The use of big data as a means to better target many forms of healthcare is undeniable. It is the buzzword of this decade and, if not a silver bullet, it certainly has the potential to move health systems on to secure the positive outcomes that we seek.
Yet most big data related talks at conferences appear to focus on registries, patient records in general and clinical trials. Not enough is being said about the diminutive vehicles that are capable of delivering this complex, yet life-saving (one hopes) data: apps.
This is why one particular session at the DIA Euromeeting in Hamburg, Germany, this year was such a breath of fresh air. Indeed, it offered the, by now well-acknowledged, nod to big data in the big sense, but it also highlighted how useful health apps can be, while pointing out significantly challenges that arise with this use.
There is no argument that apps can transform – and indeed are already transforming – the way in which we deliver data to their various repositories. In short, a secure mobile health patient engagement solution – because this rather large mouthful is what they essentially are designed to be – empowers patients to self manage their care and puts them to a large extent at ease in terms of parting with at least some of their health data.
Nevertheless we are faced with some significant gaps when it comes to health apps. For example, who governs the reliability of these apps? There is certainly no EU-wide legislation – as yet – that helps patients to determine which apps will genuinely benefit their health. The European Commission is moving in this direction, but until it papers over this particular crack, patients are obliged to rely on their own judgement, as well as that of friends, the internet and, perhaps, health professionals, among others.
This is a cause for concern considering the sheer volume of apps that are appearing. For example, about 5 years ago, according to a speaker at the DIA, there were some 70,000 healthcare-related apps available in the US alone – but that was 5 years ago. One can only imagine to what extent this figure has exploded in the meantime.
Then there is also a “legal” grey area surrounding the use of these apps. For example, if an app encourages a patient to opt for a particular medical product – even if this is not explicit – would that constitute direct to consumer advertising? Moreover, what if an app in some way pointed in the direction of off-label use of a medical product – would this automatically be declared illegal? These are just some of the questions with which the DIA speakers grappled.
It may well be time to create a guideline to answer many of these questions as well as the obvious ones about data privacy and integrity. Perhaps someone could put this into an app?1