Here are four key areas of concern those in healthcare have when it comes to the future of mHealth apps, tools patient are utilizing in greater numbers.
The FDA believes the use of mobile medical apps will become widespread before the end of this decade, predicting 500 million users worldwide by 2015. By 2018, it expects half of all smartphone owners worldwide to have downloaded a medical app. While these apps are becoming more common, many in the medical field question whether they'll be beneficial to patients and/or physicians within that same time frame.
Some of the questions they're asking include the following:
Who Are the Intended Users of Medical Apps?
Marketing medical apps to physicians would help ensure that the users of these apps can recognize incorrect healthcare information. However, in a 2013 article appearing in Perspectives in Biology and Medicine, William H. Krieger argues that medical apps are increasingly being marketed to patients instead of medical professionals. While many app developers include a disclaimer that the apps are for entertainment purposes only, Krieger notes online reviews and user comments that prove individuals are ignoring this warning. He goes on to suggest that marketing medical apps to patients creates a potential conflict of interest wherein a pharmaceutical company could create an app that recommends its own drugs above or instead of others.
Who Will Regulate Medical Apps?
The FDA has already approved roughly 100 medical apps but said in September 2013 that it will leave most apps unregulated so it can focus solely on evaluating those that pose the biggest risk of harming patients when the apps don't work as intended. This group primarily includes apps that serve as an accessory to a regulated medical device, such as those that help doctors monitor their patients' implanted pacemakers. The FDA will avoid regulating any apps that coach patients on managing their diseases or that organize medical info for user lookup.
Do Medical Apps Include Accurate Info?
An October 2013 study from the IMS Institute for Healthcare Informatics assessed over 40,000 healthcare apps available in the U.S. Apple iTunes app store and found that the majority of these apps do little more than provide general medical information. But how much of that information is accurate? A study in JAMA Dermatology focused specifically on four mobile apps used for detecting melanoma. The researchers found that three of the four apps incorrectly classified 30 percent or more of known melanomas as "unconcerning" or benign. As the researchers stated in their conclusions, "Reliance on these applications, which are not subject to regulatory oversight, in lieu of medical consultation can delay the diagnosis of melanoma and harm users." Additional studies are needed to assess apps for other medical specialties as well.
Is Patient Privacy Protected?
Last year, Privacy Rights Clearinghouse studied the privacy policies and protections of 43 popular medical apps. They concluded that mobile health and fitness app users should not assume that any of their data is protected or private. Fitness/diet/exercise apps, which currently make up the majority of available medical apps, have recently come under fire by privacy advocates after the fitness tracking app called Moves was acquired by Facebook. Deborah Peel, founder and executive director of Patient Privacy Rights (a bipartisan, nonprofit organization that works to give patients control over their own sensitive health records), told The Washington Post, "[health data] is the most valuable information in the digital age, bar none," which is why privacy advocates predict that information about intimate health conditions will soon be acquired through mobile medical apps and sold to the highest bidder.
Given these four concerns, it's hard to feel confident about the efficacy of mobile medical apps in the near future. For now, consider asking patients which, if any, medical apps they are currently using and warn them of the issues that many within the medical community have raised. Also remind them to speak to you before acting on any diagnoses, drug recommendations, or medical information obtained from these apps.