A recent survey of 3000 physicians by Manhattan Research shows that more than a third of them have recommended mHealth apps to their patients in the past year.
According to Monique Levy, vice president of research at Manhattan Research, about equal numbers of physicians advised patients generally to use mHealth apps for certain purposes and recommended that they use specific apps. A much smaller number — in the "single digits," she told Medscape Medical News — "prescribed" apps with the expectation of getting follow-up data from patients.
John Moore, president and chief executive office of Chilmark Research, which also studies this area, told Medscape Medical News that the current numbers represent an increase over those of 2 years ago, when about 20% of physicians were recommending mHealth apps to their patients.
However, Moore does not view the increased involvement of physicians in this area as a major, game-changing advance. Most of the apps that physicians are recommending, he said, are probably fitness and diet applications such as FitBit and Weight Watchers. Less than 10% of physicians have prescribed an app related to a chronic condition, he said. "According to our analysis of the market, some of this is occurring, but it's all in pilots."
Adam C. Powell, a healthcare economist and president of the Payer+Provider Syndicate in Boston, Massachusetts, agreed that physicians still limit most of their mHealth prescribing to stand-alone wellness and fitness apps. "Often, physicians recommend that patients work on improving their diet and increasing their physical activity, and physicians have been recommending that for a long time," he said. "What I think this [Manhattan Research] finding means is that a significant number of physicians have been suggesting mHealth apps as a means to achieve one of these goals."
The Next Step?
Among the reasons why physicians have been reluctant to go further than this, Moore said, is that they do not know what to do with the data they would receive from smartphones using chronic disease apps. "There are questions about where to put the monitoring data and how to manage it and base alerts on it," he pointed out. "It involves a lot of workflow changes. And who's going to be responsible for it in the practice?"
Nevertheless, Manhattan Research found that more than a fifth of physicians were monitoring patients remotely, using either home or mobile technology. Moore said he regarded this kind of activity as a stepping stone to the prescribing of mHealth apps for chronic conditions.
Powell, who coauthored a JAMA commentary about a proposal to review and certify mHealth apps for safety and efficacy, cited a couple of other issues. First, unless physicians are in an accountable care organization that takes financial responsibility for care, they are not being compensated for looking at this data. Also, the use of data from mHealth apps opens up new areas of liability.
For instance, the US Food and Drug Administration has approved only about 100 mHealth apps so far. Other observers, including Eric Topol, MD, Medscape's editor-in-chief, who is an ardent mHealth proponent, have noted that there are few peer-reviewed studies showing that the use of these applications leads to better outcomes. In addition, Moore observed that the current app marketplace is a "mess" because there's no way of knowing which apps are worthwhile.
IMS Health, a healthcare research and technology firm, is trying to shine some light in this darkness by using an algorithm to rate the 16,000-plus healthcare apps in the Apple store. It also has launched an application called AppScript that enables physicians to securely send mHealth prescriptions from their mobile devices to their patients' smartphones and tablets.
Although AppScript is designed primarily for large healthcare organizations, IMS recently launched a trimmed-down version of it for independent practitioners, Matthew Tindall, the company's global director of consumer solutions, told Medscape Medical News.
Tindall said IMS is piloting AppScript with "lots of providers" around the country, although the only one he named was Carolinas Healthcare System. The company hopes to present initial data from these pilots at the mHealth Summit later this year, he said. Meanwhile, he added, IMS continues to refine its rating algorithm and is trying to provide as much useful information as possible to AppScript customers.
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Cite this: Over a Third of Docs Recommend mHealth Apps, Survey Shows - Medscape - Jun 10, 2014.
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