Easy on those apps: Mobile medical apps gain support, but many lack clinical evidence
Skip to main content
MDHC_Logotype_white
Subscribe
  • My Account
  • Login
  • Subscribe
  • News
    • This Week's News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • People
    • Regional News
    • Digital Edition
    • Ohio to save $240M in Medicaid drug costs by running its own PBM
      MACPAC approves recommendations on specialty drugs, behavioral health
      Top R.I. state official will take over, review hospital agency
      No region in the world spared as virus cases, deaths surge
    • No region in the world spared as virus cases, deaths surge
      We're losing engaged providers, and healthcare will pay the price
      J&J vaccine problems hamper U.S. military vaccines overseas
      U.S. suicides dropped last year, defying pandemic expectations
    • Calls mount for Biden to track U.S. healthcare worker deaths from COVID
      Front-line workers want more assistance after a year of COVID-19
      Healthcare providers enter Philadelphia's legal fight to enact gun laws
      Taking population health expertise to the market
    • Cigna and Oscar expand their small business partnership
      5 things to know about Agilon Health's proposed IPO
      More than a half million Americans gain coverage under Biden
      Insurance auto-retention policies could halve number of people kicked off coverage
    • MACPAC approves recommendations on specialty drugs, behavioral health
      No region in the world spared as virus cases, deaths surge
      CMS wants to bump pay for hospices, SNFs next year
      MACPAC wants to cut Medicaid spending on high-cost specialty drugs
    • Outgoing UHS chief made almost 50% less in 2020 than 2019
      A hundred dollar bill cut into strips with a colorful background.
      Population health still at odds with fee-for-service
      Private equity could increase long-term Medicare spending, MedPAC says
      Jeb Bush, Marilyn Tavenner getting in on healthcare SPAC frenzy
    • Healthcare data breaches
      By the Numbers: National health information service providers
      Health systems are navigating the digital divide and vaccine access
      woman doctor shaking hands with nurse and smiling
      Sponsored Content Provided By Philips
      A stronger healthcare system requires bold new ways of working together
    • Fight against STDs lost amid coronavirus testing blitz
      Beyond the Byline: Kids' unchecked mental health needs pose long-term consequences
      Hospitals vary widely in reducing C-section rates, but some progress in other maternal health metrics
      Home improvement to be provided by ProMedica's new healthy homes initiative
    • Novant Health adds chief payor performance officer
      Kaiser Permanente names Comer chief IT officer
      Mass General Hospital's Slavin to retire as CEO
      UnitedHealthcare names Thompson as new CEO
    • Midwest
    • Northeast
    • South
    • West
  • Insights
    • ACA 10 Years After
    • Best Practices
    • Special Reports
    • Innovations
    • The Affordable Care Act after 10 years
    • A close-up of a woman receiving a COVID-19 vaccine.
      Providers in underserved communities work toward equitable vaccine distribution
      Josh Bradshaw
      How one rural Illinois county vaccinated 84% of its senior citizens by early March
      Dr. John Fischer
      Patient-reported outcomes tool for hernia surgery helps physicians improve care
      New care model helps primary-care practices treat obesity
    • Jennifer Pannone and her daughter Victoria.
      Mental health access for children needs attention
      A family photo of the the Hangens.
      Stressing the already burdened pediatric behavioral health system
      What's next for on-demand telehealth companies?
      A map of the U.S. with images of the coronavirus.
      The digital divide becomes a new social determinant of health
    • Ryan McGinnis
      Finding efficiencies in the OR using tech
      Dr. Daniel Hall
      UPMC pilots machine learning, telehealth to inform patient transfers
      A woman being recorded using her inhaler on a smartphone.
      Digital check-ins, connected inhalers help control asthma
      A phone screen showing the question, "Mary we hope this information was helpful and we'd like to keep guiding you. Are you interested in knowing when it's your turn to receive the vaccine?"
      Chatbots, texting campaigns help manage influx of COVID vax questions
  • Transformation
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Nearly 1 in 5 Americans skipped care due to cost last year
      COVID-19 long-haulers need holistic treatment, providers say
      Amazon expanding employee clinics into two more states
      What's next for on-demand telehealth companies?
    • Malpractice premiums peak in 2020, AMA survey shows
      A rendering of a cancer research institute at the University of Southern California that will include 5G.
      Healthcare providers determine how to best use ultrafast 5G
      Two-thirds of largest hospitals aren't complying with price transparency rule
      'Silver lining': Hospitals keep practices born in COVID rush
    • Addressing long-standing barriers needed for mental and physical health integration
      A close-up of a woman receiving a COVID-19 vaccine.
      Providers in underserved communities work toward equitable vaccine distribution
      The waiting room of a Kaiser Permanente clinic at a Target location.
      Health systems revamp their approach to retail clinics
      Josh Bradshaw
      How one rural Illinois county vaccinated 84% of its senior citizens by early March
    • CMS wants to bump pay for hospices, SNFs next year
      CMMI pauses new Direct Contracting model applications
      CMS wants to boost payments over 2% for inpatient rehab, psych facilities
      40 Oregon providers, insurers sign value-based care pact
  • Data/Lists
    • Rankings/Lists
    • Interactive Databases
    • Data Points
