Analysis of the usage date revealed uptake for the app was high; 76 doctors used the app at least once a week. There was a maximum of 791 page views in one day.

The most popular content that was accessed was the Oxford Handbook of Clinical Medicine, the Oxford Handbook of the Foundation Programme and the BNF Commercial content was accessed most frequently. This was reinforced by triangulation with interviews and questionnaires. Several responses mentioned the ‘easy access to the Oxford Handbooks’ and the ‘ability to search through all the books’ as the most useful component of DrCompanion.

On asking how the app could be improved a common theme was ‘more local clinical guidelines’. From interviews and questionnaires it seems that junior doctors felt that the current local guidelines available were poorly designed, difficult to read and not fit for purpose. However they commented that ‘guidelines at your fingertips are always a really useful thing’ and that more guidelines on the app would ‘be a real time saver’. Doctors mentioned currently guidelines can ‘be difficult to find’, due a lack of availability of computers in hospitals (‘there is never enough computers in hospital’) and hospital intranets that are ‘not user friendly’.

The most accessed topics were clinical emergencies such as chest pain, Diabetic Ketoacidosis, and electrolyte abnormalities. These were top topics across all the published content. Interview transcripts suggested that trainee doctors were often accessing the app at point-of-care to remind or update clinical knowledge contemporaneously – ‘usually on my way down to A&E I would look at them’, ‘it would be my get out of jail free card when stuck on the wards’.

Another theme from interview analysis was that of acceptability of use of smart phones in the hospital environment. Doctors commented that ‘GPs just googling something’ was a common complaint and that use of smart phones may ‘undermine’ clinical skills, especially in front of a more elderly cohort of patients. 

The app, especially commercial content, was well-used by our cohort. Junior doctors liked the range of content available to them and the ability to search multiple sources in one app. The cohort continued to use the app throughout the year that it was available to them.

The ability to use pre-downloaded content stored in the app without an active data connection was also noted to be an advantage. Doctors commented on the lack of computers, slow internet connections and poor 3G/4G signal available to them in many hospitals and cited DrCompanion as an alternative when needing to acquire information.

Interviews revealed point-of-care use was popular and valued amongst junior doctors. Doctors cited the app as extremely useful when about to see patients, when experiencing common ward dilemmas and to consolidate learning immediately after having seen patients or on the move. This highlights an important advantage that smartphone apps have over more traditional methods. Apps provide information at your fingertips in a busy, mobile job where having accurate information immediately available is essential for patient safety.

Doctors noted that to improve the app, a wider range of more easily accessible local guidelines should be included. Local guidelines were highlighted  to be an essential tool for junior doctors day-to-day job and were often commented to currently be cumbersome to search for, for example on the trust intranet. It was therefore felt that being able to access them easily via an app would be preferable.

Although it is nearly impossible to measure a change in patient outcomes due to smartphone apps like Dr Companion it is clear that junior doctors use it and find it useful in their daily practice. More research needs to be done on the acceptability of the use of smartphones by doctors to the general public, and the use of apps in a wider cohort of doctors, from consultant to medical student.