Ashish Atreja, MD, chief innovation and engagement officer and a practicing gastroenterologist at Mount Sinai Medical Center in New York, says some of his patients have benefitted from using mHealth apps.
One patient, who had idiopathic GERD, used an app Atreja had suggested to document her quality of life. “Her GI symptoms were controlled, but her anxiety was through the roof,” he recalls. As a result of using the app, she recognized that her symptoms were related to anxiety, and Atreja referred her to a behavioral health specialist.
Atreja and his colleagues also have recommended apps to help patients track their responses to medications. “For the patients whose GI symptoms are not controlled, we are able to see the pattern, and we are able to more proactively step up the medication, instead of waiting for them to come back in three to six months,” he says.
Scher also has had some success. The apps he most frequently prescribes are related to nutrition and blood pressure tracking. He advises physicians to start with wellness apps, because “it’s a simpler way for people to get involved in their own health.”
Doctors should establish a trust relationship with a patient before asking them to download an app, he adds. “If you don’t establish that relationship and just say ‘use this app,’ it’s like saying, ‘take two aspirins and see me in the morning.’”
FURTHER READING: Physicians leaving the profession over EHRs
Krebs notes that tracking diet or exercise or symptoms with an app “doesn’t necessarily” lead to behavior change. However, as a VA psychologist, he has recommended apps to a few younger patients to help keep track of their thoughts and moods.
Even if a doctor can get patients to download apps, there’s no guarantee that they will use them or stick with them. Krebs has studied the use of a weight-loss app, for example, and found that when patients set their weight-loss goals too high, they tended to drop out of the program. On average, he says, patients kept using the app for 17 days.
“Patients have to desire to self-manage,” Scher notes. “I’ve had patients monitor their blood pressure using an app for up to two weeks, and I get a 100% response rate. You have to start small and keep patients engaged. Ninety-five percent of apps that are downloaded are never looked at or used only once. So you have to start with something that will keep patients coming back. ”