Lost symbol iconThe proliferation of mobile health (mHealth) apps appears to be an abundant cornucopia of “lite” tools that look simple to access and easy to use. But this growing menu of a la carte choices that promise to keep us healthy, track our numbers, and access useful health information can also, in the words of three Dutch health researchers, “drive us crazy.”

Why mobile health app overload drives us crazy, and how to restore the sanity, by Lex van Velsen and colleagues, makes the case that the plethora of mHealth apps available in online app stores is a fragmented, disorganized marketplace that limits their usefulness.

Van Velsen et. al. argue for three solutions to this problem:

  • App developers should join the open source movements, evolving a few “gateway” platforms that would enable accessing the right app by the right person at the right time
  • Standardize content, so that information provided by apps is understandable. Van Velsen and the team believe that the Centers for Disease Control (CDC) should play a leading role in collaboratively creating and publishing this standard, assisted by the Food & Drug Administration (FDA)
  • Personalize content to the user based on their preferences and “context.”

The benefits of mobile health apps are well articulated and understood, having the potential to improved patient education and self-management of chronic conditions, along with helping clinicians be more productive and improve workflow on-the-go. The challenges, though, continue to limit the usefulness of mHealth apps: the smartphone’s small screen, lack of consistently reliable content, and privacy/security challenges of mobile devices have been cited as barriers to optimal use of mobile health.

Above all of these is the fundamental issue of app overload, the team notes. They quote Gary Anthes, the technology writer, who observed in 2011’s The invasion of the mobile apps, “A stroll through the app stores is a little like visiting an urban flea market, where there are first-rate products but where low-price goods of dubious value abound, and support is practically nonexistent.”

Health Populi’s Hot Points:  We’re absolutely overloaded and “overblessed” with mobile health apps without a net. The phenomenon has reached mass media embrace, with a USA Today article from August 2012 claiming, “Smartphone apps now playing doctor.” 

The uncertainty of the FDA’s role, for which Van Velsen and team argue, continues to cloud the market. At the same time, Apple is reportedly working to improve app discoverability and search, and Happtique is vetting mHealth apps for clinicians with an eye toward “app prescribing” to patients (THINK: a new form of information therapy).

In my California HealthCare Foundation paper, How Smartphones Are Changing Healthcare for Patients and Providers, I warned, “Caveat emptor, health app downloader,” and that, “ultimately, smartphone technology is only as important as its ability to empower users to communicate and collaborate in the interests of health.”

I asserted that in April 2010, nearly 3 years ago. Since then, we’ve experienced hockey-stick growth in the multiplication of health apps available to consumers and clinicians. But we’ve kilometers to go, yet, before discoverability, usability and interoperability are the rule, not the exception.