Maybe you have one on your own iPhone. Or maybe at your toddler’s last checkup your doctor used hers to show you a picture of your daughter’s inner ear. Or maybe you are that doctor!
Whoever you are, there’s a pretty good chance you are one of the 70% of Americans who use some form of mobile health (mHealth) app every day. Even so, whether you’re the patient or the doctor, there’s also a pretty good chance that mHealth apps remain something of a mystery to you. After all, with such a wide ocean of different kinds of mHealth apps out there, it’s hard to know where to cast your net and find the information you need.
This guide is for you.
From all the types of mHealth apps you need to know about and links to over twenty specific apps you should consider downloading, to all the reasons why you should approach mHealth apps with caution, here you’ll find the answers to all your questions.
What types of mHealth apps are out there?
Shopping for mHealth apps is kind of like fishing in a lake that is stocked with many different species of fish–you never know what’s going to show up in your net. There is a seemingly vast array of “species” of mHealth app on the market, some of them with overlapping capabilities. Finding the one that fits your needs can be a daunting task.
Notice how I use the word seemingly.
That’s because that vast array of mHealth apps can actually be boiled down to a good solid number.
Ten, to be exact.
Every mHealth app can be classified into one of these ten categories, or “species,” if you will. Find the right category and you’ve already narrowed your search substantially. To make finding the right app a little bit easier for you, here’s a list of the ten “species” of mHealth apps:
1. Clinical assistance apps
Clinical assistance apps have various functions, such as allowing doctors to check EHRs or access lab results during an appointment. These apps may also allow for image viewing and patient education, so a doctor can use them during an appointment to illustrate the information he or she is giving to a patient.
Some notable examples of clinical assistance apps are:
2. Monitoring apps
This kind of app is taking off right now. As the name suggests, monitoring apps allow a doctor to keep an eye on the behavior or symptoms of a patient remotely. For example, a patient could use an app to take an ECG and then send the results to his or her doctor. Monitoring apps also give doctors telehealth capacities, an increasingly popular option right now.
Examples of monitoring apps include:
3. Reminder apps
This is a basic kind of app that can be used as a way to remind patients of appointments or when to take medications, for example. Sometimes reminder apps come as part of an EHR package or as part of a larger app, but they are also available independently.
Three good examples of reminder apps are:
- Talksoft Connect: iOS and Android
- My PillBox: Android
- OnPatient: iOS and Android–Note that this app is part of a larger EHR system by drchrono.
4. Reference/database apps
Probably the oldest kind of app, the reference app allows doctors to look up drug dosages or symptoms. It is quickly replacing older databases, and taking the spot once held by large reference tomes.
Noteworthy reference apps include:
5. Healthy life apps
A category that encompasses fitness and diet apps, as well as other types of apps, healthy life apps are largely used by patients rather than by doctors. They are probably the most popular mHealth apps, especially those focused on fitness.
Some popular examples of healthy life apps are:
6. Efficiency/communication apps
These apps, which allow doctors to communicate within and between medical facilities, foster interoperability, collaboration, and, ultimately, better patient care. For example, using a communication app allows a doctor to securely send information about a patient to a specialist at another facility. They also allow for a more efficient workflow in the medical practice, something many doctors are striving for.
Three examples of communication apps are:
7. General facility information apps
These are apps developed by a particular practice, usually a hospital. General facility apps give patients and family members general information about the facility, the services it offers, and amenities it provides. An app could include maps of the hospital and surrounding neighborhood or lists of available doctors at the facility, among other things.
Notable examples of general facility information apps include:
- MyWay by Boston Children’s Hospital: iOS and Android
- Fit4KidsCare by Miami Children’s Hospital: iOS
- Patient by Mayo Clinic: iOS and Android
8. Patient portal apps
Another up-and-coming type of app is the patient portal app, which gives patients mobile access to their own electronic medical records and allows for easier patient-doctor communication. They often come as part of an EMR software package.
Good examples of patient portal apps are:
- NextGen Patient Portal–Comes as part of the NextGen EHR software system.
- PortalConnect by Hello Health–A free app but available only to users of one of the Hello Health software solutions.
- InteliChart Patient Portal: iOS and Android–Sold independently but integrable with a wide variety of EHR systems.
9. Specialty apps
Specialty apps are fairly self-explanatory. Aimed at specialists, they provide tools like vision screening tests or anatomical models, for instance.
