April 2016
By Tom Stibolt, MD, Mobile Musings Column Editor
There is a lot written and said about mobile health apps. Proponents would have us believe that these apps are the solution to many problems. Critics counter with many arguments including that the apps are used by people who would be healthy anyway, they are difficult to use, and so on. There are a number of recent interesting discoveries regarding these apps.
A survey report from Accenture found that the vast majority of consumers and doctors believe that wearables help patients engage in their health. The number of U.S. consumers using wearables and mobile apps for managing their health has doubled from 16 percent in 2014 to 33 percent today. In addition, four in 10 consumers who use health apps said they have discussed or shared mobile app data with their doctor in the past year; 76 percent or patients who were asked by a doctor to use wearables to track their health followed their physician’s recommendation.
The survey found some problems as well. Many believe that wearables lack the ability to keep the users’ attention in the long run, and while they may use it for a few months later use becomes less consistent. There is also a problem with compatibility of data sharing between consumers, health care providers and other potential partners. Data sharing creates its own set of problems, and 90 percent of users say they are willing to share data with medical providers. However, 63 percent are willing to share that data with their health plans, and 31 percent are willing to share it with their employers.
Privacy and security are other important concerns. A March article in the Journal of the American Medical Association examined privacy policies of diabetes apps available in the Google Play Store. Of 211 apps examined, 81 percent did not offer privacy policies. This compares to a similar study in 2013 found 74 percent of free apps and 60 percent of paid apps had a privacy policy in the app or on the developer’s website. Possibly worse, of the 41 apps that did have privacy policies, 17 percent of the privacy policy provisions said data may be disclosed to advertisers. Additionally, 48 percent of the provisions said cookies would be used, 61 percent said they would share the data if required by law, and 43 percent said the data would be stored in the developer’s system. This further heightens my concerns about privacy. The researchers point to the problem of the absence of federal legal protections against the sale or disclosure of data from medical apps to third parties.
A study published in Healthcare Informatics concluded that less than half of the more than 1,000 health care related-apps reviewed by researchers appeared to be useful for their potential for patient engagement. The researchers conducted a systematic search of iOS and Android app stores, and an analysis of apps targeting individuals with chronic illnesses. For the study, usefulness was determined based on the four criteria: description of engagement, relevance to the targeted patient population, consumer ratings and reviews, and most recent app update. The researchers also attempted to categorize the apps with regard to how well they would meet the needs of patients with differing levels of health care engagement. They concluded that, just as treatment needs to be tailored to the patient, the same applies to apps, as mobile health apps “appeal to different audiences by offering varied functionalities.”
Finally, researchers from the University of Washington surveyed 211 patients and interviewed 21 doctors, dieticians and other health care providers regarding their expectations on how patients’ self-tracking data should be shared and used. They found that health care providers lack the capacity or tools to review or instantaneously interpret data from lifestyle, fitness or food tracking mobile apps. Interviewed doctors say patients have increasing access to their health care data but are also increasingly overwhelmed by it.
When managing chronic disease or symptoms, day-to-day lifestyle tracking data can be useful, but doctors don’t have a way to use these data efficiently and effectively. Providers feel pressured because they want to help and analyze data, but every format is different and data is not validated. They recommend validation studies, and also that app developers provide user-friendly summary pages, versus the unwieldy logs that patients print out.
Who knew wearables could be so wearing?
Further Reading:
http://www.commonwealthfund.org/publications/issue-briefs/2016/feb/evaluating-mobile-health-apps
http://jama.jamanetwork.com/article.aspx?articleid=2499265#jld150059r2
Editor’s note: The ATS does not endorse any of the programs or products mentioned in this column.
