Using smartphone software applications (apps) to remind patients to get vaccines is an increasingly viable solution to overcome gaps in traditional patient reminder systems, and a useful patient education tool, according to researchers at the National Association of Pediatric Nurse Practitioners 2013 Annual Meeting.

Traditional vaccine outreach reminder methods such as telephone calls, mailed paper reminders, and in-person home visits are problematic, as they are dependent on the reliability of patient contact information.

“Providers have expressed a need for alternative recall methods that are not so time, labor and financially intensive,” Jessica L. Peck, DNP, RN, MSN, CPNP-PC, CNE, CNL, of Capstone College of Nursing at the University of Alabama, wrote in a poster session presented on Thursday. “With 194 U.S. smart phone users projected by the year 2015, the opportunity to harness technology for this purpose is present.”

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In a separate poster presented at the same session, Kathy Chojnacki RN, MSN, CPNP-AC, and Jodi Shroba RN, MSN, CPNP, both of Children’s Mercy Hospitals and Clinics in Kansas City, Miss., touted the benefits of apps to improve health literacy among patients with chronic asthma and allergies to enable better self-management.

“Mobile devices such as tablets and smartphones are become more cost effective and more readily available forms of electronic communication. The healthcare system is primed and ready to utilize these devices in clinical practice,” they wrote.

An app for vaccination reminders

In the first poster, Peck examined usage and feedback of the “Call the Shots” app for Android devices to test the feasibility of and willingness of parents to adopt app-based immunization reminder systems.

The “Call the Shots” app performed four main functions:

  • Notifying end users when their child’s immunizations were due
  • Prompting users to call their pediatricians office to make an appointment for needed immunizations
  • Providing general immunization information
  • Educating parents about immunizations via an FAQ page

Approximately 500 parents of children aged 18 years and younger from a convenience sample at a large pediatric practice were invited to download the app at office visits during in a 60-day timeframe. Participants were then administered questionnaires to rate ease of use and helpfulness based on Robert Wood Johnson criteria for evaluating healthcare apps.

A total of 262 parents accessed the website, 45 of whom downloaded the app.

Although initial results and feedback have been positive, according to Peck, the initial data set is too small to draw meaningful results. She is currently in the process of launching the app in the Apple iTunes store to reach a larger audience, and plans to replicate the study in a larger sample size using multiple platforms.

For more information about the project and to download the “Call the Shots” app for Android devices, visit

Apps as patient education tools

In the second poster, Chojnacki and Shroba critiqued several apps for allergy, asthma and rhinitis to assess the overall benefits and limitations, as well as opportunities for integrating mobile technology into clinical practice.

They identified several asthma-specific benefits with the AsthmaMD app, including the ability to increase patients’ knowledge of their diagnosis and educate patients about methods to reduce:

  • Symptomatic days
  • Asthma-related ER visits
  • Rescue therapy use
  • Daily dose of inhaled corticosteroids necessary to provide symptom relief

Limitations to using apps in clinical practice include inaccurate or incomplete medical information from online sources, lack of wireless internet capabilities, high costs associated with implementing institution wide systems and reduced face-to-face interactions between providers and patients.

Despite these concerns, mobile technology exerts growing influence on children and should not be passed up as a vehicle to reach pediatric populations with chronic conditions.

For example, U.S. children and adolescents spend more than 7.5 hours per day using electronic media and more than half have their own mobile phone, results from a 2010 Kaiser Family Foundation Study found.

Overall, “the increased use of smart phones and mobile devices provide the perfect climate for integration of applications into patient care,” Chojnacki and Shroba concluded.


  1. Peck J. #TH-21. “Smartphone Immunization Reminders: Parnetal Use of a Smartphone Reminder and Information System Based on the Health Belief Model.”
  2. Chojnacki K, Shroba J. #TH-2. “Allergy and Asthma Education in an Ever Changing World of Technology.”

Both presented at: NAPNAP 2013 Annual Meeting. Orlando: April 17-19, 2013.