mHealth may have lots of money, but it still has a long way to go

KEY TAKEAWAY: Studies indicate people with chronic conditions want to use mHealth devices at home for care management, but the devices and apps they’re trying are too complex or confusing. More than 100,000 (health) applications are now available in the leading app stores, and the assortment is constantly growing,” says a BAEK study that was discussed at the congress. But only a fraction of the programs are certified as medical products.Mobile health apps for smartphones and tablet computers are especially popular with young people. And demand is rising. There’s a caveat, though. An app can never replace a doctor – at best it can only supplement one, but the problem is that too many patients may be relying on apps that have not been medically tested. The other problem is that many mobile app developers are lax when it comes to data privacy. Users should be careful not to thoughtlessly share personal information.

Chronic Conditions…

A report from digital health analyst Parks Associates indicates 27 percent of those surveyed with a chronic condition want a mobile health device that tracks their condition – yet significant numbers also report that the devices they now have are too complicated to use or don’t work properly.

A lot of patients simply do not have a good grasp on health metrics – meaning they either don’t know what their current health metrics are, or they do not know what they should be, the survey noted. Plus, even when patients do know their numbers, it is not guaranteed that they understand what those numbers mean. To make sense of health metrics and chronic disease management, patients need support from their healthcare providers.

Accuracy Issues?

An independent study of 18 popular mHealth sensors used by people with diabetes finds that two-thirds aren’t meeting standards for accuracy, potentially putting those users at risk.

The analysis of 18 FDA-approved blood glucose monitoring systems (BGMSs) by the Diabetes Technology Society found that only six meters recorded blood glucose levels within 15 percent of mg/dl of the laboratory value in at least 95 percent of the tests. In layman’s terms, this means a person with diabetes can be confident that a blood glucose reading is accurate 19 times out of 20.

Compared with the traditional method of in-office visits, does self-monitoring of blood glucose (SMBG) via digital tools result in better health and wellness for people with non-insulin-treated type 2 diabetes?  In the case of a 450-person cohort studied at 15 primary care practices across the University of North Carolina, Chapel Hill health system, the answer was a flat “No.”

The patients were randomized into three different groups. Two groups were given the Telcare connected blood glucose monitor, with one of those groups simply checking in with the device and the other doing the same plus receiving “enhanced patient feedback” (in the form of automated, one-way messages delivered directly on the meter). The third group did not receive a device. After the patients were randomized into groups, their primary care clinicians worked with them to manage their conditions, with those whose patients were using the Telcare devices receiving a summary of the data via their electronic health records.

Researchers were measuring outcomes based on hemoglobin A1c levels and health-related quality of life. Over a year’s time, there were no significant differences in hemoglobin A1c levels nor health-related quality of life over all three groups.

“Incorporating technology into self-management activities has been touted as potentially transformative for patients, and to date some smaller studies support this notion. However, our findings do not,” the researchers wrote in an article published by the Journal of the American Medical Association.

Pharma may have the solution

[inlinetweet prefix=”” tweeter=”” suffix=””]Can you imagine a mHealth app developed by pharma that had been clinically tested to show that it provided both accurate data and improved patient outcomes?[/inlinetweet] It would ne recommended by physicians and insurers alike and I’m sure widely adopted.  mHealth developers need to work closely with pharma R&D people yo better understand the clinical trial process.

There is no doubt that mHealth is going to happen, but where, how and when depends on integration of pharma, insurers and physicians not Apple, Microsoft or others.