At this point, are mobile healthcare apps more novel than useful?
This question was sent to me for a perspective last week and I found myself typing a reply in a session at the annual meeting of the California Institute to Advance Precision Medicine.
As I was typing up my response, Brennen Spiegel, MD, MSHS, of Cedars-Sinai Medical Center, presented on the use of wearables technology and mobile applications in monitoring and predicting cardiac events. In a recent study a remote monitoring application demonstrated a 6% increase in survivor rates over cancer patients that did not have remote monitoring of treatment and symptoms. These cases show us that mobile applications can have profound impact in real life health care outcomes. This is promising and exciting – but it also presents a problem: How do we sort the signal (valid and reliable apps) from the noise (junk applications built with no clinical validity)?
Eric Topol, MD gave a fabulous talk on the need to put more power into the hands of patients through direct access to their medical data. He also acknowledged the difficulty we face as digital health becomes the “hot” new space and venture money ruses unproved technologies to market that pose a risk to patient health.
Tom Insel, MD pointed out that many academics do fantastic research on horrible software products that function but leave much to be desired in terms of UX and design elements that meet commercial grade expectations. I have certainly seen hundred of examples of this kind of mobile health application.
Signal or Noise?
Mobile healthcare apps are a novel part of healthcare history and fall onto a spectrum of usefulness. Very practical implementations of mobile apps already exist that help patients and providers communicate more efficiently, access health records, and schedule clinic visits.
There are also apps that harness mobile to gather data on patients (biometric, self-report, etc.) that were not as easily accessible before.
Issues arise from apps that have not done their due diligence in making sure their product is clinically valid and reliable. A lack of scientific rigor in producing an app can have harmful effects like misdiagnoses or bad medical advice. However, the government is taking steps to regulate mobile healthcare. The FDA launched a trial pre-certification program that is a collaboration with 9 companies to determine what criteria should be included in evaluating all digital health companies in the future. Additionally, in 2016 the FTC hit Lumosity with a $2 million fine for falsely advertising the efficacy of its brain-training platform.
Nonetheless, I have great hope for what digital health can do for healthcare. Mobile platforms provide an accessibility and affordability that has the ability to truly democratize the health system.
As discussed above there have already been success stories. Another example is that telemedicine has been used by pregnant women in rural areas, giving them access to obstetrics specialists who would otherwise be too far away for them to have an appointment.
My advice is to take mobile healthcare app assertions with a grain of salt if they sound too good to be true, and hold each app that comes out to a high clinical standard.