Consumer Mobile Health Apps: Current State, Barriers, and Future Directions

This paper discusses the current state, barriers, and future directions of consumer‐facing applications (apps). There are currently more than 165,000 mobile health apps publicly available in major app stores, the vast majority of which are designed for patients. The top 2 categories are wellness management and disease management apps, whereas other categories include self‐diagnosis, medication reminder, and electronic patient portal apps. Apps specific to physical medicine and rehabilitation also are reviewed. These apps have the potential to provide low‐cost, around‐the‐clock access to high‐quality, evidence‐based health information to end users on a global scale. However, they have not yet lived up to their potential due to multiple barriers, including lack of regulatory oversight, limited evidence‐based literature, and concerns of privacy and security. The future directions may consist of improving data integration into the health care system, an interoperable app platform allowing access to electronic health record data, cloud‐based personal health record across health care networks, and increasing app prescription by health care providers. For consumer mobile health apps to fully contribute value to health care delivery and chronic disease management, all stakeholders within the ecosystem must collaborate to overcome the significant barriers.

[1]  J. Plevinsky,et al.  Is There a Good App for That? Evaluating m-Health Apps for Strategies That Promote Pediatric Medication Adherence. , 2016, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[2]  Sarah Iribarren,et al.  Review and Analysis of Existing Mobile Phone Apps to Support Heart Failure Symptom Monitoring and Self-Care Management Using the Mobile Application Rating Scale (MARS) , 2016, JMIR mHealth and uHealth.

[3]  Sean P Mullen,et al.  Increasing Physical Activity With Mobile Devices: A Meta-Analysis , 2012, Journal of medical Internet research.

[4]  Carly M. Goldstein,et al.  Adherence to Antidepressant Medications: A Randomized Controlled Trial of Medication Reminding in College Students , 2015, Journal of American college health : J of ACH.

[5]  Joseph A Cafazzo,et al.  Beyond the Randomized Controlled Trial: A Review of Alternatives in mHealth Clinical Trial Methods , 2016, JMIR mHealth and uHealth.

[6]  Mark Erik Larsen,et al.  Quantifying App Store Dynamics: Longitudinal Tracking of Mental Health Apps , 2016, JMIR mHealth and uHealth.

[7]  Shannon Kelly,et al.  Effectiveness of iPad apps on visual-motor skills among children with special needs between 4y0m–7y11m , 2017, Disability and rehabilitation. Assistive technology.

[8]  Ali Sunyaev,et al.  Availability and quality of mobile health app privacy policies , 2015, J. Am. Medical Informatics Assoc..

[9]  Jordan Rivera,et al.  Mobile Apps for Weight Management: A Scoping Review , 2016, JMIR mHealth and uHealth.

[10]  Joshua R. Vest,et al.  More than just a question of technology: Factors related to hospitals' adoption and implementation of health information exchange , 2010, Int. J. Medical Informatics.

[11]  P. Schulz,et al.  Mapping mHealth Research: A Decade of Evolution , 2013, Journal of medical Internet research.

[12]  Mark Erik Larsen,et al.  Mobile Apps for Bipolar Disorder: A Systematic Review of Features and Content Quality , 2015, Journal of medical Internet research.

[13]  Begoña García Zapirain,et al.  Security Recommendations for mHealth Apps: Elaboration of a Developer’s Guide , 2016, Journal of Medical Systems.

[14]  D. Aberle,et al.  Consumers’ Patient Portal Preferences and Health Literacy: A Survey Using Crowdsourcing , 2016, JMIR research protocols.

[15]  C. Gidengil,et al.  Evaluation of symptom checkers for self diagnosis and triage: audit study , 2015, BMJ : British Medical Journal.

[16]  C. Given,et al.  Beta Testing a Novel Smartphone Application to Improve Medication Adherence. , 2017, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[17]  Aravinda Thiagalingam,et al.  Mobile Phone Apps to Improve Medication Adherence: A Systematic Stepwise Process to Identify High-Quality Apps , 2016, JMIR mHealth and uHealth.

[18]  Ronald Andersen Medicine's Dilemmas: Infinite Needs Versus Finite Resources , 1994 .

[19]  Ruth M. Masterson Creber,et al.  Review and Analysis of Existing Mobile Phone Apps to Support Heart Failure Symptom Monitoring and Self-Care Management Using the Mobile Application Rating Scale (MARS). , 2016 .

