Medical Apps: To be Trusted?

Guest Blogger: Dr. Stephen Chow, M.D.
University of Mississippi Medical Center
Division of Gastroenterology

“False assurances and false panics add to patient anxiety and jeopardized patient well-being.”

3:00 AM approaches, and I’m paged for a new admission with hypertensive urgency (very high blood pressure). In taking the patient’s history, we had a great conversation about his life, his accomplishments, and how he came to find himself in the hospital on this particularly ghastly hour of the night. More often than not, patients end up teaching me a thing or two – be it about their history, respective expertise, culture, or the tenacity of the human spirit, to name a few.

In our discussion, I learned about an app he was using to measure the volume of air he breaths through his mobile app, GP Imports’ Spirometer Pro. A spirometer is a diagnostic tool that measures ventilation patterning and volume – the amount and way a person breaths – and this app was claiming to achieve this using only a phone, all for the low price of $0.99. Concerning? I’d say so.

Seal MicroMedical Spirometer
Seal MicroMedical Spirometer

The app’s disclaimer states that it “works very similarly to real spirometers” and is for “entertainment purposes only.” As a physician, I am concerned when unregulated sources and apps make unjustifiable and unsubstantiated claims. It is already difficult for a patient to navigate the plethora of medical information available online, and these types of apps serve to further expose patients to unnecessary risk.

“Early studies evaluating whether these apps work or not tend to paint a pretty dim picture of them. The results aren’t that promising.”

People are using mobile apps to help manage their health more and more. According to the FDA, 500 million smartphone users worldwide are using a health care application, and by 2018, 50 percent of the more than 3.4 billion smartphone and tablet users will have downloaded mobile health applications.

Doctor

Many of the hundreds of medical apps available act as great tools for tracking and evaluating individual health. I love it when a patient shows me a well-documented medical history. It allows us to work collaboratively in creating the best plan to move forward.

The emergence of untrusted medical apps, however, adds a worrying dynamic to the mix. The New England Journal of Medicine published an editorial regarding this growing problem, citing that “Early studies evaluating whether these apps work or not tend to paint a pretty dim picture of them. The results aren’t that promising.” While the FDA has increased their regulatory framework and practices on medical apps over the past number of years, the problem still proliferates.

Wired magazine share this view, calling attention to a number of apps that exist with questionable medical claims. These include Instant Blood Pressure, an app that claims to take blood pressure using only your phone, and Pulse Oximeter Pro, an app claiming to measure oxygen saturation.

DoctorIn my opinion, medical apps require a higher standard to meet than others. Medical devices share the same burden in their FDA approval process, and apps should be no different. There are direct and identifiable risks letting a consumer wrongly believe that what they’re downloading (and paying for!) is something that can be used to determine their medical status. False results, false assurances, and false panics add to patient anxiety, lack of education, physician and systemic saturation, potential increased costs, and most importantly jeopardized patient well-being.

As the patient and I were discussing the app, I told him that there are many great medical apps out there, but this particular one isn’t based on any studies that I knew of and wasn’t FDA approved, so I advised not to use it. He was completely understanding, and we continue to laugh about it when I see him in follow up.

Providing great education doesn’t just stop with teachers in the classroom. When medical literacy and patient insight it poor, it leads to poor outcomes for the patient and may damage the therapeutic relationship between the physician and patient. As physicians, we act as the teachers of our patients, and learning about the technologies that better our health is a great thing. It’s also our responsibility to ensure a well-rounded understanding about what’s credible and what’s not.

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