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Evaluation of Diabetes mhealth apps 2017


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Presentation made at the ITCH 2017 conference in Victoria.

Published in: Healthcare
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Evaluation of Diabetes mhealth apps 2017

  1. 1. Ronak Brahmbhatt, Shadi Niakan, Nishita Saha, AnukritiTewari, Ashfiya Pirani, Natasha Keshavjee , Dora Mugambi, Nasrin Alavi , Karim Keshavjee ITCH 2017,Victoria, BC Feb 17, 2017 LINK TO OPEN-ACCESS PAPER:
  2. 2.  The Problem  What’s preventing us from solving it?  What we discovered about mhealth apps  What we did to overcome the deficiency in mhealth apps  What we learned when we applied that to diabetes apps  Discussion  Limitations  Recommendations
  3. 3.  Diabetes  Chronic disease with increasing prevalence worldwide  Cost 12.5 billion dollars annually to Canadians  Most important step in DM treatment is self-management involving lifestyle changes and long term adherence to meds  Technology involving mhealth apps is a novel approach to life style management and medication adherence
  4. 4.
  5. 5. Conflicting Information: App provides information that conflicts with that received from health care providers (Bierbrier, Lo & Wu, 2014); Health Literacy: Language and terminology of the app may not be compatible with the patient’s health literacy (Caburnay, 2015); Data Entry: Patient has to enter the data themselves (Gruman, 2013); Meaningful Use: Patient cannot use information in a meaningful way; e.g., he or she cannot order diagnostic testing or prescribe medications to himself or herself; Lack of incentives like cost saving or social approval;
  6. 6. Not Habit Forming: Daily use of the app is not required and therefore the patient does not get into the habit of using it; Unknown Provenance: Providers don’t value data collected by patients in apps downloaded from an app store whose provenance and pedigree is not known or established (Terry, 2015); Lack ofTools: There is no way for providers to consume the large amounts of data that are collected in apps (Terry, 2015) i. i.e., visualize, analyze, derive meaning from; Lack of Interoperability: Providers unable to integrate app data into their own (EMR) for analysis or follow-up or share the data in their EMR with their patient’s apps (Abebe, 2013).
  7. 7.  Based on our screening criteria for optimal diabetes apps, how well functioning are currently available diabetes apps in the app stores?
  8. 8.  We developed screening criteria using our reference architecture for design and development of mhealth apps,  Apple iTunes and Google Play app stores were searched for diabetes apps –found 201  Following a calibration exercise, two individuals independently reviewed and evaluated each app against the screening criteria  Data was collated and analyzed
  9. 9.  201 total apps were reviewed  No app met all the criteria outlined  Most apps were replacement of paper journals or diaries  Many apps were recipe apps  Majority of the apps provided education/recommendations  Most of the apps failed at integrations with devices (glucometer, BP machine) and patients medical records (EMR, primary care provider)
  10. 10.  Many apps were conference apps or guideline apps for professionals  Of the highest scoring apps, major reasons for not getting a higher score  Lack of integrations with devices–relatively easy these days (but requires FDA approval)  Lack of integration with EMRs –many features are dependent on this
  11. 11.  There is great need for high quality apps which can be prescribed by a physician and whose use can be monitored by the health care team  Apps need to focus on managing the whole patient along with their disease and not a small part of a patient’s care such as self management  Better embedding physician patient relationship into patient app interactions for provider guided management
  12. 12.  Due to budgetary constraints, we did not download apps from the stores  Some vendors had poorer descriptions of their product than others  A very small number of apps were in languages that are not understood by the people conducting the review  We were not able to quantitate which apps are used and which ones are not  We did not include any patients in defining the criteria nor in reviewing the apps.
  13. 13.  Apps should be prescribed and monitored by health care providers  Requires participation of EMR vendors in developing APIs for apps  mhealth app certification by a standards organization would go a long way to ensuring higher quality apps and increasing the level of trust for apps by health providers  An Interoperability Kit for EMRs andApps would help make it easier to deploy an app  Standard interoperability for apps with medical devices would lower the investments required to create good apps