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App Prescribing: The Future of Patient-Centered Care

By Ben Chodor

Dr. Leslie Kernisan recently wrote a great piece about app prescribing, asking, “Should Ibe prescribing apps, and if so, which ones?” Since Happtique is all about integratingapps into clinical practice, I jumped at the chance to add to this important discussion.

Dr. Kernisan is right to be concerned and somewhat skeptical about app prescribing.More than 40,000 health apps exist across multiple platforms. And unlike other aspects ofthe heavily-regulated healthcare marketplace, there is little to no barrier to entry into thehealth app market—so basically anyone with an idea and some programming skills canbuild a mobile health app. The easy entry into the app market offers incredible opportu-nity for healthcare innovation; however, the open market comes with certain serious con-cerns, namely, “how credible are the apps I am (or my patients are) using?”

When Happtique launched, we focused our initial energies on bringing clarity to this crowded market. While theinterest in mobile health was skyrocketing, it was really hard to find specific health apps. Commercial app mar-ketplaces bucketed apps into just two categories: “Health & Fitness” and “Medical”—forcing patients andproviders to scroll through dozens of pages of apps in search of the “right” one. With the help of doctors, nurses,and medical librarians, Happtique classified nearly 20,000 apps into over 300 topic-specific categories related tohealth care profession, disease state, or specialty.

As we sorted through thousands of apps, two important ideas occurred to us. First, healthcare isn’t a traditionalconsumer product. Healthcare consumers, i.e., patients, have always relied on a trusted advisor—a clinician—totell them what products (pharmaceuticals) and services (treatments) to purchase. In other words, patients wantproviders to help them select the right apps for their health management plans. Second, we realized thatproviders are not going to recommend apps to patients if they are not confident that the app is secure, deliverscredible content, safeguards user data, and functions as described.

To address those issues, Happtique has spent the last year developing the Happtique Health App CertificationProgram (HACP), which launched earlier this month. Working with Intertek and clinical organizations like theAAMC and CGFNS, Happtique‘s certification program will test health apps against a set of published standardsand performance requirements that encompass operability, privacy, security, and content. Apps meeting thesestandards will receive the Happtique Certification Seal. We think this program will go a long way in helpingbuild patient and provider confidence.

Another important factor in building clinical confidence in apps is research. Let’s face it: doctors love data. Andwe’re starting to see some empirical evidence about health apps. For example, WellDoc ran a randomized, con-trolled trial to test effectiveness at improving health outcomes using their FDA-approved DiabetesManager app.The study found that the average decrease in A1C (a strong indicator of average blood glucose levels) for patientsusing the app was around 2.0%, as compared to 0.68% for patients not using the app. Certainly, some health con-ditions will benefit more from apps than others. But as the number of health apps continues to grow, more clini-cal trials around apps will provide much-needed validity to the concept of app prescribing.

While app certification and data from trials will help address Dr. Kernisan’s concerns about which apps to pre-

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scribe, she also notes that ease of prescribing is essential for widespread adoption of apps into clinical practice.Happtique agrees. Our mRx™ Mobile Health Platform not only allows clinicians to securely prescribe apps, butalso to send patients videos and documents. Imagine sending discharge papers or a post-op instructional videodirectly to your patient via email. No more wondering if the rehab exercise sheet made it home—the mRx™ Plat-form allows the prescribing clinician to see whether the patient has clicked the link to download content and canresend to patients, if necessary.

App prescribing offers an unprecedented opportunity to increase patient engagement and improve care manage-ment. To become a meaningful part of patient care, the clinical recommendation of apps must be, in Dr.Kernisan’s words, “thoughtful and person-centered.” That’s why it’s important to remember that while the pre-scribing technology is automated, the actual prescribing of apps is not. Clinicians still have to choose which apps,videos, and content to send to their patients. Happtique hopes that our Certification Program and prescribingplatform, coupled with emerging app efficacy trials, will help providers identify and integrate health apps into awhole-person approach to managing healthcare.

Ben Chodor is the CEO of Happtique, a company whose mission is to integrate mobile health into patient care and daily life.