The Pros and Cons of Mobile Health Apps

Just like with apps in general, the use of mobile health (mHealth) apps is a rising technological trend. Just look at the figures: There are more than 100,000 health apps offered by Apple and Android, according to mobile market research firm Research2Guidance. The firm also estimates that 50 percent of the more than 3.4 billion smartphone and tablet users worldwide will have downloaded mobile health apps of some kind by 2018.

Some of your patients may have mentioned using these apps, and outside of giving advice, there's only so much you can control. It's mainly important to impart to your patients that, as with any technology, there are pros and cons to consider before downloading free or paid mobile health apps. Although mHealth apps can help patients literally take their health into their own hands, they should not be considered a replacement for regular doctor's visits and medical care.

Let's start by breaking down the most prominent pros, all of which revolve around ease and awareness:

• Convenience. Nearly two-thirds of Americans own a smartphone, meaning more people have the ability to monitor and manage their health on the go. Many mHealth apps are available to download for free or at a minimal cost, and some allow users to set pill or appointment reminders, access their medical records in real time, or view post-visit instructions.
• Encouraging healthy behavior. Research published in The BMJ examined whether healthy people could benefit from health apps. Speaking to the New York Times, Dr. Iltifat Husain said that the apps could help users "correlate personal decisions with health outcomes" and help doctors keep patients accountable for their behavior.
• Education. Certain health apps can be informative and educational. There are apps for medical reference, terminology, and anatomy, as well as apps that help identify prescription drugs. Some apps also enable access to medical journals and other literature.

But what about the other side of the coin? Here are three cons that have doctors and health officials worried about mobile health apps:

• Data privacy. Many health apps raise data privacy concerns. In 2013, Privacy Rights Clearinghouse, a nonprofit advocacy organization in San Francisco, analyzed 43 free and paid apps, finding that 72 percent of them exposed personal information such as dates of birth, email addresses, and medical information. Only half of the apps linked to a privacy policy, which typically explains what personal information is gathered and if data is shared with or sold to third parties and why. The study also found that paid apps posed less of a risk to users' privacy, likely because they do not rely on advertisers to make money.
• Inaccurate information. Some apps claim to be able to measure a user's heart rate and stress levels using a sensor beneath the phone's camera. Others claim to be able to measure blood pressure using the phone's screen or camera. When tested, these apps often give varying results or cannot get a reading at all, but rarely is there a warning that the information provided is untested and potentially unreliable. If a user looks closer, however, they might find a warning that the app is intended for "recreational use only."
• Lack of regulation and approval. A study published in the Journal of the American Society of Hypertension found that only 3 percent of the top 107 apps found using the terms "hypertension" and "high blood pressure" were developed by health care agencies. None of the apps had been approved by the FDA, although 14 percent could turn into a medical device to measure blood pressure. The authors of the study concluded that such apps reveal an "urgent need for greater regulation and oversight in medical app development."

It is important to exercise discretion and common sense when using mobile health apps -- and your patient base needs to understand this. Be sure to have them review any privacy policies to see how their information may be used and whether the app has been approved or is regulated by the FDA. Encourage them to read the disclaimers, if any, to find out if the app is intended for entertainment or recreational use, as well.

In the end, you can't control what your patients are looking at on their phones, but you can encourage them to treat any health info gleaned from these apps with caution and a fair amount of doubt.