    • Health Systems Financials
      Executive Compensation
      Physician Compensation
  • Op-Ed
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
    • Dr. Alan Kaplan
      The risks, rewards of taking organizations 'where they haven’t gone before'
      Wellstar CEO calls adapting for the pandemic her bold move
      Howard P. Kern
      Recognizing the value of telehealth in its infancy
      Dr. Stephen Markovich
      A bold move helped take him from family doctor to OhioHealth CEO
    • Drs. Hal Paz and Joshua J. Joseph
      Mobilized to fight the COVID crisis: a blueprint for community and academic partnerships
      Dr. Stephen Markovich
      Making sure we're aligned along the path to achieving inclusion
      Barry Ostrowsky
      Ending racism is a journey taken together; the starting point must be now
      Laura Lee Hall and Gary Puckrein
      Increased flu vaccination has never been more important for communities of color
    • We're losing engaged providers, and healthcare will pay the price
      Dr. Chris DeRienzo
      How COVID-19 broke health systems and made them stronger
      Bonnie Castillo and John Welton
      Dueling opinions: The role of mandated nurse staffing ratios
      Still crossing the quality chasm: a look at the IOM's seminal report 20 years later
    • Letters: Eliminating bias in healthcare needs to be ‘deliberate and organic’
      Letters: Maybe dropping out of ACOs is a good thing for patients
      Letters: White House and Congress share blame for lack of national COVID strategy
      Letters: VA making strides to improve state veterans home inspections
    • Sponsored Content Provided By Optum
      How blockchain could ease frustration with the payment process
      Sponsored Content Provided By Optum
      Three steps to better data-sharing for payer and provider CIOs
      Sponsored Content Provided By Optum
      Reduce total cost of care: 6 reasons why providers and payers should tackle the challenge together
      Sponsored Content Provided By Optum
      Why CIOs went from back-office operators to mission-critical innovators
  • Awards
    • Award Programs
    • Nominate
    • Previous Award Programs
    • Other Award Programs
    • Voting Open - 50 Most Influential Clinical Executives
      Nominations Open - Top 25 Innovators
      Nominations Open May 24 - Top 25 Emerging Leaders
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Minorities in Healthcare
      • - Luminaries
      • - Top 25 Minority Leaders
      • - Minorities to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Excellence in Nursing Awards
    • Design Awards
    • Top 25 COOs in Healthcare
    • 100 Top Hospitals
    • ACHE Awards
  • Events
    • Conferences
    • Galas
    • Webinars
    • COVID-19 Event Tracker
    • emburse certify modern healthcare custom media webinar logo lockup
      Sponsored Content Provided By Emburse
      Webinar: Making it easy to manage costs
      virtualmed staff modern healthcare custom media logo lockup
      Sponsored Content Provided By VirtualMed Staff
      Webinar: Best practices for creating a successful telepsychiatry program
      telehealth visit man touching neck while speaking to doctor on computer
      Sponsored Content Provided By Accumen
      Webinar: How telehealth has evolved into a standard of care
      modern healthcare custom media and trimedx custom webinar logo lockup
      Sponsored Content Provided By TRIMEDX
      Webinar: Bridging the gap between clinicians and administration to improve capital equipment planning
    • Women Leaders in Healthcare Conference
    • Social Determinants of Health Symposium
    • Healthcare Transformation Summit
    • Leadership Symposium
    • Virtual Briefings
      • - Hospital of the Future
      • - Mental Health
      • - Patient Safety & Quality
      • - Strategic Marketing
      • - Virtual Health
      • - Workplace of the Future
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Minority Leaders Gala
    • Top 25 Women Leaders Gala
  • Listen
    • Podcast - Next Up
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
    • Dr. Chris DeRienzo
      Next Up Podcast: Building team spirit in the wake of COVID-19
      Mikelle Moore
      Next Up Podcast: Mikelle Moore on recognizing all hospital workers during the pandemic
      Empty boardroom
      Next Up Podcast: What's going to happen tomorrow? Succession planning during emergencies
      Next Up Podcast: Educating patients on the COVID-19 vaccine with Tanya Andreadis
    • Beyond the Byline: Kids' unchecked mental health needs pose long-term consequences
      Beyond the Byline: How COVID-19 has impacted hospital finances
      An older man sitting on a hospital bed with his back toward the camera.
      Beyond the Byline: Upcoding could explain why hospitals are increasingly billing for the most complex treatment
      Beyond the Byline: Insurers are betting on virtual-first plans as COVID-19 shifts care pathways
    • James garvert neustar healthcare insider podcast image
      Building on basics
      Healthcare Insider Podcast Episode Art - Premier
      Why Roger Weems and other consultants are leaving the big firms to join Premier
      James garvert neustar healthcare insider podcast image
      Outreach during COVID-19
      ann barnes healthcare insider podcast image
      Leading with intention to promote diversity and inclusion
    • The Check Up: Matt Eyles
      The Check Up: Matt Eyles of AHIP
      The Check Up: Dr. Tom Shanley
      The Check Up: Dr. Tom Shanley of Lurie Children’s Hospital of Chicago
      The Check Up: Dr. Harold Paz
      The Check Up: Dr. Harold Paz of Wexner Medical Center at Ohio State University
      The Check Up: Pat Schou
      The Check Up: Pat Schou of the Illinois Critical Access Hospital Network
    • ivana naeymi-rad one on one intelligent medical objects
      Video: Ivana Naeymi Rad of Intelligent Medical Objects
  • MORE +
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Technology
November 28, 2015 12:00 AM

