According to an article in the NY Times ?before long, your doctor may be telling you to download two apps and call her in the morning. ?The idea of medically prescribed apps excites some people in the health care industry, who see them as a starting point for even more sophisticated applications that might otherwise never be built. But first, a range of issues ? around vetting, paying for and monitoring the proper use of such apps ? needs to be worked out.?
If smartphone-based systems can reduce the amount of other medical care that patients need, the potential benefit to the health care system would be enormous; the total cost of treating diabetes alone in 2007 was $174 billion, according to the most recent statistics from the Centers for Disease Control and Prevention.
One of the pioneers in the prescription-app field is a company called WellDoc. Its DiabetesManager system, which patients can use through a smartphone app, standard cellphone or desktop computer, collects information about a patient?s diet, blood sugar levels and medication regimen. Patients can enter this data manually or link their devices wirelessly with glucose monitors.
WellDoc says that in a clinical trial, DiabetesManager was shown to reduce significantly the blood sugar levels in diabetes patients.
Happtique, an online mobile application (app) store for healthcare, has a new e-prescribing solution dubbed ?mRx? that enables physicians to prescribe medical, health, and fitness-related apps for their patients.
Those results persuaded the Food and Drug Administration to give the system clearance to operate as a medical device. At over $100 a month, the cost is more akin to diabetes drugs than to most smartphone apps.
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Obstacles Remain
But, for the vast majority of providers and, by extension, patients, several very large obstacles remain for health apps according to KevinMD.com;
The vast majority of providers don?t know anything about health apps.?Most practicing physicians don?t have any idea what apps are out there for their patients. Heck, most providers don?t have much of an idea of what apps are out there for themselves !
Assuming providers knew about apps, they need guidance on what apps are safe. I believe docs are never going to prescribe an app unless a trusted organization confirms its value and accuracy or a trusted colleague tells them about how great it is. Maybe that is where the FDA comes in? But, even with FDA approval, apps don?t fit into nice categories like drugs do (it?s easier to compare two statins than it is to compare two diabetes apps). I?m not sure how this will work exactly but I know there needs to be some higher authority validating, and in essence taking some of the responsibility, from providers. This is what Happtique is trying to do; we?ll just have to see how well it works from a clinical buy-in perspective.
Providers don?t know how it fits into practice. Providers are going to want to know how the apps fit into their practice. Right now I think that?s still unclear. Obviously more data on mood trends as somebody is starting new meds for depression is great, as long as it is presented to the provider in a digestible way. But, what if the patient is suicidal according to the app and there is no feedback mechanism to trigger an alert. If providers are now prescribing patients to enter this additional information, are providers on the hook to assure they know when an immediate response is warranted and then to respond to it?
Lack of payment. Unfortunately this might be the biggest obstacle. In the NHS story references above, the apps were going to be free to patients. In the US, that is not the case, at least it isn?t today. Prescribing patients to spend additional money is likely going to prevent widespread uptake. Or maybe different payers will have different ?app formularies? so providers will have to wade through lists to see what approved apps are free based on payer. That would be great. Also, if providers aren?t paid for responding to app messages or alerts it?s likely not going to happen.
For pharma opportunities in mHealth apps
Regardless of where we are not in mHealth one trend that is going to be increasing is that more and more people are going to go mobile and use mobile devices to help them manage their lives and health.
Biopharma marketers should start strategizing on how mobile apps can both provide better patient outcomes while meeting brand objectives. ?With two primary formats, iOS and Android, it?s not going to be easy or inexpensive but the learnings and the potential to share information with HCP?s on how mobile can provide better patient outcomes is going to be very valuable.
The real question is ?will patients use them ?? but if they provide real value to the patient and are fairly easy to use my guess is that more and more people are going to rely more on their apps to assist them in maintaining good health.
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