Receiving mHealth data
Wellness and fitness apps are intended to help patients manage their own health. Although they may share some data on their exercise or weight loss efforts with doctors during visits, the apps aren’t typically designed to keep physicians informed on how many steps patients have taken each day or their daily calorie count.
In contrast, some apps for people with chronic diseases such as diabetes and hypertension are specifically designed to send data to their physicians.
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Very little of this monitoring data, however, is being transmitted to doctors’ offices, Krebs says. “To sift that data and bring it into an EHR, you need infrastructure too big for a small provider,” he explains. “In a big hospital, there’s too much red tape, privacy issues and other barriers.”
Physicians don’t want to look at raw data, so the information needs to be sifted and relevant data points presented in an easy-to-grasp format, Scher says. This requires the use of analytics to make the data actionable.
Also, doctors don’t want to leave their EHR workflow to view the data on a website. So the data has to flow directly into their EHR, Livingston says. “If we could have six weeks of blood pressures in a patient’s real life, doing what they really do over time, and could see that data simply and easily, that would help a primary care doctor manage hypertension,” Livingston notes. “But if that data can’t be pushed and pulled into the EHR simply and easily, it won’t be used.”
Future of app prescribing
Jogi is downbeat about the current state of app recommendations, calling it a fad. “If the apps were more personalized and knew more about the history of the patient and they were connected to other apps like medication reminders, they could make a difference,” he says. “But what’s out there requires so much of the patient. Even the passive data being delivered by the app is useless.”
Livingston, on the other hand, forecasts that despite apps’ current shortcomings, they will be much more widely used five years from now than they are today.
“We’ve got to solve the issue of data portability and interoperability,” he argues. “And app developers have to focus on whether the data is actionable and usable by the physicians. Until we solve that problem, we’re going to stay in this direct-to-consumer marketing, where apps are marketed to consumers and consumers are using them and may or may not be sharing that data with their physician.”