[20]  Bambang Parmanto,et al.  Perspectives on the Evolution of Mobile (mHealth) Technologies and Application to Rehabilitation , 2014, Physical Therapy.

[21]  Pierre-Jean Benghozi,et al.  Additional file 1: of Unaddressed privacy risks in accredited health and wellness apps: a cross-sectional systematic assessment , 2015 .

[22]  K. Terry Prescribing mobile apps: What to consider. , 2015, Medical economics.

[23]  G. Zeilig,et al.  Tablet Apps and Dexterity: Comparison Between 3 Age Groups and Proof of Concept for Stroke Rehabilitation , 2016, Journal of neurologic physical therapy : JNPT.

[24]  L. Osterberg,et al.  Adherence to medication. , 2005, The New England journal of medicine.

[25]  Lori Wozney,et al.  A Systematic Review of Cognitive Behavioral Therapy and Behavioral Activation Apps for Depression , 2016, PloS one.

[26]  S. Flatt,et al.  App-based psychological interventions: friend or foe? , 2015, Evidence-Based Mental Health.

[27]  Deborah Richards,et al.  Security and Privacy Issues Related to the Use of Mobile Health Apps , 2014 .

[28]  Hadi Kharrazi,et al.  Mobile personal health records: An evaluation of features and functionality , 2012, Int. J. Medical Informatics.

[29]  D. Bates,et al.  Patients’ Attitudes Toward Electronic Health Information Exchange: Qualitative Study , 2009, Journal of medical Internet research.

[30]  Calum Hartley,et al.  iPads and the Use of “Apps” by Children with Autism Spectrum Disorder: Do They Promote Learning? , 2016, Front. Psychol..

[31]  C. Quinn,et al.  Cluster-Randomized Trial of a Mobile Phone Personalized Behavioral Intervention for Blood Glucose Control , 2011, Diabetes Care.

[32]  Kenneth D. Mandl,et al.  SMART on FHIR: a standards-based, interoperable apps platform for electronic health records , 2016, J. Am. Medical Informatics Assoc..

[33]  C. Vandelanotte,et al.  Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour: a systematic review , 2016, International Journal of Behavioral Nutrition and Physical Activity.

[34]  CC Quinn,et al.  Cluster-randomized trial of a mobile phone personalized behavioral intervention for blood glucose control. Diabetes Care 2011;34:1934–1942 , 2013, Diabetes Care.

[35]  Lindsey E. Dayer,et al.  Smartphone medication adherence apps: potential benefits to patients and providers. , 2013, Journal of the American Pharmacists Association : JAPhA.

[36]  B. J. Fogg,et al.  A behavior model for persuasive design , 2009, Persuasive '09.

[37]  Elizabeth R. Lorah,et al.  A Systematic Review of Tablet Computers and Portable Media Players as Speech Generating Devices for Individuals with Autism Spectrum Disorder , 2015, Journal of autism and developmental disorders.

[38]  Isabel de la Torre Díez,et al.  Privacy and Security in Mobile Health Apps: A Review and Recommendations , 2014, Journal of Medical Systems.

[39]  J. Wolf,et al.  Diagnostic inaccuracy of smartphone applications for melanoma detection. , 2013, JAMA dermatology.

[40]  A. Haines,et al.  The Effectiveness of Mobile-Health Technologies to Improve Health Care Service Delivery Processes: A Systematic Review and Meta-Analysis , 2013, PLoS medicine.

[41]  Stoyan R. Stoyanov,et al.  Development and Validation of the User Version of the Mobile Application Rating Scale (uMARS) , 2016, JMIR mHealth and uHealth.

[42]  Isaac S Kohane,et al.  Time for a Patient-Driven Health Information Economy? , 2016, The New England journal of medicine.

[43]  N. Terry Mobile health: assessing the barriers. , 2015, Chest.

[44]  Danit R Shahar,et al.  The Impact of a Web-Based App (eBalance) in Promoting Healthy Lifestyles: Randomized Controlled Trial , 2015, Journal of medical Internet research.

[45]  D. Bates,et al.  In search of a few good apps. , 2014, JAMA.

[46]  Tobias Dehling,et al.  Exploring the Far Side of Mobile Health: Information Security and Privacy of Mobile Health Apps on iOS and Android , 2015, JMIR mHealth and uHealth.