Mobile Health Apps - Breakthrough Or Liability?
By Monica E. Oss Chief Executive Officer, OPEN MINDS July 12, 2012
Developed by OPEN MINDS, 163 York Street, Gettysburg PA 17325, www.openminds.com. All rights reserved.
I'm trying to figure out where mobile apps fit in the delivery of health and human services. On one hand, there are the "app as breakthrough" proponents - whose view is like the recent article in Scientific American, The Real Promise of Mobile Health Apps. Author Francis Collins muses that, "...right now, the majority of users are much like me, treating their new apps as gee-whiz toys rather than as valuable tools for improving their health...the real potential of mHealth lies with much more committed users, such as the children with type 1 diabetes who took part in a yearlong...study, published in Diabetes Care, [that] showed that youngsters who used the automated system had significantly better glycemic control and diabetes self-management skills than those who did not."
But even this app proponent notes "Who will set rules for privacy of mHealth data? Who will provide protections if privacy is breached?" That was also the question in a new Journal of the American Health Information Management Association article about the risks of mHealth, Managing Health Information in Mobile Devices. As author Lydia Washington notes, "It is widely accepted that any health information captured or stored by clinicians using either a personal mobile device or one provided by the health care organization becomes part of the HIPAA-designated record set if that information is used to make decisions about a patient." She outlines four policy areas that organizations need to address as they adopt mobile health technologies:
- Recognize the data on your mobile device is part of the "official health record" - You are liable for protecting this information in the same way you need to protect health data stored on your electronic health record system (EHR), your consumer computer files, or your patient's paper files.
- Develop policies that outline acceptable mobile use - Just like social media, health care professionals are often unaware that their conduct with this technology has the potential for liability and litigation. Like all other aspects of a successful business, strong policies delivered up-front can help organizations avoid costly ambiguity later.
- Conduct a security risk assessment - Whether or not your organization provides mobile devices to your clinical team, it is likely that some of your team is already using their personal devices in communication with patients. Assessing and addressing security risks that already exist is a must.
- Create a litigation response plan - Do everything you can to prevent a data breach, but also have a plan to address any security breaches that occur.
I do think apps are here to stay (and for a look at some of the current apps, check out The OPEN MINDS Tech List: Smartphone Applications premium members). Consumers like them; they can be used to improve consumer satisfaction; they can improve quality of care; and they can decrease the cost of care. Prepare for mHealth like you would any future changes in the environment. Keep the Boy Scout motto in mind and "Be Prepared."
The OPEN MINDS Tech List: Smartphone Applications
The takeover of society by smartphones has been fast and (almost) complete (see Smartphones, More Popular Than Computers all members), and in this environment, the health care provider organization that can find a way to leverage these tools to their advantage will be ahead of the competition. A smartphone application, or "app," is simply a mobile software program that is designed to perform a specific function on a smartphone. The number of smartphone applications available to consumers is continually growing, which means that now is the time for your organization to consider what is available and how these new apps compliment (or replace) the services offered by your organization.
Consumers use smartphone apps for everything – from banking and shopping, to restaurant reviews and driving directions. More recently, we've seen a explosion in the number of apps focused on health care, including behavioral health care. Below is a list of applications available in the field, which touch some important health and human services categories, including mental health services, addiction treatment, and chronic disease management. Stay tuned – we will continually update this list in the coming weeks.
12 Steps Companion features a reader, search tool, sobriety calculator, notes, and AA contacts database.
Contact Information: 1025 Meadow St, Reno, NV 89509; Phone: 775-772-2484 Website: http://www.deanhuff.com/DeanHuff/12_Steps_Companion.html.
This sobriety app features both daily and random inspirational support messages, an email synch and delivers a selection of recovery oriented books and resources.
Contact Information: P.O. Box 11 15251 Pleasant Valley Rd. Center City, MN 55012; Phone: 651-213-4200 E-mail: firstname.lastname@example.org; Website:http://www.hazelden.org/web/public/mobile_app_24_hours.page.
ACHESS is a smartphone-based relapse-prevention system to help alcohol dependent patients by providing communication with peer support groups, addiction experts, timely monitoring, reminders and alerts, and one-touch communication with a care manager.
Contact Information: 1513 University Ave, Rm 4120 Madison, WI 53706; Phone: 608-262-8442; Fax: 608-890-1438; E-mail: email@example.com; Website:http://www.niatx.net/Content/ContentPage.aspx?NID=164.