Easy on those apps: Mobile medical apps gain support, but many lack clinical evidence

Joseph Conn
  • Tweet
  • Share
  • Share
  • Email
  • More
    Print

    Mobile medical applications increasingly are being used by patients and consumers. Now healthcare providers are evaluating whether and how to work with their patients in tapping these apps. But they're proceeding cautiously because of the dearth of clinical evidence for many consumer apps, and because some developers may be misleading consumers by overstating their products' capabilities.

    In September, developers of a consumer-marketed mobile app, UltimEyes, agreed to pay $150,000 to settle an enforcement action by the Federal Trade Commission based on the claim that the app was “scientifically shown to improve vision.” The promoters “did not have the scientific evidence to support their claims,” the FTC said.

    Earlier this year, the federal agency went after marketers of two mobile apps, Mole Detective and MelApp, “for deceptively claiming their mobile apps could detect symptoms of melanoma even in its early stages.” The apps' marketers reached settlements that bar them from continuing to make such unsupported claims, the FTC said.

    The FTC action on the melanoma apps followed research led by Dr. Laura Ferris, an assistant professor at the University of Pittsburgh, that was published in JAMA Dermatology in 2013. Her team looked at four such apps. “We saw that they didn't work all that well,” Ferris said in an interview. “You can't just put these out there with no validation or no data to back them up, because the stakes are too high.”

    That's a particular issue for the poor, the uninsured, and the underinsured who might buy an app for a few dollars and diagnose themselves, rather than pay for a doctor's visit, she said.

