COMMENTARY

The Big Problem With Mobile Health Apps

David Lee Scher, MD

Disclosures

March 04, 2015

In This Article

EHR Issues

The most important electronic connection we have with our patients is now the EHR. The goal of EHRs is to have all patient health information in one place. This means easily merging data from a variety of sources: pharmacies, other providers, hospitals, even different EHR systems—and, increasingly, apps that collect patient data.

This dream has yet to be fulfilled, and many experts have doubts that it will ever take place in a comprehensive way. The last thing we need is to have to go to a different website to access data for every app we are prescribing for our patients. To be truly useful, the information from apps needs to find its way into the EHR.

This is probably the biggest challenge for the widespread adoption of mobile health technology. The prospect of data "lost in space," with the physician unaware of its existence, is a real concern from both the patient management and medicolegal perspectives.

Having the information in one place decreases the possibility that important patient information will be lost or overlooked because it isn't easy accessible. Technically, this is not hard to do. The EHR companies themselves have been the roadblock. Few EHR vendors have been open to integration and interoperability with mobile medical apps. This would involve sharing code with app developers in a competitive marketplace in which their software is proprietary.[11]

At least one EHR manufacturer is working with Apple—which has developed a way for different health and fitness apps to share data using Apple software—to address this issue.[12] The ability to get data from different apps into an EHR is presently the focus of the Office of the National Coordinator, the government agency in charge of electronic health information.

The Promise of Telehealth

Although telehealth encompasses a variety of technologies, it is commonly understood to be healthcare videoconferencing. According to a recent survey, 64% of patients would have a videoconference with their physician, if available, with convenience being the biggest factor in their decision.[13] It is therefore reasonable to assume that patients will one day choose a physician who offers telehealth visits over one who doesn't, because of this convenience.

Telehealth has the potential to decrease office visits and hospitalizations by increasing availability of care to those who have difficulty getting out of the house or leaving work, who have been recently discharged from the hospital, or who live in areas where specialists are far away.

The most common uses of telehealth at the moment are for patients with mental health issues (eg, depression or anxiety), those with neurologic problems (eg, acute stroke diagnosis), and remote intensive-care management (eg, for cardiac disease).

Videoconferencing—available via apps on mobile devices—has been reimbursed by some private insurers for years.[14] But it will need to be routinely covered before we can all adopt it.

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