[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/04/Screen-Shot-2016-04-27-at-11.41.46-PM-640×308.png” thumb_width=”250″ /]Well, that was fast! Apple’s CareKit framework, specifically for clinical care app developers, was only announced last month and opened its official doors yesterday, but three developers had early access. Their apps hit the market yesterday: One Drop (diabetes management), Iodine for Start (depression medication management), and Glow for Glow Nurture, an app for pregnant women, and Glow Baby, an app for new mothers. Four hospitals have also announced app development underway using CareKit modules: Beth Israel Deaconess (chronic condition management), the University of Rochester (Parkinson’s), Texas Medical Center (care coordination), and Cleveland Clinic (asthma and COPD).
There are four modules which developers can selectively use (pictured).
- CareCard, which helps patients track care plans and action items
- Symptom and Measurement Tracker, which helps patients keep a log of their experiences
- Insights Dashboard which integrates the care plan data from CareCard with the symptom data from the Symptom and Measurement tracker to create insights about the effectiveness of treatments
- Connect, which helps patients share data with their providers or other caregivers.
The three in market yesterday, for instance, all used Connect; Iodine and One Drop use Care Card and One Drop uses the Symptom Tracker.
The article’s comments from developers and hospitals highlight a move to a standardized framework for clinical apps, which may be wishful thinking as most of the world uses Android, but addresses the validation and certification conundrum that’s plagued health apps for years. We’ll wait and see if Apple sustains the lead here. Mobihealthnews. Apple ResearchKit/CareKit page. The Verge, Ars Technica, TechCrunch
[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/12/alp-mountains-peaks-in-winter.jpg” thumb_width=”150″ /]An app developer and a healthcare/digital health innovation lab get into the certification game. Can they fly over the treacherous peaks this time? Social Wellth made good on their promise (or threat?) to get into the app vetting business this past week through announcing a partnership with Columbia University-based HITLAB at the HITLAB Summit this week to develop a certification organization known as Xcertia. Last year, Social Wellth acquired the remains of Happtique from GNYHA Ventures [TTA 12 Dec 14]. The Xcertia principles center around privacy, security, operability and content–as Happtique’s did. The intent is to not only develop a program to certify apps based on established standards, but also form a Signature Steering Committee to ensure they maintain “their definitive set of criteria for evaluating mobile health apps.” MedCityNews, release
Possible conflict of interest. It all sounds positive, but the head of Xcertia, David Vinson, is also the CEO of Social Wellth, which despite its nonprofit-ish name makes its living by developing consumer apps and “dashboards” for insurance companies, a task grandly called (from their press release) “the curation of digital health experiences by leveraging mobile health technologies that allow for integration and aggregation of all digital assets.” Social Wellth also makes quite a bit of hay on its website about app curation for its clients. (more…)
No sooner had I given my keyboard the final tap to publish the conclusions of my work yesterday on medical apps than the first item hit my inbox that suggest that certification is a flawed proposition.
The suggestion of this iMedicalApps article is that the Happtique saga has shown certification to be impossible. Instead it is suggested that people make up their own minds based on peer review on sites (you’ve guessed it) such as theirs, and a greater understanding of apps. The key paragraph for me is (more…)
This article in iMedicalApps takes a look back at the controversy that swirled around Happtique only four weeks ago–when Harold Smith III of Monckton Health and Fixmo went public on major data security flaws in two of their 19 certified apps–and moreover how Happtique did not respond to his concerns either in December or on the process in March [TTA 13 Dec]. It was the talk of the last big US gathering prior to International CES, the mHealth Summit.
Unfortunately, Satish Misra, MD, one of their editors, provides an argument best described as a ‘circular firing squad.’ Dr. Misra is absolutely correct on the enormity of curating and certifying tens of health/medical apps. But the point of the article seems to be that any kind of evaluation mechanism or certification is a fool’s errand.
The logic presented as this Editor interprets the article: Since Happtique’s certification process had standards which were complicated and arbitrary (plus, as it turned out, flawed), it proves that it’s useless to pursue standards and certification. In addition to being ‘resource intensive’ for reviewing tens of thousands of apps, standards cannot decide what app is the right choice, even if that was not the intent of the certification. So doctors and ‘end users’ have to become ‘app-literate’; hang the fact that the point of curation and certification is to do at least some of the heavy lifting (pre-screening) job for them beforehand! Back to the start: reading all the peer review stuff on thousands of medical apps, if it’s reviewed at all, as iMedicalApps does for some. (And will these reviews be 100% accurate? Will they subject every app to data security screening? What are their standards?) Back to Square One: DIY and Dodge City. Apps present too much (unpaid) work for docs to think about, patients use (then abandon) apps that can be privacy risks, because they don’t know any better and they aren’t white-hat hackers after all….
Remaining unconsidered by iMedicalApps is the plausibility of what Master Data Cruncher IMS Health is taking on with AppScript and AppNucleus [TTA 15 Dec]: a proprietary 25-point methodology (AppScore) that automates the classification and evaluation of health apps plus a hosting platform that uses IMS information to assist developers in creating secure, effective apps.
A far more detailed exploration of why at the very least an objective certification/evaluation process is needed is explored by Editor Charles in his continuing series Driving Up Medical App Usage in the UK, especially Part II (Part I here.) Watch for Part III shortly.
News and announcements around app certification definitely were hot topics in the past week or so, but are they more heat than light? Do these certifications adequately address efficacy? Stephanie Baum, in her follow-up to the Happtique kerfuffle in MedCityNews, opens up the discussion with the proposition: “It seems like there needs to be some way to prove that apps actually help people.” Bradley Merrill Thompson of Epstein Becker & Green points out “It’s certainly useful to know that an app works from a software perspective reliably, but it is even more valuable to know that the app can actually improve health.” While Happtique certification standards have a gap here, this Editor would point out that they were evolved nearly two years ago when the reporting/analysis needed for this was largely not available. Newer programs such as Johns Hopkins’ mHealth Evidence and the new IMS Health AppScript [TTA 15 Dec] can dip into the ‘big data’ pool far more effectively. Will Happtique be able to address this, or leave the ‘last mile’ to others? And what is the real and quantifiable demand for app certification anyway? Health app prescribing by physicians is a question mark in this Editor’s observation; the larger market may be health plans and programs such as Partners HealthCare’s Wellocracy, Cigna’s GoYou and Aetna’s CarePass.