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Sunday, November 18, 2012

Not all medical apps are bad, Nashua physician says

Not all medical mobile apps deserve a bad rap.

Just ask Dr. Kevin Pho, an internal medicine provider for the Nashua Medical Group. ...

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Not all medical mobile apps deserve a bad rap.

Just ask Dr. Kevin Pho, an internal medicine provider for the Nashua Medical Group.

“From the physician’s standpoint, for the most part, they’re good,” said Pho, a physician social media speaker, blogger and contributor to USA Today. “More and more patients are

coming to me with apps on smartphones and saying, ‘I’ve been tracking my blood sugar. I’ve been tracking my blood pressure.’ … I think it empowers patients to be more conscious about their health decisions.”

Over the last few years, smartphones have become the tools people use for directions, photo-taking and tweeting.

Increasingly, they’re being used as aids for people’s medical and health needs, ranging from calorie counters who track their daily food intake to diabetics who check their daily blood glucose levels.

“We are in an age of the digital patient,” Pho said. “There’s just so much data out there.”

But that doesn’t mean the avalanche of medical information available in the palm of your hand is necessarily sound.

An examination by the New England Center of Investigative Reporting revealed a lack of regulation on many mobile applications has led to unproven products that offer the promise of a cure with no medical evidence to back it up.

But not everyone is complaining. In New Hampshire, not a single complaint has been lodged against a fraudulent medical app.

Still, that hasn’t stopped the calls for increased regulation.

“I think one of the cautions when it comes to mobile apps is a lot of them haven’t been studied yet,” Pho said. “Drugs go through rigorous studies, but mobile applications are just so new.

“Patients are going onto iTunes’ apps store and downloading things and we don’t know how reliable they are – or what kind of advice they give – and I think there should be some caution because they’re not regulated.”

Apps that claim to cure medical ailments have come under attack lately, sometimes deemed money-grabbing “solution” scams, akin to television infomercials that claim to relieve users of acne or addiction, but really just relieve users of their cash.

Some apps claim to cure acne blemishes with smartphone light, while others profess fixes to ringing in the ears with an app that hums.

“Anyone can come up with an app, and we don’t know if they have any medical background or anything like that,” Pho said. “I think we need a feeling-out process to see whether apps help patients, especially these advice apps, and whether they’re credible.”

Then there’s the debate about who should regulate them.

“There’s all this unregulated medical information out there,” Pho said. “Some say, ‘Should the FDA be regulating them?’ ‘Should medical apps be considered medical devices in the future?’ ”

The issue is larger than the medical app market itself. As resources grow online, more people are turning to Google and WebMD.com for medical information rather than to their doctors.

“There’s a lot of bad information on the Web. … The same goes for apps,” Pho said.

“The fact is it’s so unregulated, there are things out there that are clearly unproven. I always advise patients to talk to their doctors.”

But regulating mobile applications could be difficult, according to one who knows: Jim Bender, CEO of Nashua software firm Ping 4, which allows organizations to send highly customized, location-specific smartphone alerts to users.

“I think that would be really counterproductive,” said Bender, who spoke about app regulation in general. “The world’s moving way, way too fast, and I’m not a big fan of regulation to begin with.”

The best oversight for smartphone applications usually are the users themselves, he added.

“It’s highly Darwinian,” Bender said, referring to the application industry. “People aren’t going to complain, ‘This is a bad app.’ They just get rid of it. An app you don’t care for, for whatever it might be, it’s scarce real estate on your phone, so if it doesn’t do what you expect it to do, you get rid of it.”

The number of consumer complaints filed with the state’s attorney general’s office seem to confirm Bender’s notion of users who just delete and don’t complain.

Jim Boffeti, senior assistant attorney general in charge of the Consumer Protection Bureau, said the state has yet to receive any complaints about smartphone applications out of the 2,400 total complaints so far this year, along with 7,000 hotline calls.

“I have not seen any, and I get all the complaints that come in,” he said. “It doesn’t mean they haven’t, but it’s not an issue that I have seen come across my desk.”

The best way to combat the misleading medical information available may be to get doctors involved with the technology.

“There is a responsibility for doctors also to have some online presence, and the same goes with mobile apps,” said Pho, who publishes his own medical blog at KevinMD.com.

Still, the use of medical and health-related mobile applications has only just begun, Pho said.

“It’s on a positive trend,” he said, citing a report by The Pew Internet and American Life Project that states 85 percent of adults use smartphones and more than half use them to gather health information.

Some physicians suggest medical apps to patients that may allow better tracking of their needs, he added, such as reminder apps that alert patients to take medication.

The most popular are the dietary diary apps.

Most of the technology costs no more than $5 to download, Pho said, although some apps, which allow users to hook up medical machinery – such as blood glucose monitors – to their smartphones can be pricier.

“You want to individualize your management plan for each patient,” Pho said. “For some it will be smartphones and for others it won’t be.”

The same goes for the doctors themselves.

“Doctors are adopting smartphones at the same rate as the general population,” Pho said.

They may use apps to check drug dosages or medical calculators that give patients cardiac risk factors and determine risks for health disease.

“There’s no question that it will grow,” Pho said.

Maryalice Gill can be reached at 594-6490 or mgill@nashua
telegraph.com. Also, follow Gill
on Twitter (@Telegraph_MAG).