Medical Apps are Snake Oil

Author: Novarum Admin

James Madara, MD, the CEO of the American Medical Association, recently lambasted the mHealth industry in HealthData Management, saying this modern day “snake oil” was contributing to a “digital dystopia”. Strong words, which are likely to have upset a few key players in the much hyped mHealth sector; but as the CEO of a medical device app developer, I believe Madara was quite right.

Interestingly, just a few days after Madara’s outburst at the AMA annual meeting, the AMA finally ratified ethical guidelines for physicians using mHealth tools, three years after discussion began. Those guidelines seem to provide little practical guidance to physicians or technology providers that will enrich the patient-physician relationship.

Anyone looking at the App Stores will see that there is indeed a crowded market of apps targeted at consumers for apparent health related uses. A market which simply didn’t exist five years ago, and is moving at such a pace that regulators and physicians are struggling to keep up.

Many of those apps use some small print along the lines of “for entertainment purposes only” to circumvent regulatory requirements. Perhaps it is tactics like this, which make health care providers much less trusting of apps than consumers.

No credible mHealth company can follow such an approach; but a relatively relaxed approach to regulatory enforcement both in the US and overseas, together with the growing globalization of the app industry, means that it will be virtually impossible to stop consumers encountering mHealth tools of varying quality and reliability. It can do nothing for the patient-physician relationship to simply shun such tools, and so health care providers will have to embrace the technology shift or face being marginalized in treatment decisions.

There is a lot of discussion in the industry about “democratizing medicine” and, as with all industries undergoing major disruption, the incumbents are unsettled or, perhaps more worryingly, simply oblivious. Healthcare professionals needn’t worry though; the plethora of apps doesn’t usurp their skilled judgments. In fact, the deluge of data they provide makes deciphering the clinically relevant information all the more important.

As well as learning bed-side manner to glean the important information from patients verbally, the doctors of tomorrow will also need to develop analytical skills that help them pick out the key digital information. Given that more than half of adult smartphone users have downloaded a “health app”, clinicians need to learn and embrace these skills now, or become extinct in a world of quacks who willingly support gimmicky apps.

However, where James Madara and I seem to have differing views is on how the AMA should be helping to manage this inevitable revolution. Whilst Madara seems happy to focus his attentions on different visions of the future prophesized in books, I think it would be far more constructive to use the AMA’s leadership position to provide accreditation to those apps which genuinely enhance patient care, supporting app developers to understand the “actual problems and needs, rather than flying on an entrepreneur’s incomplete views”, and facilitating access to clinicians for trials to evaluate the true effectiveness of these technologies.

Through those routes clinicians could gain the same level of confidence that consumers are already starting to show in the mHealth revolution; whilst good app developers, such as the 188 mHealth apps the Commonwealth Fund identified as useful in February 2016, would have the means to make their products stand out above alternatives of questionable benefit.