There are over 15,000 medical apps available, many with patient management programs and tools. The mHealth industry is envisioning these apps to become integral parts of healthcare practice, being touted to improve efficiency, decrease medical errors, and improve patient outcomes. If the apps are going to have the opportunity to do all this, certain initiatives need to be undertaken.
Educating both the public and health care providers about the existence, importance, and role of these types of apps and their ‘prescribability’ is necessary for widespread adoption to take place. Awareness campaigns by payers, the industry, telecommunications companies, governmental agencies, and professional health care organizations (medical specialty societies, patient advocacy groups, and non-profits) will undoubtedly contribute to the effort.
Getting the apps to patients and even more importantly, getting the most appropriate apps to patients will be an important goal. Connectivity will initially be an obstacle with some wireless environments. However, open architectures and institutional app ‘stores’ will be common solutions to this problem. Informatics-guided clinical decision tools will recommend personalized app programs (one or a combination of apps) for a given patient. A hospital knowledge officer or the patient’s physician might then oversee and either approve or amend the program before it is prescribed. Technology will allow the provider to electronically prescribe the app as a prescription, much like a medication. The app might be emailed, or delivered in another electronic form. One could also see that an e-prescription of an app would automatically go to the app owner to deliver any necessary hardware to the patient’s home.
I think that the most exciting aspects of prescribing apps will be the possibility of personalized prescriptions based on mining the patient’s clinical data found in the EHR, as well as the automaticity of the process itself, from prescribing to monitoring or wireless provider-patient interactions. Prescribing apps at points of care (office, hospital, other outpatient facility) will, in my opinion, become the way in which these apps will gain the most acceptance. The Department of Health in England has recommended 500 apps to general practitioners to prescribe to patients (http://www.telegraph.co.uk/health/healthnews/9097647/Doctors-told-to-prescribe-smartphone-apps-to-patients.html). Efforts such as this will promote the use of the technology.
Of course, patient adherence is a concern. The download must be completed. The ancillary equipment, if required will need to be set up. Patients or caregivers must comply with active data entry or messaging. Actionable alerts, if programmable need to be adjusted and fixed by the provider. While the automated technology involved with prescribed apps make the process easy, there are still human aspects which are required. Hopefully technology will never replace that side of health care.