Mobile Apps for Consumer Health Richard James, U. Pennsylvania Biomedical Library

Smartphone Demographics and Usage 2015 Pew Global Attitudes Survey 2014 Pew Internet Project Survey

Smartphone Demographics and Usage Younger adults — 15% of Americans ages 18-29 are heavily dependent on a smartphone for online access. Those with low household incomes and levels of educational attainment — Some 13% of Americans with an annual household income of less than $30,000 per year are smartphone-dependent. Just 1% of Americans from households earning more than $75,000 per year rely on their smartphones to a similar degree for online access. Non-whites — 12% of African Americans and 13% of Latinos are smartphone-dependent, compared with 4% of whites. Pew US Smartphone Use in 2015

Smartphone Demographics and Usage 2015 Pew Global Attitudes Survey 2014 Pew Internet Project Survey

Mobile Health Apps by Category Categories for the approx. 165,000 health-related apps available for iOS and Android Estimated 1.7 Billion downloads of apps in this category globally. http://www.economist.com/news/business/21694523-mobile-health-apps-are-becoming-more-capable-and-potentially-rather-useful-things-are-looking

Mobile Health Apps by Category “Fitness”: including weight loss/calorie tracking, workout and activity tracking Sleep Quality Menstrual Cycle Monitoring Diabetes self-care Migraine Anxiety Health Information Pharmacy

Consumer Interest in m-Health Apps http://www.gfk.com/global-studies/global-studies-fitness-tracking/

Consumer Interest in m-Health Apps http://www.gfk.com/global-studies/global-studies-fitness-tracking/

Consumer Interest in mHealth Apps Use of Mobile Apps: A Patient Centered Approach. Academic Emergency Medicine. 2015;22:765–768 http://onlinelibrary.wiley.com/doi/10.1111/acem.12675/pdf

The market is ready, consumers are ready, how about providers?

Healthcare Interest in mHealth Apps Currently, 16% of Healthcare Professionals Use/Recommend Apps to clients and patients. In the same survey, almost 50% said they planned to do so within the next 5 years. In a separate survey, about 40% of physicians said they did not know enough about apps to be comfortable recommending any. Modern Healthcare 45.48 : 20-22 (http://tinyurl.com/jgjpx93) hAp://quan,a-inc.com/media/press-releases/quan,amd-poll-finds-physicians-are-split-on-the-use-of-medical-apps-and-42-believe-more-regula,on-is-necessary/

http://www. commonwealthfund http://www.commonwealthfund.org/publications/issue-briefs/2016/feb/evaluating-mobile-health-apps

Oversight and Regulation of Apps http://www.fda.gov/downloads/MedicalDevices/.../UCM263366.pdf http://www.fda.gov/downloads/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/UCM263366.pdf#page=23 https://www.ftc.gov/tips-advice/business-center/guidance/mobile-health-apps-interactive-tool

Oversight and Regulation of Apps App store policy for Apple: Android does not regulate apps

In top 5 health apps (until revoked) Many HTN apps include high quality info

Missed 1 in 3 of potentially significant concerns

Of the six monitoring apps highlighted here from the App Store’s “Popular Medical Apps” page, only one documented a plausible connection to any kind of medically- related expertise Popular Medical apps, November 1 2016, https://itunes.apple.com/gb/genre/ios-medical/id6020?mt=8

Smartphone Apps for Calculating Insulin Dose: a Systematic Assessment (http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-015-0314-7)

Colorectal Smartphone Apps: Opportunities and risks Colorectal Dis Colorectal Smartphone Apps: Opportunities and risks Colorectal Dis. 2012 Sep;14(9):e530-4. doi: 10.1111/j.1463-1318.2012.03088.x

Alternatively, just download Pokemon Go https://newsblog.drexel.edu/2016/07/18/quick-take-pokemon-go-and-accidental-exercising/

The Impact of Low Health Literacy https://health.gov/communication/literacy/BPH-HealthLiterateApps.pdf

What is the “CRAAP Test”? A standard classroom tool for teaching information literacy and source evaluation: C Currency or Timeliness of Information R Relevance and importance of the source A Authority, Credentials, and Affiliation of the source A Accuracy of the information presented P Purpose of the information and its authors Standards for this tool originated in print texts, and have been developed to apply to internet sources in an effective way. https://www.csuchico.edu/lins/handouts/eval_websites.pdf

What is the “CRAAP Test”?

Applying the “CRAAP Test” to Apps There are well-established strategies for finding the elements of the CRAAP test: Author information and affiliations on book jackets and article headers. Date markers and domains for websites: .mil, .gov, etc. Critical reading to discover point-of-view, biases, and intentions. Functionality of web links, “about” information, author profiles, design. These standard approaches do not hold up well when evaluating apps.

Applying the “CRAAP Test” to Apps There are well-established strategies for finding the elements of the CRAAP test: “Authors” of apps are usually software developers The classic test is keyed to textual and website structural elements Absence of significant text content within most apps Interactivity and ease-of-use is not measured Apps are predominantly commercial products

Applying the “CRAAP Test” to Apps Queensland University of Technology developed the Mobile Apps Rating Scale (MARS) Incorporates the evaluation of app platform-specific design and interaction features. However, information and evidence quality scores are weighted equally with aesthetics and design quality scores. Try this with your own favorite app: MARS Evaluation https://drive.google.com/open?id=0B_Ohb9M_aDvW eTQ4NllyeXFpVDA

Exercise: AliveCor

Exercise: AliveCor https://www.alivecor.com

Exercise: AliveCor https://itunes.apple.com/us/app/kardia/id57976914 3?mt=8

Future Trends? In Search of a Few Good Apps. JAMA. 2014;311(18):1851-1852. doi:10.1001/jama.2014.2564 (ONC: Office of the National Coordinator for Health Information Technology)

Future Trends Count of articles by year categorized with MESH: “Mobile Applications”: extracted November 1, 2016

Future Trends? Integration into Healthcare http://www.commonwealthfund.org/publications/issue-briefs/2016/feb/evaluating-mobile-health-apps

Future Trends? Commercial Curation Repeating the mistakes of internet past: development, production, and persistence of apps is challenging to keep up with.

Future Trends? Certification http://jamanetwork.com/journals/jama/fullarticle/1852662 http://rankedhealth.com

Future Trends? Trusted Sources RxUniverse: Mt. Sinai App Lab project: creating, curating, and linking condition-appropriate apps within the EHR http://www.healthcare-informatics.com/article/mobile/mt-sinai-platform-curates-digital-health-apps https://mobile.va.gov/appstore http://mhealth.jmir.org/announcement/view/67

Future Trends? Professions and Societies RxUniverse: Mt. Sinai App Lab project: creating, curating, and linking condition-appropriate apps within the EHR http://www.healthcare-informatics.com/article/mobile/mt-sinai-platform-curates-digital-health-apps https://mobile.va.gov/appstore http://mhealth.jmir.org/announcement/view/67

Future Trends? Professions and Societies Xcertia Project

? Questions? E: rjame@upenn.edu T: 215-746-4034 @Pennnursinglib http://mhealth.jmir.org/article/viewFile/mhealth_v3i1e27/2 http://www.commonwealthfund.org/publications/issue-briefs/2016/feb/evaluating-mobile-health-apps http://www.hon.ch/HONcode/Patients/Conduct.html