Download two apps and text me in the morning
May 2013
Health and wellness are increasingly just an app away
It is possible, even probable, that one day soon your doctor will prescribe an app to manage a healthcare issue rather than a pill.
Health and wellness applications on smartphones are dramatically changing the way we negotiate our personal health challenges and everyday wellness.
Wellness and medical apps have come a long way fast. The apps most of us see and use are those available to the public, mostly free of charge helping us to modify our behaviours and improve our health. Thousands of apps are also available to registered medical practitioners, medical students and allied healthcare providers to teach, remind, summarise and capture information. These apps are increasingly sophisticated, registered and regulated by government authorities and vary in price from 99 cents to hundreds of dollars each.
Medical apps are primarily used as teaching tools – simulating surgeries for example – or apps to capture, analyse and share clinical information. Technology in the healthcare environment is without doubt revolutionising the way the system works and creating extraordinary efficiencies as well as challenges.
Widespread adoption of mobile telecommunications devices and the explosion in the smartphone apps market has created an ‘app economy’, heavily impacting on many industries, creating opportunities for many developers and dramatically changing our behaviours. Healthcare is one of these industries.
Consumers, rather than doctors, have historically driven the expansion of the app economy, initially by downloading apps such as RunKeeper, to encourage us to exercise more, and MyNetDiary to monitor calorie intake. Generally the uptake of wellness apps is stimulated by us, rather than our doctor, to better manage our wellness. They are all usually free of charge, usually self prescribed and almost always adopted with little or no medical supervision or advice.
On the flip side, a growing number of doctors are actively prescribing apps, typically under direct supervision, to monitor and motivate behaviour change with more complex health issues. These days doctors prescribe certain apps to monitor blood glucose and blood pressure (with additional appcessories), transmitting continuous data to the doctor’s rooms from your smartphone on a daily basis. So how do we, and health practitioners, know which apps are safe, effective or even based on quality science?
The app store is becoming a virtual pharmacy with treatments on the shelf from 99 cents, but where are the checks and balances that should be in place to ensure safety and efficacy? I’ll come back to that a little later on.
The rise of health and wellness apps and tablets (not the swallowing kind) as diagnostics and health management tools is known as “mhealth” or mobile health.
This industry phenomenon encompasses a wide range of applications – from simple self-motivation apps, through texting reminders for the immunisation schedule of newborn babies, up to sophisticated diagnostics apps for STDs with a smartphone kit.
Apple’s iOS devices carry the lion’s share of apps and accessories geared to physicians or your personal health, but Android is catching up in terms of available apps.
Apps have become so prolific and sophisticated that the federal Food and Drug Administration (FDA) in the United States, the primary global authority for approving new drugs and diagnostics, recently felt the need to craft a review and approval process for medical apps, and it is about to be enforced for the most vital ones out there. On the chopping block first will be those that transform the smartphone or tablet into a medical device, such as glucose meters or blood pressure monitors, and which control existing FDA-approved gear like insulin pumps.
Smartphone apps within the healthcare industry fall into two main categories: health or wellness apps and medical apps. Wellness apps do not require approval in Australia from the Therapeutic Goods Administration (TGA) or the FDA in the United States. These apps relate to the general health and wellbeing of the individual and involve non-invasive monitoring programs such as monitoring calorie intake for example.
By contrast, medical apps can be utilised for the purpose of providing diagnostic tools and remote monitoring, and can include sensor-based applications such as blood glucose monitoring. There are far fewer medical apps than there are wellness apps.
Medical apps that make certain diagnostic or treatment claims (as opposed to just providing information or bio feedback) may be classified as medical devices, in which case they would require approval from regulatory authorities, proving they are safe and effective and can back up their claims, before they could be marketed and sold. So there is the check and balance.
Accelerating the rise of mhealth technologies are a range of market forces, including: an ageing population demanding assisted technologies to help them live independently, personalisation of healthcare and the growing phenomenon where more and more patients are taking control of their health in accessing online diagnostics, treatments and preventative technologies, combined with the continued downward pressure on government health budgets, needing to provide faster, more effective and cheaper treatments.
But the fundamental market force that is driving the rise of the app economy is the average consumer. You and me. We are recasting the relationship with our healthcare providers. Many of us are taking greater control over our own health needs and playing the lead role in managing our wellness. This is a very attractive trend in healthcare and one that will offset some of the financial burden from government to the individual. The more we can motivate our population to invest in preventative health measures, such as overall wellness, along with self-motivated and managed behaviour modification to reduce the impact of disease, the better it is for all of us.
A 99 cent app versus a pill? That’s not too hard to swallow.
Michelle Gallaher is CEO, BioMelbourne Network.
biomelbourne.org
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