mHealth App Development: Current Practices and Future Perspectives

By May 9, 2019 Mobile Health

mHealth App Development and Standardization of Innovative Technologies

Advanced digital technology has become an integrated part of today’s health care industry. With the increasing use of smartphones worldwide, mHealth app development has become an essential aspect of digital health. Note that mHealth apps are defined as software programs for a mobile device designed to improve patient health outcomes. Figures show there are more than 325,000 health apps available online, which can be divided into higher-risk apps and lower-risk apps (Van Velthoven et al., 2018). Interestingly, wellness and chronic disease management apps are the top two categories that reveal high user engagement, retention, and satisfaction.

Yet, despite the popularity of mHealth apps, users, providers, and regulatory bodies agree that app development can face numerous challenges. Note that the process of mHealth app development covers various steps, such as planning, research, design, and testing. One of the major challenges consists in the fact that apps can be developed quickly by people with non-medical experience. As a result, some apps may lead to poor content, low-quality care, and negative outcomes. With the increasing use of apps among patients and clinicians, lack of evidence-based principles for app development can result in deterioration in health.

Therefore, standards and strict guidelines are needed to ensure consistency and patient well-being. To create effective standards for innovative technologies, health software developers must review multidisciplinary standards, such as the ISO 14971:2007 Application of Risk Management to Medical Devices and the International Society for Pharmaceutical Engineering (ISPE) Good Automated Manufacturing.

mHealth App Development: Challenges and Perspectives

Standards for mHealth app development: With a large number of health apps available online (paid and free) and more than 45,000 mHealth app developers (Kao & Liebovitz, 2017), health app development faces numerous challenges. A recent systematic review revealed that there are no clear regulations for the development of mHealth programs (Van Velthoven et al., 2018). Standards, as explained earlier, are essential to reduce risks, boost revenue, and improve access and quality. Depending on their various functions and purposes, health apps must be strictly regulated to improve patient outcomes and safety. Standards can also enhance a company’s reputation and benefit economies. At the same time, regulatory oversight should not become a burden to technological advancement, which is developing at a rapid pace. Thus, one of the most effective ways to improve innovative regulations concerning mHealth app development is an open crowd-sourced app rating system. Such a system can be used to validate standards; it can help experts examine app content and allow consumers to rate app usability. Scientific evidence is also crucial to enhance the standardization of mHealth app development. In fact, more and more randomized controlled trials and literature sources support the rapid pace with which mHealth app development is expanding. Note that clinical trials and publication practices might be time-consuming, so real-world evidence is essential in research.

Privacy concerns in mHealth app development: Healthcare app developers should also consider patients’ privacy and safety. Medical information is sensitive, and personal health information management can be a tricky task. It’s not a secret that health apps require confidential details, such as name, age, and access to storage data. Such data should not be used without consent; boxes that grant permission must be implemented. App developers have faced strong negative reactions after some companies have used data without approval. Cloud adoption is another major challenge for developers. Note that since some cloud-based storage databases cannot be properly secured, innovative standards and security regulations must be employed in app development practices (Van Velthoven et al., 2018).

Hospital information systems and mHealth app development: Since mHealth apps collect a wide range of metrics and personal information, data can be integrated into hospital information systems and electronic health records (EHRs). Nevertheless, app developers must decide which information is valid in order to be integrated into patients’ medical records. Mathematical algorithms and clear standards can facilitate app development. To set an example, the Substitutable Medical Applications and Reusable Technologies (SMART) is an innovative initiative which can help developers create apps that run across various electronic health records platforms. Note that SMART employs the Fast Healthcare Interoperability Resources (FHIR), which is a draft standard for exchanging digital health records. Interestingly, companies like Epic allow developers to access their electronic health records system. Free and easy access can also help patients and providers track appointments and check test results. Personal health records (PHRs) kept by the patients – not the providers – are also essential in today’s app development. Such tools can help users store medical information (e.g., blood type) across multiple networks and beyond borders (Kao & Liebovitz, 2017).

mHealth App Development: Benefits and Health Care Practices

Benefits of mHealth app development: Although app development is a challenging area, mHealth app developers can create health apps with multiple benefits, for both patients and providers. Health care apps and e-patient portal apps can facilitate communication and research. Health professionals can prescribe apps and wearables to track treatment and medication adherence. With sophisticated audio and video capabilities, mobile devices and programs can help people with disabilities or users in remote locations access medical care. In addition, apps can boost a company’s revenue and reputation.

mHealth app development explained: Thus, the number of app developers is increasing. Developers can create apps from scratch for Android, iOS, and Windows operating systems. Note that previously, app developers have been criticized for creating high-end apps only for certain operating systems (e.g., Android). Application programming interfaces (APIs) can benefit app development, so different apps will meet different user needs (e.g., review prescription). The successful integration of artificial intelligence and machine learning is an essential factor for success in the field of mHealth app development. Nevertheless, as explained earlier, strict guidance is needed to support the process. We should mention that some apps have been taken down for promoting unhealthy choices (e.g., pro-smoking apps). The Food and Drug Administration (FDA) regulations are also needed to help providers and consumer choose a health app, which can improve patients’ well-being.