Some useful specialty apps are:
- GoCheck Kids (Pediatric photoscreening)
- EZ Derm (Dermatology): iOS–Can only be used as an element of EZDERM EHR software.
- CancerRX (Oncology): iOS
10. “Super apps”
As the name might suggest, this is an exciting new type of app. An actual super app is not yet available to purchase, but it will be soon. The key element of a super app is its ability to access and analyze information from multiple connected health devices at the same time; and that’s exactly what Google Fit and Apple HealthKit will do in the near future.
Now that you have a better idea of what kind of mHealth app you’re looking for, you may be wondering,
Who’s using mHealth Apps and how?
Maybe you think word of mouth is a good way to find out which app would be right for you, or maybe you’re just curious about who else is among the users–either way, the answer to your question may surprise you. Here’s a hint: It’s not teenagers!
Women over 25. By far the most popular and widely-used apps are those that fall into the “healthy life” category. Over the beginning of 2014, health and fitness apps usage saw a 62% growth, which is significantly greater than the growth in the mobile apps market in general. Statistics indicate that apparently the majority of fitness and diet app users are female and over the age of 25.
Baby Boomers. Somewhat surprisingly, the Baby Boom generation forms a rising audience for mHealth apps as they continue to keep up-to-date with technological innovations. Wanting to maintain control of their health data and stay organized when it comes to their well-being and fitness, 50-70 year-olds are increasingly using mobile health apps both to personally monitor diet factors such as caloric intake, and to communicate health data easily to their doctors. As a result, app developers are beginning to take an increasing interest in how to appeal to their Baby-Boomer audience, creating larger screens and more voice-activated apps with an older generation in mind.
Medicare and Military. Despite their propensity for “healthy life” apps, many app users in the U.S. exhibit a marked lack of trust when it comes to storing their other types of health records online. Also, less than half of the people who utilize fitness or diet apps talk to their doctors about the information they’ve gleaned from the apps. However, Medicare and military patients have shown themselves willing to use the iBlueButton app, which is a federally promoted app that allows users to send health records from a mobile device directly and securely to their doctor. Other patients who do not currently utilize mHealth apps have expressed a willingness to do so if recommended by their physicians.
Whereas patients have demonstrated a generally positive reaction to mHealth apps, physicians have not exhibited a unified front when it comes to these apps, leaving many people to ask,
What’s going on with Doctors and mHealth Apps?
Why aren’t more doctors recommending mHealth apps? This is perhaps the one question that is uppermost on people’s minds. Recent statistics show that about a third of doctors recommend their patients use mHealth apps, but that leaves two thirds of physicians who still will not suggest using apps. A recent poll of 250 doctors shows that the reasons doctors aren’t recommending apps are mixed:
- Lack of knowledge. There is a definite lack of knowledge among doctors about what kinds of mHealth apps are available. This is probably because only 15% of mHealth apps are marketed towards physicians.
- Lack of regulation/lack of data. Other doctors do not feel comfortable prescribing apps due to the lack of regulation or due to a lack of studies on apps’ effects on their patients’ health. In the poll mentioned above, this reason seemed to have the most significant effect on doctors’ decision not to prescribe mHealth apps, with 42% of physicians citing lack of regulation and 21% citing lack of data.
- Worries about influx of data. About 21% of doctors are afraid that prescribing apps could lead to an influx of patient data that would overwhelm their practice.
But…doctors do love their smartphones
However, these statistics could change soon. Physicians are increasingly instituting EHR systems that have mobile capabilities as well, and about half of doctors communicate with patients using either patient portals or other secure messaging systems. Most doctors, nurses, and physicians assistants (80%) use a smartphone professionally; and about half of clinical workers use tablets professionally. Around half of doctors who own smartphones do use them for patient education purposes.
Remote monitoring using apps
More than a fifth of all doctors use mHealth apps to monitor patients remotely. Some hospitals, such as the Mayo Clinic College of Medicine, are doing the same. Specifically, Mayo Clinic recently tracked the physical activity of patients using the Fitbit app.
With such a positive attitude towards mHealth apps on the part of patients, doctors will likely soon change their mindset towards apps and begin to work them in as a regular part of their practice.
