New Models of Care, Not Just Mobile Health Apps

In order to envisage a better (i.e. more transparent, safe, accessible, sustainable and efficient) health system than we have today, we must lift our vision above the siloed mobile health app as the building block of future improvement.  Seen correctly, mobile apps are the current delivery channel of choice for new, digitally-enabled models of care, but not the solution on their own.

 

If today’s vast pile of overwhelming, under-regulated, piecemeal mobile health apps is our vision for a future health system then something is very wrong…

When talking about mobile health (also known as mHealth) apps, we need to be careful to understand that this is not the desired endpoint of digital healthcare.  The explosion of mobile health, wellness, fitness and lifestyle apps (with an estimated 100,000+ across the Apple App Store and Google Play Store) has resulted in an overwhelming degree of choice for health consumers, patients, carers and health providers.  A small number of these apps have the potential to transform the health system.  Many are not particularly helpful, and a large number are utter rubbish.

Some of the risks of poorly constructed mobile health apps are:

  • Overdiagnosis – Through constant monitoring of personal health data, there is a risk that some health consumers become hyper-sensitized to small changes in data values.  For example, patients recording their own blood pressure may become overly concerned about values that slightly or briefly rise above recommended levels.  This could result in self-diagnosis, without the application of appropriate clinical knowledge and an understanding of context.
  • Self-diagnosis – Armed with large amounts of increasingly democratised medical knowledge, there is a very real risk that patients will use this in inappropriate ways and in the wrong context.  This can and does, unfortunately, lead to patients self-diagnosing conditions, with unhelpful and sometimes serious consequences.
  • Siloed data – Many mobile health apps store data on the mobile device on which they run.  This data is then locked in yet another health information silo, with little ability to be integrated with a patient’s health record, or to be viewed or actioned by health providers.  This risks making the challenge of fragmented health information even worse.
  • Damaging relationships with health providers – Inappropriately overconfident patients can experience a deterioration in their relationships with health providers.  Significant frustration can be experienced on both sides when patients self-diagnose, or become convinced that certain treatments should be applied.

 

Although the Apple App Store does have strict guidelines for health apps, it’s not Apple’s (or Google’s) job to ensure that mobile apps actually deliver benefits for patients, carers and health providers.  However, at Semantic Consulting we’re working on some public resources for assessing and navigating this potentially overwhelming space.  It would be great to hear from you regarding how you’d like to see quality of mobile health apps being measured…

In order to envisage a better (i.e. more transparent, safe, accessible, sustainable and efficient) health system than we have today, we must lift our vision above the siloed mobile health app as the building block of future improvement.  Seen correctly, mobile apps are the current delivery channel of choice for new, digitally-enabled models of care, but not the solution on their own.  The mobile app is only inherently a good thing in that it allows us to reach into the pocket of the health consumer, allowing the creation of a two-way digital channel.  Through this channel we can monitor patient behaviour, apply clinical decision support, interact with patients and their carers and seek to modify health behaviours.

But these benefits only come in to play when we connect patients, carers and clinicians in a complex, interconnected network.  Mobile is a necessary part of these emerging networks, but it is not sufficient.  Deliberate design is required to ensure that appropriate subsets of patient gathered data are made available to clinicians at the right time, in a way that does not make their job harder, overwhelm them, or lose the data signal amongst the noise.

Patient and carer engagement is a fantastic thing, but not if it encourages patients to become isolated from their care teams.  I really hope that we can start applying a more carefully considered approach to how we use mobile apps and devices, particularly in the development of exciting new, digitally-based models of care.

 

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