|Articles|June 22, 2015

Prescribing mobile apps: What to consider

Mobile health (mHealth) is a confusing landscape, to be sure. IMS Health, which rates mHealth apps and provides a formal mechanism for app prescribing, estimates there are 63,000 health apps in the Apple and Google stores. The number and variety make it difficult for physicians to find and recommend the good ones. As a result, prescribing mHealth apps is new to most physicians.

More than a third of doctors said they prescribe mHealth apps, but half of those clinicians had only suggested that patients shop in an app store, Medical Economics reported in fall 2014. A more recent March 2015 survey by Research Now found that 16% of physicians were prescribing mobile apps. But 46% of the respondents expected to integrate this new tool into their practices within five years.

Yet not all patients have smartphones, and those who could benefit the most from mHealth apps--older patients with chronic diseases-are least likely to possess this technology. Less tech-savvy patients may also have trouble with the Bluetooth-enabled devices that are required to use many mHealth apps.

So should you consider prescribing mHealth apps? You may well face numerous uncertainties, including which to prescribe, how to integrate the data they produce into your workflow, whether and how to integrate patient-generated data in your EHR, and how to motivate patients to download and stick with the apps you prescribe.

Nevertheless, the ubiquity of smartphones and the outsized role they play in the lives of many patients make mHealth apps a compelling tool for patient engagement. What follows are some insights into and tips on mHealth prescribing from experts and physicians who have already taken the leap.

Lack of evidence

While some physicians have seen the benefits of mHealth prescribing, the evidence of their efficacy is in short supply, notes Steven Steinhubl, MD, director of digital medicine at the Scripps Translational Science Institute, in a recent interview with the Institute for Health Technology Transformation.

Matt Tindall, director of consumer solutions for IMS Health, tells Medical Economics that his firm has found only 260 scientific studies of particular apps in the literature.

Moreover, some add-on devices and apps for smartphones produce inaccurate data. Hypertension experts have questioned the reliability of some mobile blood pressure devices. Another study found that three of four skin lesion apps misidentified 30 or more melanoma lesions as benign.

Partly because of concern over the validity of commercially available apps, some healthcare systems have created their own mHealth software, says David Collins, senior director of health information systems for the Health Information Management and Systems Society (HIMSS). But most organizations have found that it’s too difficult and expensive to develop mobile apps in-house, he adds.

Some healthcare organizations offer external apps that meet their criteria to consumers in their own app stores. About 10% of healthcare systems recently surveyed by HIMSS, including prominent ones such as Ochsner Health and the Cleveland Clinic, have their own app stores.

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