This application allows you to look up the status of a claim while at your doctor’s office and show the staff your virtual card right on your phone.
Contact Information: Aetna Building 1 980 Jolly Road Blue Bell, PA 19422; Phone: 1-800-872-38662; Website: http://www.aetna.com/about-aetna-insurance/sas/mobile/iphone-app.html.
AutismTrack™ is a portable, customizable data tracking tool that tracks interventions, behaviors and symptoms. Checkboxes allow daily recording of any therapy, medicine or diet.
CBT Referee allows you to write down the thoughts in your head when they happen so you can catch flawed thinking and learn from it.
Comprehensive Medicine combines the best of natural and prescription therapies to create optimal health. Cures A-Z is the free Comprehensive Medicine specialist in your pocket! Health conditions ranging from A to Z and their treatments are presented in easy to understand language. Backed y thousands of research studies, it’s a powerful, practical, science-based health resource!
Contact Information: 3811 Edward Rd. Princeville, HI 96722; Website: http://plumamazing.com/store/product_info.php?products_id=115.
This application provides cognitive behavioral therapy (CBT) techniques in response to depression, in either a stand-alone environment or as a support to traditional psychotherapy.
The official American Red Cross First Aid app puts expert advice for everyday emergencies in your hand, with videos, interactive quizzes and simple step-by-step advice.
Contact Information: National Headquarters 2025 E street N.W. Washington, DC 20006 Phone: 202-303-5551; Website: http://www.redcross.org/FirstAidApp.
This free mobile app helps patients manage and monitor their migraines. The app provides the latest migraine news, patient tips and expert opinion through Health Union.
Contact Information: 1 International Plaza Suite 550 Philadelphia PA 19113; Phone: 484-985-9715; Fax: 484-450-2513; E-mail: firstname.lastname@example.org; Website:http://migraine.com/migraine-meter/.
iCBT is a personal-use Cognitive Behavioral Therapy tool, and lets users manage stress and anxieties on demand and within moments.
iPromises is an iPhone recovery app that provides user with trigger alerts, a visual journal, and a directory of phone numbers for AA meetings, the ability to build a virtual support community and a daily positive message.
Contact Information: 20781 Big Rock Drive Malibu, CA 90265; Phone: 562-293-4150; Fax: 310-943-0485; Website: http://ipromises.org/.
iTriage allows you to save, access, and share the health care information most important to you.
This interactive application guides users through Exposure and Response Prevention (ERP), for Obsessive Compulsive Disorder.
Medscape is a drug reference app and mini-textbook packed with protocols for disease pathologies for quick reference and refreshing you medical knowledge.
MoodKit is designed to help you apply effective strategies of professional psychology to help users engage in mood-enhancing activities, identify and change unhealthy thinking, rate and chart mood across time, and create journal entries using custom templates designed to promote well-being.
Contact Information: Thriveport, LLC PO Box 16066 Encino, CA 91416; Email: email@example.com; Website: http://www.thriveport.com/products/moodkit/index.php.
MyCalmBeat improves your calmness through slow breathing, allowing you to monitor to calculate your personal best breathing rate where you are calmest, and then train by breathing at that rate.
Pocket Sponsor is titled after the book by the same name, is designed for teens and young adults dealing with alcoholism and addiction recovery by providing a summary of 31 days of morning and evening meditations.
The U.S. Department of Veterans Affairs line of mobile applications (including PTSD Coach and Breathe2Relax) provides users with self management education about PTSD, a PTSD self-assessment, information on where to find support, and tools that can help users manage the stresses of daily life with PTSD.
This application provides three meditations and meditation tips to help support your experience with the guided meditations.
Soneso Depression Test & Tracker allows users to determine and track depression levels, and provide users cues to when they should see professional help for official diagnosis and treatment for depressions.
Track3 is diabetes and carbohydrate counter app for helping patients manage blood sugar and diet.
Training Faces is a game for individuals with Autism and other special needs to recognize emotions to help improve social skills by recognizing the emotion, the cause behind the emotion and speedup recognition.
MyM3 (My Mood Monitor), a self-administered checklist screening tool that can assess the risk for depression, an anxiety disorder, bipolar disorder and post-traumatic stress disorder (PTSD).
OPEN MINDS. (2012, July). The OPEN MINDS Tech List: Smartphone Applications. OPEN MINDS Management Newsletter.