]. The lack of medical apps regulation means that for many, the validity and reliability of their content is currently unknown. Recently, the US Food and Drug Administration stated that it would urgently investigate the need for regulation, with the aim to reduce medical errors through the use of technology [6]. We believe guidelines regarding the use of MCDs and medical apps in operating theatres are urgently required. More work is needed to enable us to make informed decisions about the risks and benefits of this trend in technology.