However, as the numbers above show, before doctors can change their mindset, they need the answer to this question:
Are mHealth apps actually having a positive effect on users’ health?
Doctors and patients alike are asking it, wondering if mHealth apps really do make users healthier or whether they are detrimental.
The short answer to this question is: It’s too early to tell.
So far, there is no one aggregate data on how mHealth apps are affecting (or not affecting) health, particularly with regards to the apps’ positive or negative effects on patient outcomes. That being said, some individual doctors are seeing positive effects in their own practices from the use of mHealth apps.
For example, early this year Dr. Mark Granick at Rutgers New Jersey Medical School saw how an iPad app could be a great help in telehealth consultations about plastic surgery emergencies. The consultations performed using the app had 100% accuracy, leading Granick to conclude that the app is a viable way to communicate in emergency consultations and a useful tool for research as well.
Dr. Granick’s experience is in keeping with other doctors’ observations of how mHealth apps facilitate communication between doctors and facilities. In cases like Dr. Granick’s, apps have allowed a decrease in medical errors and major advances in efficiency. By providing a one-stop place for patients to record certain health data and for their physicians to access that data, mHealth apps allow doctors to make better, more comprehensive decisions. Also, mHealth apps may allow for better data gathering analysis with the final end of optimal population health.
The outlook on mHealth apps’ effect on healthcare is not, of course, uniformly positive. A few preliminary studies on weight-loss apps, for instance, have failed to show that the apps are having much of an effect on how successful the users are at losing weight. However, until more scientific studies have been conducted, the question of mHealth apps having a significant effect on healthcare remains unanswered.
Not all questions are without definitive answers, however. Another big question that doctors and users are asking is,
Should I be concerned about mHealth apps?
Unfortunately, the answer is yes. The two main concerns are the apps’ lack of medical authority and their possible infringement on patient privacy.
Bad advice and misdiagnoses
While many mHealth apps claim to offer accurate medical advice, most have been developed by people who have little to no medical knowledge. Many apps have not been tested in clinical trials, and many are not regulated by the FDA. This means that the majority of mHealth apps do not offer authoritative medical advice.
This can have devastating effects on app users who rely too heavily on mHealth apps for medical advice and thus neglect seeking information and treatment from a physician. One worrisome example is the inaccuracy of apps that claim to diagnose melanoma, four of which were tested just last year by JAMA Dermatology. The results were shocking: Three out of the four apps misdiagnosed 30% of malignant moles.
Other studies have shown similar results, validating concerns about the efficacy and safety of existing mHealth apps.
Potential privacy disaster
mHealth apps’ inaccuracy is not their only aspect worth worrying about–these apps can also open users up to major privacy breaches. This holds true for both free and paid apps, although the privacy issues may vary according to the price tag of the app.
For instance, free apps put users at risk of having their personal health information shared with the advertisers upon whom the apps depend for income. These advertisers can then use that information to target app users with personalized ads, much like what Google does already.
Paid apps offer similar problems, including the risks intrinsic to sending unencrypted data, which exposes that data to hackers. Furthermore, federal privacy legislation does not cover the data generated by mHealth apps, so apps that share personal health information without a user’s permission are not liable for privacy breaches unless they violate the app company’s internal policies.
It is clear that new standards need to be put in place for mHealth apps, standards both for accuracy of the medical advice they offer and for the privacy of app users. Recently, the FDA passed regulations as regards mHealth apps, but these regulations take the form of recommendations and preserve a certain degree of enforcement discretion for the FDA. Also, the FDA included in its guidance the opinion that most mHealth apps do not place users at a high risk, despite recent suggestions otherwise. Perhaps the next couple of years will see an increase in FDA regulation. Until then, doctors may continue to be wary of the apps, and users may remain at risk of privacy breaches.
What’s next for mHealth apps?
I’ve already hinted at the answer: The upcoming year will see the beginning of super apps, along with greater adoption of the same type of apps that are already on the market. The upcoming year may also see increased mHealth regulations by the FDA, which might alleviate the fears some doctors have of prescribing mHealth apps for their patients. Further studies on the effectiveness of the apps may also, depending on the results, lead to an uptick in the number of physicians that feel comfortable recommending mHealth apps.
It’s an exciting time for mHealth apps!
What’s been your experience with mobile health apps? Have you used them in your practice or recommended any to patients? Add your thoughts in the comments below!