Areas of mHealth app development: Some of the most prominent areas of app development include wellness management, disease management, medication compliance, and self-diagnosis (Kao & Liebovitz, 2017):

  • Wellness management app development: Wellness management apps and connected devices are among the most popular mHealth apps on the market. Advanced digital accessories can help users track health-related aspects, such as jogging, weight, sleep, and body mass. When it comes to food intake, for instance, online libraries can help consumers choose healthy meals and activities. Despite the increasing popularity of wellness management apps, developers must consider the fact there’s little evidence-based information about wellness app efficacy and effectiveness. Therefore, researchers, developers, and clinicians must collaborate to create app content based on vigorous medical testing. Interestingly, clinical trials reveal that social media channels can boost user engagement, so Help buttons and online support groups become crucial features in wellness app development.
  • Disease management app development: Due to the fast pace of population aging, chronic diseases become one of the greatest burdens on global health. As a result, disease management apps are becoming more and more popular. From asthma to diabetes, such apps can help users manage their symptoms, log vital metrics, and track drug intake. When it comes to medication compliance, apps and journals can be highly beneficial. Such tools can set reminders, allow users to scan medications, and track side effects. In fact, medication adherence leads to a decrease in hospitalization readmissions. Nevertheless, app development must be based on clear standards to overcome any possible inconsistencies in content and feedback. Reminders and push notifications should be non-invasive and engaging.
  • Mental health app development: Mental health is another popular area of research and health app development. Mental health software programs have the potential to improve mental health treatment and reduce fatal outcomes. Since conditions, such as depression and autism, are common, apps can be used to benefit people’s well-being and learning skills. Nevertheless, mental health apps are inconsistent; many appear and disappear from the online market without any evidence-based benefits or recommendations for further research. Studies even reveal that not many mental health apps integrate crucial principles like cognitive behavioral therapy (CBT). App developers must consult experts in the field of mental health to create products which can promote patients’ well-being. Last but not least, apps must be easy to use and personalized (Goodwin et al., 2016).
  • Self-diagnosis app development: Self-diagnosis is also a promising field of health app development. Self-diagnosis apps can eliminate commuting and decrease waiting times. Such apps can benefit people in remote areas and resolve emergencies cases (e.g., bioterror attacks). Nevertheless, numerous risks may arise. For instance, self-diagnosis may lead to a delay in an actual medical diagnosis, which can be fatal. The vetting process also becomes questionable (e.g., taking and comparing pictures). To set an example, research showed that three of four self-diagnosis apps incorrectly classified more than 30% of melanomas. Although artificial intelligence and online libraries can support the diagnosis of a wide range of medical conditions, diagnoses should be validated by human health professionals. Standards and expert opinion must be implemented into health app development.
  • Rehabilitation app development: Rehabilitation software programs are another prominent field in digital health. Apps that track posture, gait, and fine motor skills are highly beneficial, especially in older patients. Tablets, for instance, can benefit stroke rehabilitation (e.g., self-training of repetitive movements). Rehabilitation apps can also assist patients with their daily activities. Neurorehabilitation apps can integrate exercises with pictures and videos, which can support and motivate patients. Once again, app development must be based on scientific evidence and clear standards. What’s more, IT specialists must understand the real needs of users with neurological disorders to improve their well-being (Rodriguez et al., 2018).

mHealth App Development: Conclusion

In today’s tech-driven world, it’s not surprising that the health care industry has turned to digital solutions to support patients, increase revenue, and improve research. Smart devices and BYOD approaches become major game-changers. Digital solutions can provide various services, such as online consultation, self-diagnosis, and wellness management programs. mHealth apps, in particular, allow patients to access medical data, track medication intake, and contact health care providers in real-time, without being admitted to the hospital. Health apps help users organize and store their medical and financial details, as well as synchronize their personal data across platforms and digital formats worldwide. In addition, mHealth apps can be utilized to access information regarding medical results, prescribed medications, and support groups.

Nevertheless, health app development is facing numerous challenges. One of the major goals is global compliance with privacy regulations and clear standards, such as the Health Insurance Portability and Accountability Act (HIPAA) rules. At the same time, the compliant app development process can become limiting; it forces developers to create a health app based on strict regulations, which might fall behind digital innovations and creativity. Therefore, app developers must find a balance between regulatory standards and innovative technologies to boost patient health outcomes and well-being (Van Velthoven et al., 2018). Note that mHealth apps have the potential to improve a wide range of health-related aspects, such as wellness management, disease management, self-diagnosis, and mental health. The health information that apps collect can be integrated into patients’ records across countries in order to support interoperability and medical research.

To sum up, technology has become an integrated part of health care, with mHealth app development transforming the future of medical research and routine clinical care. With the increasing use of smart devices, patients and providers rely on health apps to facilitate diagnosis, treatment, and care. Hence, app developers should work along with regulatory bodies, health professionals, and users to create original and effective mHealth apps because a single Download button can save a life and reshape health practices worldwide.

Resources

  1. Goodwin, J., Cummins, J., Behan, L., & O’Brien, S. (2016). Development of a mental health smartphone app: perspectives of mental health service users. Journal of Mental Health, 25 (5), p. 434-440.
  2. Kao, C., & Liebovitz, D. (2017). Consumer Mobile Health Apps: Current State, Barriers, and Future Directions. PM & R: The Journal of Injury, Function and Rehabilitation, 9.
  3. Rodríguez, M., Vázquez, S., Casas, P., & Cano de la Cuerda, R. (2018). Neurorehabilitation and apps: A systematic review of mobile applications. Neurología (English edition), 33 (5), p. 313-326.
  4. Van Velthoven, M., Smith, J., Wells, G., & Brindley, D. (2018). Digital health app development standards: a systematic review protocol. BMJ Open.
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Author Shuhan He MD

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