mHealth and Mobile Medical Apps: A Framework to Assess Risk and Promote Safer Use

Abstract

The use of mobile medical apps by clinicians and others has grown considerably since the introduction of mobile phones. Medical apps offer clinicians the ability to access medical knowledge and patient data at the point of care, but several studies have highlighted apps that could compromise patient safety and are potentially dangerous. This article identifies a range of different kinds of risks that medical apps can contribute to and important contextual variables that can modify these risks. We have also developed a simple generic risk framework that app users, developers, and other stakeholders can use to assess the likely risks posed by a specific app in a specific context. This should help app commissioners, developers, and users to manage risks and improve patient safety.

What makes a mobile app successful in supporting health behaviour change?

“…Cost alone is not indicative of quality or effectiveness. As mobile device use becomes ubiquitous, practitioners will need to be better informed regarding the design and content of mobile health apps so they can assess for themselves their value and worth for clinical practice (Lewis and Wyatt, 2014). Currently, there is limited evidence and guidance to support these decisions (Mohr et al, 2013).…”

“…Stoyanov et al (2015) have developed a Mobile Apps Rating Scale (MARS) that rates apps according to their engagement, functionality, aesthetics, information quality and subjective quality (Baumel and Muench, 2016). Other authors have recommended the development of risk assessment frameworks to support practitioners (Lewis and Wyatt, 2014). However, most of these endeavors are focused on product evaluation and provide little support to help the practitioner wishing to evaluate an app's effectiveness within the context of a clinical intervention (Baumel and Muench, 2016).…”

“…However, most of these endeavors are focused on product evaluation and provide little support to help the practitioner wishing to evaluate an app's effectiveness within the context of a clinical intervention (Baumel and Muench, 2016). In the absence of such support, clinicians need to be judicious when recommending health care app use to service users, not least because of safety and confidentiality concerns (Lewis and Wyatt, 2014).…”

Are mobile health applications useful for supporting shared decision making in diagnostic and treatment decisions?

“…A recent study [37] showed that mHealth apps caused anxiety among breast cancer patients waiting for surgery by sending them multiple reminders. mHealth and medical apps may generate different risks to patients and their safety, and these risks could be even more harmful in complex apps [38]. There are also security concerns regarding patients’ information in mHealth apps, such as risk of data breaches or tampering [39].…”

Development, Testing and Reporting of Mobile Apps for Psycho-social Interventions: Lessons from the Pharmaceuticals

“…There is currently an interest in standardizing interventions in this area, and there have been attempts to establish criteria to self certify eMedia delivered interventions [5]. Similarly, there is an interest in evaluation of risk assessment of such interventions [6]. Surprisingly, the regulatory agencies have not paid sufficient attention to eMedia-delivered interventions until recently.…”