    Given the growing use of mobile medical apps, “I think we will be seeing an increase in scrutiny and enforcement by the FDA and the FTC,” said Monica Chmielewski, a partner at Foley & Lardner. She doubted that more “innocuous” apps like weight trackers would be subject to scrutiny. “But when you have these mobile medical devices treading in the areas of diagnosis and treatment, for those I think we'll see increased enforcement.”

    Only 16% of healthcare professionals currently use mobile applications with their patients, but 46% plan to do so in the next five years, according to a 2015 survey of 500 professionals by Research Now, a Plano, Texas-based market research firm. Even so, 86% of the professionals surveyed said they believe mobile apps will increase their knowledge of their patients' conditions, while 46% said the apps will improve their relationships with patients.

    Research Now also surveyed consumers who use medical apps and found that 96% said they believe the devices help them improve the quality of their lives. Sixty percent use them to monitor their activity and their workouts, 49% to count their calories and 42% to monitor weight loss.

    “I have patients asking me all the time about health-related apps,” said Dr. Mike Sevilla, a family physician who belongs to a six-physician group practice in Salem, Ohio. “It's really a great way for me to talk to my patients and make them accountable” for managing their own health.

    He recommends apps from the Mayo Clinic and WebMD to patients. “We're coming into the holidays and people are already thinking about weight loss and lowering their cholesterol and counting their steps.” Sevilla said. He believes home blood-pressure readings via apps often are more accurate because patients' blood pressure can rise when they come to the doctor's office.

    MH Takeaways

    Experts say the key to success in using mobile medical apps is not the technology itself, but making it part of a well-designed, coordinated-care process.

    Estimates of the size of the U.S. mobile health market vary widely. Manu Varma, head of strategy for Philips' Hospital to Home business unit, which sells devices and consults with providers setting up mobile health programs, said the market is growing 20% a year. For healthcare providers, a major factor driving that adoption is the shift to value-based payment, which creates a powerful incentive to keep patients healthier and reduce costs by avoiding unnecessary hospitalizations and emergency department use.

    Banner Health in Phoenix has implemented a project called Intensive Ambulatory Care, which uses an array of mobile devices for home health monitoring of about 600 patients with multiple chronic conditions.

    The program, which is free to patients, involves several ambulatory teams each consisting of two physicians, two nurses, two social workers, a pharmacist and a health coach who serve up to 40 patients. The devices, supplied by Philips, include a wireless scale and monitors for blood pressure, pulse rate, blood oxygen and glucose, plus video communication.

    Results from the initial 135-patient pilot program indicated a 27% reduction in enrolled patients' cost of care, primarily because of fewer hospital admissions and shorter lengths of stay, as well as lower outpatient healthcare costs, said Dr. Hargobind Khurana, Banner's senior medical director of health management. “Patients like it a lot,” he said. “They adopted the technology more easily than we thought.”

    As with the introduction of any new clinical-care process, there are safety issues with mobile health. “We're going from a situation where we had no data to one where we probably have more data than we need,” Khurana said. “You have to have processes in place where we don't respond to data that's flawed. You validate by talking with the patient. You understand that data is just one part of the decision tree.”

    Research shows that mobile apps can offer clinical benefits, particularly when used in a structured healthcare program. A literature survey published in PLOS Medicine in 2013 by researchers at the London School of Hygiene & Tropical Medicine concluded that text messages to patients' mobile phones were effective with smoking cessation and in boosting patient compliance with antiretroviral medication regimes.

    In September, the American Heart Association concluded that the evidence generally supports using mobile medical apps to address smoking, weight, healthful eating, regular physical activity, blood glucose, blood pressure and cholesterol levels. The association said heart researchers have found that consumer health-informatics tools have a positive impact on knowledge, adherence, self-management and behavior changes related to healthful eating, exercise and physical activity—but not on obesity.

    Smartphone apps also were deemed “useful tools at the point of care and in mobile clinical communication, as well as in remote patient monitoring and self-management of disease.” But the association noted concerns that the apps generally “fail to incorporate evidence-based content” and lack “rigorous testing” for efficacy.

