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Think of Mobile Medical Apps as Durable Medical Equipment


Would you just give a patient crutches or a piece of equipment at home without giving them instructions on how to use it? To effectively use medical apps, patients need plenty of information and encouragement.

Mobile medical apps (MMAs) are used for many purposes. Some are actually medical devices, as defined by the FDA , and others are used to provide education and information to help patients prevent or manage a chronic condition or assist with their treatment compliance. Durable medical equipment (DME) are things like wheel chairs, home oxygen equipment, and other items patients use at home to manage their care. Unfortunately, most people think of mobile medical apps more like drugs, where you just prescribe or recommend them and hope for the best. To no one's surprise, the failure and non-compliance rate is as dismal for apps as it is for drugs, where it is estimated that half of patients don't take their medicines the right way for the prescribed amount of time.

Instead, consider apps as durable medical equipment. Would you just give a patient crutches or a piece of equipment at home without giving them instructions on how to use it? To be effective, mobile medical apps should be recommended, not alone, but with:

1. Evidence that they are clinically valid and do what they say they are supposed to do

2. Education for patients and their caregivers on how to use the app

3. Monitoring and reinforcement to be sure the app is being used correctly or that the use has not fatigued

4. An incentive to use the app to create and reinforce behavior modification.

A recent example was a report of a VA study that used techniques to manage pain patients. The authors reported that a stepped-care intervention that combined analgesics, self-management strategies, and brief cognitive behavioral therapy resulted in statistically significant reductions in pain-related disability, pain interference, and pain severity in veterans with chronic musculoskeletal pain.

Mobile medical apps fail for many reasons, just like some drug therapies. But expecting a patient to get better by telling them to "just use this" is an unrealistic expectation and only leads to frustration and non-compliance. They need more. Now who will do that, how they will do that and how they will get paid to do that is another story.

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