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Published on 21.12.16 in Vol 2, No 1 (2016): December

This paper is in the following e-collection/theme issue:


    Preliminary Analysis of Worldwide Usage Patterns in a Mobile Palliative Care Reference App

    1Program in Liberal Medical Education, Department of Computer Science, Brown University, Providence, RI, United States

    2Department of Computer Science, University of Florida, Gainesville, FL, United States

    3Clinical Informatics and Innovation Fellowship, Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States

    4Department of Psyschosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, United States

    Corresponding Author:

    Haipeng Zhang, DO

    Department of Psyschosocial Oncology and Palliative Care

    Dana Farber Cancer Institute

    450 Brookline Avenue

    Boston, MA, 02215

    United States

    Phone: 1 617 459 1650

    Fax:1 617 643 6722



    Background: Fast Facts and Concepts for iOS and Android is the world’s most downloaded point of care mobile reference application for palliative care providers. This free mobile app leverages the Fast Facts and Concepts article repository that was started in 1999 at the End-of-Life/Palliative Education Resource Center at the Medical College of Wisconsin. Our team released the initial iOS version of the app in summer of 2014. Since then, it has been downloaded over 13,000 times.

    Objective: The purpose of this project is to evaluate and describe user behaviors of palliative care clinicians on a global scale using an analytics layer integrated into Fast Facts and Concepts.

    Methods: An analytics layer was integrated and disclosed with version 1.0.3; an analytics event is triggered when an article is read or when a search is made. The event, along with anonymous user metadata, was sent to a Web server where it was segmented. Summary statistics were generated using Python scripts and include category weight, article rank, and search term clusters. We evaluated user behavior of the Fast Facts and Concepts app during a 3-month window to better understand the needs of the userbase.

    Results: Our dataset had 26,733 events and 1461 unique users from 41 countries collected over 3 months. Prognosis was the most active category, with searches for Palliative Performance Scale accounting for a third of prognosis reads. Articles about dosage featured heavily, especially on methadone titration. On the spectrum of illness, physiological categories such as gastrointestinal and renal diseases were generally more popular than psychiatric disorders. Articles about interpersonal skills from categories such as Communication; Ethics, Law, Policy; and Psychosocial and Spiritual Experience were the least read. All of our conclusions are supported by chi-squared tests with P values <.01. More detailed results are included in the poster.

    Conclusions: This analysis shows that most users consult the app for guidance in symptom management and prognosis. The usage patterns described above suggest that the app is likely being used at the point of care as a clinical reference for medical decision making and therapeutic guidance. Our study provides evidence that mobile applications can be effective tools to distribute quality palliative care resources on a global scale. Our results also indicate which topics should be emphasized in medical education and how increased vigilance about these topics can optimize patient care; with a large active user base, we have the opportunity to make even more precise conclusions in the future.

    iproc 2016;2(1):e13



    This poster was presented at the Connected Health Symposium 2016, October 20-21, Boston, MA, United States. The poster is displayed as an image in Figure 1 and as a PDF in Multimedia Appendix 1.

    Figure 1. Poster.
    View this figure

    Multimedia Appendix 1


    PDF File (Adobe PDF File), 1MB

    Edited by T Hale; submitted 06.06.16; peer-reviewed by CHS Scientific Program Committee; accepted 02.08.16; published 21.12.16

    ©David Liu, Jess Smith, Haipeng Zhang. Originally published in Iproceedings (, 21.12.2016.

    This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in Iproceedings, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.