Evaluation of Diabetes mhealth apps 2017
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The document summarizes research evaluating 201 diabetes mobile health apps based on screening criteria. Key findings include: - No app met all criteria, which focused on integration with devices, medical records, and provider guidance. - Most apps were replacements for paper journals and lacked more advanced functions. - Better integration with electronic medical records and prescription/monitoring by healthcare providers could improve app quality and usefulness. - Standardization of app certification, interoperability with records and devices, was recommended to facilitate development and adoption of higher quality diabetes management apps.
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Evaluation of Diabetes mhealth apps 2017
- 1. Ronak Brahmbhatt, Shadi Niakan, Nishita Saha, AnukritiTewari, Ashfiya Pirani, Natasha Keshavjee , Dora Mugambi, Nasrin Alavi , Karim Keshavjee ITCH 2017,Victoria, BC Feb 17, 2017 LINK TO OPEN-ACCESS PAPER:
- 2. The Problem What’s preventing us from solving it? What we discovered about mhealth apps What we did to overcome the deficiency in mhealth apps What we learned when we applied that to diabetes apps Discussion Limitations Recommendations
- 3. Diabetes Chronic disease with increasing prevalence worldwide Cost 12.5 billion dollars annually to Canadians Most important step in DM treatment is self-management involving lifestyle changes and long term adherence to meds Technology involving mhealth apps is a novel approach to life style management and medication adherence
- 6. Conflicting Information: App provides information that conflicts with that received from health care providers (Bierbrier, Lo & Wu, 2014); Health Literacy: Language and terminology of the app may not be compatible with the patient’s health literacy (Caburnay, 2015); Data Entry: Patient has to enter the data themselves (Gruman, 2013); Meaningful Use: Patient cannot use information in a meaningful way; e.g., he or she cannot order diagnostic testing or prescribe medications to himself or herself; Lack of incentives like cost saving or social approval;
- 7. Not Habit Forming: Daily use of the app is not required and therefore the patient does not get into the habit of using it; Unknown Provenance: Providers don’t value data collected by patients in apps downloaded from an app store whose provenance and pedigree is not known or established (Terry, 2015); Lack ofTools: There is no way for providers to consume the large amounts of data that are collected in apps (Terry, 2015) i. i.e., visualize, analyze, derive meaning from; Lack of Interoperability: Providers unable to integrate app data into their own (EMR) for analysis or follow-up or share the data in their EMR with their patient’s apps (Abebe, 2013).
- 9. Based on our screening criteria for optimal diabetes apps, how well functioning are currently available diabetes apps in the app stores?
- 10. We developed screening criteria using our reference architecture for design and development of mhealth apps, Apple iTunes and Google Play app stores were searched for diabetes apps –found 201 Following a calibration exercise, two individuals independently reviewed and evaluated each app against the screening criteria Data was collated and analyzed
- 12. 201 total apps were reviewed No app met all the criteria outlined Most apps were replacement of paper journals or diaries Many apps were recipe apps Majority of the apps provided education/recommendations Most of the apps failed at integrations with devices (glucometer, BP machine) and patients medical records (EMR, primary care provider)
- 14. Many apps were conference apps or guideline apps for professionals Of the highest scoring apps, major reasons for not getting a higher score Lack of integrations with devices–relatively easy these days (but requires FDA approval) Lack of integration with EMRs –many features are dependent on this
- 15. There is great need for high quality apps which can be prescribed by a physician and whose use can be monitored by the health care team Apps need to focus on managing the whole patient along with their disease and not a small part of a patient’s care such as self management Better embedding physician patient relationship into patient app interactions for provider guided management
- 16. Due to budgetary constraints, we did not download apps from the stores Some vendors had poorer descriptions of their product than others A very small number of apps were in languages that are not understood by the people conducting the review We were not able to quantitate which apps are used and which ones are not We did not include any patients in defining the criteria nor in reviewing the apps.
- 17. Apps should be prescribed and monitored by health care providers Requires participation of EMR vendors in developing APIs for apps mhealth app certification by a standards organization would go a long way to ensuring higher quality apps and increasing the level of trust for apps by health providers An Interoperability Kit for EMRs andApps would help make it easier to deploy an app Standard interoperability for apps with medical devices would lower the investments required to create good apps