Researchers at the University of Michigan Medical School and Boston’s Brigham & Women’s Hospital published a new study that suggests that app makers are falling short when it comes to actually serving those who could get the most benefit from mobile health apps.
The researchers, led by UM assistant professor of learning health sciences Dr. Karandeep Singh, said even the “best” apps for patients with chronic conditions fell short. These patients have high health costs and may have care needs that are complicated by lower income or level of health knowledge.
The team evaluated apps aimed at people who live with asthma, arthritis, diabetes, high blood pressure, depression, lung disease, liver disease, kidney disease, heart failure and addiction to drugs, alcohol or tobacco. They also evaluated apps for people who have survived a stroke, battled cancer, been diagnosed with memory loss or dementia or are obese or living with pain.
The study is based on a review of 137 of the most highly rated or often-recommended mHealth apps aimed at people with chronic conditions among the more than 165,000 programs in the Apple and Google app stores.
The study showed a varied range of apps for different conditions. For example, people with diabetes or depression can find a wide range of highly rated apps, but people with arthritis or chronic pain cannot.
The researchers also found that the ratings for the apps weren’t always a reliable guide. Physicians and non-physicians on their evaluation team often rated apps much higher or lower than the app store’s ratings, based on how useable or useful the apps were for particular patients.
“We found that the consumer-generated rating on the app store is a very poor marker of how usable an app is, and whether a physician would recommend it. Clearly, the work is not done once consumers have rated an app. Going forward, we need to evaluate apps on the basis of what would it take for physicians, and organizations that issue clinical guidelines, to start recommending them to patients,” Singh said.
Many of the apps offered tracking functions, education, reminders and alerts, but very few provided guidance based on what the user entered.
Of the 121 apps that allowed people to enter information into their phones based on their health for the day, such as blood sugar, blood pressure or suicidal moods, only 28 of them reacted appropriately when the patient entered a dangerous value.
“Do we really want our mHealth apps to be passive observers, or should we expect that they do more than that, and model themselves after crisis hotlines with specific action plans?” Singh said.
The research suggests that the lack of advice for users may be based on how mHealth apps are regulated by the Federal Trade Commission, which responds to misleading claims; the U.S. Health & Human Services Dept.’s Office for Civil Rights, which oversees compliance with health privacy laws; and the FDA, which requires app makers to remove apps from the app store, but does not have to review mHealth apps before they’re made public.
Most of the apps allowed users to share their information with others, but via insecure channels. Half of the apps allowed sharing through email, 17% allowed text-message sharing and only one allowed users to share data directly into the electronic health record used by their medical team.
“Clearly there is a large-scale proliferation of apps happening related to health and people have made the switch over to smartphones,” Singh said. “But the question is, to what extent are apps serving the needs of patients with chronic diseases and their caregivers, as opposed to generally healthy people seeking help with wellness?”