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Should physician societies endorse and approve mHealth apps?

By Jennifer Bresnick

- When you browse the health and fitness category of your smartphone’s app store, you might see fitness programs, calorie counters, pregnancy trackers, sleep aids, and collections of healthy recipes.  But you might also see self-diagnosis tools, guides to taking medicinal herbs, and even an app that purports to let you hypnotize yourself in five minutes to help you stop smoking.  Consumers are downloading and using these apps at an increasingly rapid rate, trusting them implicitly, and potentially internalizing misinformation and delaying professional care because they have no idea that developers can sell whatever they please under the guise of “healthy advice”.

After years of this free-for-all, which has pushed the mHealth market into a global juggernaut expected to be worth $26 billion in a few years’ time, the Food and Drug Administration (FDA) is just starting to step in to provide regulation for the booming mHealth sphere, and will attempt to separate the wheat from the chaff in order to help consumers and physicians use mobile tools more safely and effectively.  But some experts argue that federal oversight can only go so far.  Certainly the FDA can dictate what can and can’t be sold on a broad level, but they won’t be testing every app for quality, medical relevance, and usability, nor will they rate them on a scale that consumers can easily understand.

But someone should, especially if patient-provided data from mobile health devices will eventually be integrated into a patient’s EHR in the latter stages of meaningful use, or if physicians whip out their smartphones in the consult room, just as they do with laptops and tablets.  Patients and physicians alike need a reliable way of deciding which products are worth their $2.99, and which have no substantial health benefits whatsoever.

Is this where medical societies come in?  Recognizable, respected organizations like the American Academy of Pediatrics, American Dental Association, and American Medical Association have name recognition and brand power.  Shoppers are more likely to buy a toothbrush if it has an ADA seal, for example, and for good reason.  They trust their dentists, and they trust the symbol of the national association that confirms their knowledge of medical matters.

And yet, Dr. Thomas Santo notes in a recent blog post on KevinMD, none of these societies have engaged in bringing quality mHealth products to consumers or physicians.  They don’t list approved or endorsed apps on their websites, and they don’t even mention mHealth as an increasingly important part of medical care.  And that might be a mistake.  “The lack of physician recommendations regarding these products is extraordinary. Without providing some guidance as to what works and doesn’t work,” Santo argues, “physicians miss the opportunity to maximize the benefits of this technology in terms of quality of care, access to care and cost, those things that occupy much of the discussion on health care today.”

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“The longer physicians wait to weigh in on these important issues, the less their voice will be heard as the industry takes off without them. As that happens, without a doubt, our profession and our patients will suffer,” Santo continues.  “Without creative physician-driven solutions to identified problems, third parties will always fill that void. An important first step might be for professional medical organizations to co-develop apps that are based on good evidence, and can effect change in the target population.”

However, medical societies need to be careful not to cross the line between a money-grabbing endorsement deal and an objective assessment of available products.  Neil Versel of MobiHealthNews recalls an AMA endorsement deal gone awry, and warns that such public relations disasters can damage a society’s credibility for years to come. “Ever since then, the AMA has been rightfully wary of lending its seal of approval to commercial products that were not its own,” Versel says. “I hardly think the organization – or any other medical society – would be eager to endorse mobile apps.”

But if national medical societies can keep their public images intact, remaining neutral on the value of mHealth while providing a valuable service to patients and physicians alike, they might be rather pleased to remain relevant to healthcare by positioning themselves as arbiters of quality and excellence.  As the industry evolves and healthcare embraces mobile apps as a valid source of information, societies may be the key to bridging the gap between federal oversight and the free market.




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