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This physician decided

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Mobile health app considerations and tips for new physicians

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by Amelia Laing

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Gone are the days when those in health care viewed the nascent mobile health industry as some sort of many-headed hydra to be feared.

The wariness with which patients and physicians once viewed health apps may have waned, but it has not disappeared; ambivalence toward mobile health remains.

Kevin Pho, M.D.—founder of the aptly named KevinMD blog, “social media’s leading physician voice”—recently penned an article titled “Why I’m not ready to prescribe mobile health apps.” In it he raises legitimate concerns about privacy and FDA oversight (or lack thereof); he also points out that inaccurate apps may lead to dangerous delays in treatment.

While Dr. Pho raises important points, others are celebrating mobile health’s current capabilities and looking for ways to realize fully mobile health’s seemingly limitless potential. Many have lauded the efforts of apps like iTriage, Epocrates and SharePractice, and private and public organizations alike are exploring the potential of mobile health.

There are as many kinds of apps as there are patients, it seems, and just as many opinions about those apps. Every physician, new and experienced, needs to determine how to approach this volatile and ever-evolving marketplace.

In hearing from three physicians who use mobile health or are actively involved in mobile health development, it becomes clear: physicians need to embrace mobile health, but they also need to be discerning. While more patient-centric models of delivery are fast replacing the paternalistic “doctor-knows-best” approach, physicians are still the experts. They owe it to their patients to contextualize information, to guide patients to reliable, trustworthy apps and to steer them away from suspect ones. These three physicians each had a unique perspective, but there were a few commonalities, including:

Get on board, mobile health is not going away.

“Pay attention to mobile health. The field is evolving very quickly and is really only now starting to reach the potential to improve care and to enhance the patient-provider relationship. . . . Patients are going to use mobile health apps. They already are, and that will only increase as the available technology becomes more sophisticated. As their health care providers, we should be familiar with the tools our patients are using and be able to help them find the right ones to fit their specific needs. . . . It is crucial to become familiar early in your medical career with apps that enhance your knowledge, improve your skills and increase your efficiency.”

Neil C. Evans, M.D., Co-director, Connected Health of the Veterans Health Administration

Research condition-specific apps.

“As a lymphoma specialist, I am committed to educating patients regarding the specifics of their particular disease and providing maximal support through the diagnostic and treatment process. The Lymphoma Research Foundation’s Focus on Lymphoma app provides a wealth of reliable and well-written information for patients. . . . I would encourage new graduates to be aware of the disease-specific tools available for patients. These apps serve to improve the quality and satisfaction of patient interactions with their providers and the health care system.”

—Ann LaCasce, M.D., Lymphoma Program at the Dana-Farber Cancer Institute 

Beware the data deluge!

“As hard as it is to believe, there is also too much data. Some of the applications being used by patients enable them to collect unbelievable amounts of data. Because they don’t know what to do with all that data, they ‘dump’ it on their physician and health care team. And that data deluge can be overwhelming. So it’s very important to sort through the noise to find the important data points.”

—Dennis Deruelle, M.D., FHM, National Medical Director of Acute Services, IPC The Hospitalist Company, Inc.

“New patient-generated data has the potential to be overwhelming to health care teams, particularly if there isn’t a clear process in place for incorporating it into a patient’s record, an understanding of how best to use the data as part of clinical care, and embedded analytics to help synthesize and understand the data. . . . There is not one easy answer, but making sure that patient-generated data is presented in a meaningful way to both patients and providers is going to be key to the future of mHealth technology. If it is done wrong, it could prove to be just white noise, data generated for the sake of data. If it is done right, it could prove to be a tool that gives both patients and providers a more holistic and nuanced view of the patient’s overall health.”

—Neil C. Evans, M.D., Co-director, Connected Health of the Veterans Health Administration

Mobile health is a tool, not a panacea.

“It’s important for physicians to remember the importance of human touch. It doesn’t need to be a lot; simply holding a patient’s hand or giving a pat on the shoulder would do. It’s the act of human contact that’s important. . . . Make sure to learn the basics. [New physicians] need to understand that technology should be an adjunct, not a substitute, for good clinical skills.”

—Dennis Deruelle, M.D., FHM, National Medical Director of Acute Services, IPC The Hospitalist Company, Inc.

“Mobile health should be kept in perspective. Mobile health is ultimately just one more tool available to the modern clinician as they partner with patients on the journey to improve health. Don’t lose sight of the patient and don’t lose sight of the mission we all share in health care—alleviating suffering and improving health for the patients who entrust their lives into our care.”

Neil C. Evans, M.D., Co-director, Connected Health of the Veterans Health Administration

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Amelia Laing

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