    In another literature review, Spyros Kitsiou, an assistant professor in biomedical and health information sciences at the University of Illinois at Chicago, and his Canadian colleagues concluded that hard-wired telemonitoring and mobile telemonitoring were effective in reducing the risk of all-cause mortality and heart failure-related hospitalizations in intervention programs for patients with chronic heart failure.

    The quality of the evidence is only “moderate,” Kitsiou said in an interview. But he argued that it's good enough to support using the devices and applications in clinical practice. “In the next five to 10 years we'll have even more evidence collected and be able to conduct more rigorous clinical trials,” he said.

    Kitsiou and his co-authors wrote that “the key to the success of these programs is not the technology itself, but the coordination of care that needs to be in place along the continuum of health services delivered for (heart failure) patients within a healthcare system.”

    He noted, however, that the digital interventions he and his colleagues evaluated were not the “run-of-the mill” mobile apps for consumers available from Apple or Google. The vast majority of consumer medical apps “have not been formally evaluated, so we know next to nothing about their effectiveness and whether they can actually harm the patient,” he said. “As the number of health apps is rapidly growing, there is an urgent need for greater regulation and oversight of these medical/health apps by FDA and other government entities.”

    Healthcare lawyers caution that providers run a variety of legal risks in using mobile apps with patients. “If the patient brings in a bunch of stuff, if you rely on it and it's wrong, it's a problem,” said Kirk Nahra, privacy practice chairman at Wiley Rein in Washington. “But if you ignore it and it's right, it's a problem. You're damned if you do and damned if you don't.”

    Robin Diamond, senior vice president at the Doctors Co., a medical liability insurer, said, “The physician needs to make sure patients know the limitations of the app” and how the provider organization handles the data produced by the app. “The patient may think, 'I don't have to worry about telling my physician my blood pressure is a little high this week,' ” she said. “But patients with mobile monitors need to be told, 'You still need to call me if you have this level.' ”

    There is also a risk that the readings produced by a mobile device may be inaccurate. “There are a lot of untested apps on the market that may be unreliable or even dangerous,” Diamond said. If treatment is prescribed based on the wrong data, the provider could be found liable, though she knows of no such cases so far.

    Dr. Art Papier, CEO and chief medical officer at Rochester, N.Y.-based VisualDX, which offers computerized diagnosis-support tools for medical professionals, noted that it's important to distinguish between medical apps for consumers and those for professionals.

    “They're two different worlds,” he said. “You do want patients engaged in following their (skin) moles, and they can certainly track them by photographing them. But you need to be cautious about apps that give people mistaken information that the mole is OK.”

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Healthcare data breaches
    Healthcare data breaches
    By the Numbers: National health information service providers
    By the Numbers: National health information service providers
    Sponsored Content
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS
    • Instagram

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    MDHC_Logotype_white
    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2021. Crain Communications, Inc. All Rights Reserved.
    • News
      • This Week's News
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition
    • Insights
      • ACA 10 Years After
      • Best Practices
      • Special Reports
      • Innovations
    • Transformation
      • Patients
      • Operations
      • Care Delivery
      • Payment
    • Data/Lists
      • Rankings/Lists
      • Interactive Databases
      • Data Points
    • Op-Ed
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Awards
      • Award Programs
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Minorities in Healthcare
          • - Luminaries
          • - Top 25 Minority Leaders
          • - Minorities to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Nominate
      • Previous Award Programs
        • Excellence in Nursing Awards
        • Design Awards
        • Top 25 COOs in Healthcare
      • Other Award Programs
        • 100 Top Hospitals
        • ACHE Awards
    • Events
      • Conferences
        • Women Leaders in Healthcare Conference
        • Social Determinants of Health Symposium
        • Healthcare Transformation Summit
        • Leadership Symposium
        • Virtual Briefings
          • - Hospital of the Future
          • - Mental Health
          • - Patient Safety & Quality
          • - Strategic Marketing
          • - Virtual Health
          • - Workplace of the Future
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Minority Leaders Gala
        • Top 25 Women Leaders Gala
      • Webinars
      • COVID-19 Event Tracker
    • Listen
      • Podcast - Next Up
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • MORE +
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing