Mobile health applications are proliferating, but for healthcare providers this creates the challenge of knowing which mHealth apps to prescribe. Which mobile health apps are safe and effective for your patients?
A new initiative called Xcertia aims to answer just that question by creating guidelines for apps that deliver value to users. The initiative was created in 2016 as a collaborative between the Consumer Technology Association, the American Medical Association, the American Heart Association, HIMSS and digital health nonprofit DHX Group. Their shared goal is to assure physicians, clinicians and patients that they can have confidence in mHealth apps that meet the Xcertia guidelines.
Here are seven steps, synthesized from a 2014 article published in the journal Translational Behavioral Medicine: Evaluating and selecting mobile health apps: strategies for healthcare providers and healthcare organizations.
As the authors write, “The following seven strategies balance the ease and efficiency of the search process against the need to understand the accuracy, evidence base, and efficacy of the app.”
Here are 7 steps to help healthcare providers evaluate the safety and efficacy of mobile health apps.
1. Review the literature – Search the scientific literature for papers reviewing apps in a content domain or strong clinical trials. You can use the same search criteria you would use to judge other systematic reviews, or try searching for “randomized trial,” “mobile app*” and the name of the condition or health behavior (e.g. “diabetes”).
2. Search app clearinghouse websites – Clearinghouses that review apps can help with identifying strengths and weaknesses. Organizations can join Xcertia for access to their preliminary mHealth app guidelines or consult other websites that evaluate mHealth apps. This can help healthcare providers evaluate the usability, functionality, content accuracy and evidence base supporting the app.
3. Search app stores – Directly searching app stores is the only way to identify apps that are directly available to patients. Make sure to search both the iTunes and Android (Google Play) stores and adjust filters to fine tune search criteria as much as possible.
4. Review app descriptions, user ratings and reviews – Publicized ratings and user reviews can help narrow the pool of candidate apps and offer insight about usability, functionality and efficacy. In addition to app descriptions, ratings and review, make sure to consider price. Patients may be more likely to try a free app, and a review of weight loss mobile apps showed that paid apps did not include more evidence-based strategies than free apps.
5. Ask your social networks – Social media networks can be a useful way of gathering tips from colleagues to assess new app trends, likability by certain user groups and other important information. Networks specific to healthcare providers, such as Doximity, are a good place to crowdsource recommendations and keep up with the latest trends.
6. Pilot the apps – You can try out new apps yourself or assign this task to a member of your team. Pay special attention to whether the app satisfies your desired functionality by imagining how you intend for a patient to use the app. For example, a diet tracking app will include very different features than an app designed to motivate increased physical activity, but both might be advertised for weight loss assistance. Make sure the app has the right features and functionality and that it is usable and accurate.
7. Solicit feedback from patients – Once you’ve recommended an app or been told a patient is using the app, follow-up is important. Different patients will have different experiences based on their health condition, behavior and other personal factors, so it’s important to elicit feedback from multiple patients to fully assess an app’s potential benefit. Useful questions could be whether the patient found the app useful, whether they are continuing to use it and whether they would recommend the app to others.
Healthcare providers know that data security is paramount. Before testing or recommending any mHealth app, make sure it is secure and HIPAA-compliant.