Prognosis for medical apps is guarded

As the use of mobile medical and health apps explodes, health care providers are trying to figure out how to work with applications that can literally deal with life or death information.

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These apps fall into two categories. There are consumer-facing apps such as MapMyRide, Glucose Buddy, and even Weight Watchers. These can be referred to as "health and fitness apps." There are even dedicated health and fitness devices, such as FitBit.

Glucose Buddy helps diabetics monitor their insulin levels

Then there are what can be described as the medical applications: apps that are used by health care providers to help clinically treat or manage information about patients. Apps within this category include iRounds, 10 Second EM, or Gas Guide.

Though they're proliferating rapidly, many of these medical apps face some strong challenges for health care providers and the hospitals in which much of the patient care is concentrated.

Hospitals, Reed explained, are very interested in adopting tablets for their medical staffs. But they also must figure out the best way for health care providers to not only access all these newly electronic medical records but interact with and update those records, too.

Clinical apps have additional hurdles.

"How do I take the data and put it into something that has clinical application?" Reed rhetorically asked, hypothetically describing an app where a physician might have to enter an order for additional morphine for a patient in need of pain management. In such an app, entering 5 picograms of the medication versus 5 micrograms (a million times more) is a huge difference, and not something you would want to get wrong due to a simple data entry error.

"This goes beyond 'look at me I lost five pounds' apps," Reed said. "We have to make sure we get this right. That means we have to embrace and work with the FDA."

Apps need a full workup

The idea of government regulations of some kind for medical apps is one that Dr. Steven Levine, professor of neurology and of emergency medicine at SUNY Downstate Medical Center, embraces wholeheartedly.

Levine is the principal scientific investigator on a study to develop mobile apps for stroke patients and their caregivers. The two-year study is funded by a grant from the federally funded Patient-Centered Outcomes Research Institute (PCORI).

Levine's team is approaching the creation of these stroke apps with a great deal of research methodology and academic rigor. The ultimate goal of these apps will be to give stroke survivors and their health care providers a way to monitor and manage the patient's life after a stroke event -- and to help keep another stroke from occurring. Since strokes are the number one combined killer globally, it's a challenge that Levine wants to get absolutely right.

This level of research is not something Levine sees much of in the medical app sector. In fact, he was surprised how few peer-reviewed papers there were measuring the effectiveness and usability of applications.

"People aren't taking the time and devoting the energy to apply the research methodology," Levine said.

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