PhD Student
College of Nursing
University of Utah
“What is it?” My patient asks
nervously.
“114.” I reply.
“That’s great! That’ll my fifth
level in normal range, right?”
“Yeah, I think you’re right. I’ll
check.” I reply, now back at my computer looking at her previous four blood
glucose levels.
Not surprisingly, my patient is
right, her blood sugar levels have been below 120 since yesterday morning. She
thanks me as I start walking out of the room. I promptly respond but she
doesn’t hear me, by then she is too busy manually inputting her blood sugar
level into one of the many glucose monitoring applications (apps) one can
download to their phone.
The growth of health
apps
This is the age we live in. The age
of the e-patient. The “E” stands for both electronic and empowered. Long gone
is the day that the doctor or nurse is the source of all health knowledge. The invention
of smart phones and mobile health applications has done for patients today what
the translation of the bible did for common people during the Reformation. This
is the medical reformation, the age when the patient is empowered with access
to seemingly endless information at their fingertips. Over 320,000 health applications like the one my
patient was using are available on app stores today. Like the religious boom
that was seen during the Reformation, in today’s medical reformation, companies
are scrambling to throw their hat in the ring and get a slice of this expanding
tech market estimated to be worth more than 27 billion dollars. The annual growth rate
is estimated to be in the 32nd percentile translating to an
average of 200 health apps being added each day to the
app store. This means more options for my patient with diabetes and any other person
looking to improve their health and health literacy, but it can also create a
source of potential danger.
Regulation is crucial
Despite information becoming more
accessible, questions remain on the quality of information patients are gaining
access to. Meaning that the information and claims stated by some of these
applications may be erroneous, misleading and even potentially harmful. The
Federal Trade Commission (FTC) warns about this and estimates that only about
half of all health sites and apps are doctor reviewed. This can be especially
dangerous if people are relying on the information they are receiving from
their apps and not seeking a second opinion from a trained health professional.
Unfortunately, a second opinion is not always obtained and now app companies
are going to great lengths to protect themselves from potential lawsuits, with many
apps incorporating multiple layers of consenting before the downloader can
finally use the applications settings. Along with the FTC, the Food
and Drug Administration (FDA) oversees the regulation of these mobile health
applications. These regulations can be found in the Mobile Medical Applications Guidance for Industry and Food
and Drug Administration Staff, a 45 pages document written to reduce the
negative consequences of this medical reformation. Consequences that although
very real, may still be outweighed by the positives.
Positive
may be too big
A staggering
96% of health app users report improved health when using an app,
according to a 2015 study done by Research Now. Not only are patients
benefiting from mobile health apps, health care providers are too. In the same
study, 86% of health professionals agreed that health apps will improve their own
knowledge of their patients condition as well as increase their patients sense
of responsibility for their health. This excitement is being shared by
hospitals, many of which are now seeing the adoption of such apps as a
necessity. Dr. Shafiq Rab, Senior Vice President and Chief Information Officer
at Hackensack University Medical Center, said:
The delivery of healthcare is moving from
large buildings and big offices into patients’ homes and mobile devices… The
new model means that we as healthcare providers must step up our game and…
provide the convenience, access, quality and transparency required to acquire
and retain patients (n.d. para. 1)
Other
primary care providers (PCP) are also aware of this shift and are already
seeking ways to “step up [their] game”, 46% of all PCPs state plans of incorporating apps
into their practice within the next five years. Additionally, different from many
priests during the Reformation, doctors seem to be open to the shifting distribution
of knowledge as job satisfaction levels and
patient-doctor relationships are being left unstrained during this shift.
Conclusion
In
conclusion, the age of mobile health apps has led to a medical reformation that
distributes knowledge and responsibility back to the patient. With this shift
in knowledge, regulatory measures must be used to protect patients from inaccurate
and misleading information. With protective measures in place, apps have the
potential to not only improve the patients’ health but also improve health care
system as we now know them. As doctors work to incorporate such technologies in
their practice, patients’ will increase in health literacy and become more
significant role players in their own care.
References
Conn,
Joseph. (2015). Easy of those apps: Mobile medical apps gain support, but lack
clinical evidence. Modern Healthcare.
Retrieved from http://www.modernhealthcare.com/article/20151128/MAGAZINE/311289981/easy-on-those-apps-mobile-medical-apps-gain-support-but-many-lack
Health information on internet is often unreliable. (2000). BMJ :
British Medical Journal, 321(7254), 136.
Rab, S.
(n.d.). The paradigm shift in medicine and how it affects technology. CIO
Review. Retrieved from https://healthcare.cioreview.com/cioviewpoint/the-paradigm-shift-in-medicine-and-how-it-affects-technology-nid-3823-cid-31.html
Research
Now. (2015). Are mobile medical devices good for our health? A new study by
research now reveal that doctors and patients say yes. Retrieved from https://www.researchnow.com/newsroom/mobile-medical-apps-good-health-new-study-research-now-reveals-doctors-patients-say-yes-infographic/
The
Growing Value of Digital Health: Evidence and impact on human health and the
healthcare system (2017). IQVIA Institute Report. Retrieved from https://www.iqvia.com/institute/reports/the-growing-value-of-digital-health
U.S. Department
of Health and Human Services Food and Drug Administration. (2015). Mobile medical applications guidance for industry and Food and Drug
Administration staff. Retrieved from https://www.fda.gov/downloads/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/UCM263366.pdf
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