Mobile medical and health apps: state of the art, concerns, regulatory control and certification

By Maged N. Kamel Boulos, A. C. Brewer, Chante Karimkhani, D. Buller, R. Dellavalle. Online Journal of Public Health Informatics, 2014

694 citations recorded by the source corpus.

This paper examines the state of the art in mobile clinical and health-related apps. A 2012 estimate puts the number of health-related apps at no fewer than 40,000, as healthcare professionals and consumers continue to express concerns about the quality of many apps, calling for some form of app regulatory control or certification to be put in place. We describe the range of apps on offer as of 2013, and then present a brief survey of evaluation studies of medical and health-related apps that have been conducted to date, covering a range of clinical disciplines and topics. Our survey includes studies that highlighted risks, negative issues and worrying deficiencies in existing apps. We discuss the concept of ‘apps as a medical device’ and the relevant regulatory controls that apply in USA and Europe, offering examples of apps that have been formally approved using these mechanisms. We describe the online Health Apps Library run by the National Health Service in England and the calls for a vetted medical and health app store. We discuss the ingredients for successful apps beyond the rather narrow definition of ‘apps as a medical device’. These ingredients cover app content quality, usability, the need to match apps to consumers’ general and health literacy levels, device connectivity standards (for apps that connect to glucometers, blood pressure monitors, etc.), as well as app security and user privacy. ‘Happtique Health App Certification Program’ (HACP), a voluntary app certification scheme, successfully captures most of these desiderata, but is solely focused on apps targeting the US market. HACP, while very welcome, is in ways reminiscent of the early days of the Web, when many “similar” quality benchmarking tools and codes of conduct for information publishers were proposed to appraise and rate online medical and health information. It is probably impossible to rate and police every app on offer today, much like in those early days of the Web, when people quickly realised the same regarding informational Web pages. The best first line of defence was, is, and will always be to educate consumers regarding the potentially harmful content of (some) apps.

Subfields: Applied Psychology, General Health Professions, Human-Computer Interaction

View Paper: https://www.semanticscholar.org/paper/b14ff21a349e8395178e1f009ad5e1cf41072d2b

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Citations in the corpus

Health App Use Among US Mobile Phone Owners: A National Survey (2015, neutral): “While not as rigorous, other techniques to promote value could involve review and ratings by expert panels such as those conducted by the UK’s National Health Service, which has launched a refereed library of health apps [20].”
Social Networks, Interpersonal Social Support, and Health Outcomes: A Health Communication Perspective (2016, background): “These types of MHealth applications can allow researchers to access available data from smartphones, including activity levels and diet information, which can be used as important health outcome measures.”
Health promotion in the digital era: a critical commentary. (2015, background): “Health promotion researchers have sought to investigate how websites and social media sites operate in generating and disseminating information about strategies for promoting health among lay people who do this voluntarily as part of social interactions and support systems [for example (Kamel Boulos”
Smartphone Sensors for Health Monitoring and Diagnosis (2019, background): “As smartphone-based health monitoring systems and applications are increasing rapidly and becoming more pervasive in society, there is a growing concern about the safety issues and associated potential dangers [183,184].”
m-Health adoption by healthcare professionals: a systematic review (2016, background): “In 2012, there were approximately 40 000 mobile device applications (apps) related to health.(6) m-Health is thus central to the concept of pervasive healthcare where information and resources services can reach anyone, anytime, and anywhere, by removing geographical, temporal, and other barriers.”
A qualitative study of user perceptions of mobile health apps (2016, background): “S Food and Drug Administration [30] or Boulos et al. [2].”
Digital health: a path to validation (2019, background): “In addition, there is a lack of objective, comprehensive, transparent, and standardsbased evaluation, which also limits confidence and practical application of existing approaches.(23) A Digital Health Scorecard— a multi-stakeholder approach that objectively and rigorously evaluates solutions—is nee”