The three m-health design characteristics for “good" mobile health apps

The cancer innovation conference

Doctors as m-health advisors for patients

Something pretty exciting happened last month – well, for The Health Safari, anyway. We won the prize for best poster presentation at the Cancer Institute New South Wales’ (NSW’s) Innovation in Cancer Treatment and Care Conference. While we were delighted by this, we were not surprised at the level of healthcare professionals’ interest in our topic – how doctors can become frontline advisors to patients about their mobile health app decisions. Here’s why.

The mobile health (m-health) app market is experiencing intense growth at the moment. Global sales of smartphones are expected to reach 1.5 billion units globally by 2016 (Forbes, April 2012), and the mobile health app market is expected to hit USD$400 million in the same timeframe.

M-health represents a radical transformation in how individuals manage their health. Like any transformation, this carries both big risks and opportunities.

Medical practitioners are at the front-line of this transformation. They are in a position to influence health consumers and lead them to apps that will benefit rather than frustrate or harm them. This means that healthcare providers need to become more fluent in m-health, and in what makes a “good” vs a “bad” app.

What it means to be a “good” m-health app

At The Health Safari, we think about m-health apps a lot.

We are a small health innovation firm located in Canberra, Australia. Our SkinKeeper for iPhone mole monitoring app (used as a case study in our Cancer Institute NSW poster presentation) was shaped by three m-health design characteristics. We think that these three characteristics are key to how doctors need to distinguish “good apps” from “bad apps”. They are:

Usability, clinical safety and functional power

Consumer usability: Does the patient find the app easy to understand and simple to use?

If an app is not usable, there are a range of consequences for the health consumer:

  1. They will not sustain their usage of the app, potentially forgoing significant opportunities to manage and co-manage their health.
  2. They will make a mistake that will at best frustrate them, at worst damage the integrity of the health record they are building, or the decision-making that they and their doctor engage in.
  3. Usability is an essential part of an app, as the experience of using an app will ultimately be a key determinant in both the usefulness (real and perceived) and satisfaction derived from it.

    Functional power: Does the app offer patients functions that will help them effectively self-manage/co-manage their health?

    Apps may make a number of claims about what they are able to achieve for their users. However, their functional power (or the lack of it) will ultimately determine the utility that a patient receives in response to their time and emotional investment in using it.

    In the skin cancer space, based on qualitative research we conducted with medical professionals and patients (both who have had skin cancer and those who have not), we observed a need for seven core functions to ensure a functional level of power suitable for users:

    1. The ability to make a comprehensive record of a skin lesion at a point in time, and over a period of time, capturing photography and ABCDE data
    2. A visual model of the body to assist in locating and relocating a particular mole
    3. the ability to capture personal, family and environmental history that is relevant to a health consumer’s skin cancer risk
    4. The ability to export (print/email) to a healthcare provider a longitudinal report for one or more moles plus their relevant risk history data
    5. An alert service to remind patients to take snapshots of a mole, or to visit a doctor
    6. Availability of credible educational information to help patients learn when they should be worried about a lesion, how to check their skin, and how to prevent skin cancer
    7. Multiple user profiles, so that a single phone owner can have a separate monitoring regimes for other family members (eg a parent, partner or child)

    Clinical safety: Does the app safeguard the health consumer against a poor health outcome?

    In the absence of a rigorous heuristic and trialling standard and certification strategy for m-health apps, both patients and doctors ultimately have to rely on their judgement and the judgement of sources that they trust as to whether an app is clinically safe.

    Some (not comprehensive) indicators that we suggest one explore to form a judgement include:

    Indicator Positive quality Negative quality
    Promotes patient-provider partnership The app actively seeks to enrich the doctor-patient relationship The app seeks to position itself as a substitute for a medical professional
    Provides clinically safe functionality The app allows users to record, monitor and/or share health information The app claims to diagnose or risk assess health issues
    Delivers trustworthy education The app uses health educational text and imagery from a credible, referenced and verifiable source The app uses health educational text and imagery that is unsubstantiated, unvetted and unreferenced
    Harnesses mature concepts The app is based on or leverages accepted frameworks and models (eg the ABCDE skin cancer diagnostic) The app invents its own frameworks and models with little clarity about provenance or medical consensus
    Delivers strong usability The app is simple, comprehensible and intuitive, and safeguards the user against error and inaccuracy The app is confusing, complicated, and does not protect the user from errors or inaccuracies
    Ensures information security The app provides secure storage and access to user’s personal health information User’s personal health information can be intentionally or inadvertently accessed without user consent

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    20:58, 27 October 2012 | Author : Lessismore

    Congratulations on your win, guys. There are a lot of dodgy apps out there - your one is great though!