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Wednesday, 15 April 2015

What is the point of health apps when we are healthy?

Do you have a health app on your smartphone? Have it ever served it's purpose? Do you truly need it, even when you are health? Are there too many app with little value? Are there room for improvement?
Such questions form a debate in the latest issue of The BMJ, which pitches an emergency doctor and editor of a website that reviews health apps against a general practitioner who argues, no, healthy people cannot benefit from them.

First, a few points from the "yes" argument of Dr. Iltifat Husain, who says healthy people can benefit - and whether we like it or not, digital health is part of a technological revolution:
  • In the US, smartphones and apps are now within most people's reach
  • Health apps on smartphones are "here to stay"
  • This has developed from a point more than 10 years ago, when apps were on PDAs.
Dr. Husain, from the Wake Forest School of Medicine, NC, concludes:
"They can help people to correlate personal decisions with health outcomes, and they can help doctors to hold patients accountable for their behavior."
One of the central points of Dr. Des Spence, however, a general practitioner in Glasgow, UK, is that "tens of thousands of health apps are perhaps mostly harmless (and likely useless)" - and that too much technology in medicine already results in "medical harm and overdiagnosis" so we should be skeptical of embracing more.
Dr. Spence's concluding point is:
"A Wild West approach to development is playing out and will use the advertising classic - fear - to sell product. War, pestilence, and famine are all out to grass; technology, medicine and overdiagnosis are the new riders of the Apocalypse.
Humanity is wasting its time on monitoring life rather than getting on and living it."
We are the ones choosing to self-monitor, or not to self-monitor, so the debate lies in how much choice we really are able to exercise, who really benefits, and whether there are any harms that outweigh benefits.
That last question falls to medicine and doctors, and is in the realm of regulators such as the Food and Drug Administration (FDA), which has just announced its position on the regulation of health apps. The FDA stated in February that it would have oversight only over those mobile medical apps that are intended to be used as medical devices, or accessories to the medical devices it would ordinarily regulate. The FDA sets out what this means:
"When the intended use of a mobile app is for the diagnosis of disease or other conditions, or the cure, mitigation, treatment, or prevention of disease, or is intended to affect the structure or any function of the body of man, the mobile app is a device."
Culled From MNT