The Utility of Mobile Apps

By December 22, 2016Commentary

While I am skeptical, even cynical, I am also always hopeful.  Maybe mobile health apps can make a real difference in quality and cost outcomes, at least for some people.  No evidence they are doing so yet.  A Health Affairs article reviews the state of field.   (HA Article)   The authors look at a range of apps, with particular attention to their utility for high-need, high-cost patients, who typically suffer from a multiplicity of chronic conditions.  They found about 137 apps that they deemed to target or be useful to high-need, high-cost patients and that they could evaluate.  They considered issues such as how well the apps served the needs of these patients, did an app store rating providing accurate and useful information, do the apps appropriately respond to user-entered information, are costs a barrier to use and do the apps have good privacy and security features.  About 40% of the app developers allowed the researchers to discuss their apps by name; the rest apparently are so confident in their apps that they don’t want an independent researcher to identify them.  Here is a good rule of thumb–if an app isn’t named in this research, don’t even consider using it.

While this is primarily a qualitative evaluation, it was performed by experts and in a thoughtful way, as objectively as possible.  Certain conditions had many apps specifically targeting them, such as diabetes and hypertension, but many conditions have only one or two, or no, apps focused on that condition.  And there was only one app specifically aimed at the elderly.  While most apps allow entering and tracking of data, few provide guidance based on the data or have other functionality that might lead to more engaged patients, such as support through social networks or rewards for behavior change.  App store ratings correlated very poorly with judgments of clinical utility.  Less than a fourth of the apps responded appropriately to entering of information that indicated a health danger to the patient.  More than half the apps encouraged insecure communication and other practices and only 64% had a privacy policy.  While mobile apps have potential, it appears most aren’t delivering on that potential.

Author Kevin Roche

The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry through Roche Consulting, LLC. Mr. Roche is available to assist health care companies through consulting arrangements and may be reached at khroche@healthy-skeptic.com.

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