An App a Day

Apple coined the phrase "there's an app for that" back in 2009. In the intervening years millions of apps have been created and made available to download. The range of apps run the gamut from useful (avoiding traffic, managing finances) to offbeat (add a cat to any picture, have a pirate voice tell you where you parked).

The sheer volume of apps makes quality and credibility even more important. This is especially true when it comes to apps related to health care. A quick search of "health" in the app store returned hundreds of entries. Figuring out which one of these apps is legitimate (is it the one with the panda bear icon?) can be challenging and the consequences of bad information are potentially life-threatening.

"People are picking up these apps and are running with them," says UW Tacoma Assistant Professor Sharon Laing. "They sound good, they sound sexy but they may not do what they claim." Laing, a psychologist by training, is interested in the field of mobile health or mHealth. She is currently working on a study of patients and care providers to assess their level of knowledge and interest in using mobile technology to help manage health.

Laing's interest in mHealth stems from her time working at the National Center for Telehealth and Technology at Joint Base Lewis-McChord. The center — commonly referred to as T2 — is focused on using mHealth and telehealth to provide psychological health and traumatic brain injury care to active-duty service members, veterans, and their families.

While at T2, Laing worked with other psychologists, technologists and software design engineers to develop apps that address the needs of service members out on the battlefield. "The psychologists, like myself, were the content experts in the areas of stress and psychological distress. Our goal was to inform the engineers about some of the issues we need to be aware of in terms of designing an app," said Laing.

Laing began by surveying low-income patients in Washington State and in Washington, D.C. "We wanted to find out about their use of mobile devices, their knowledge of mobile devices to address health care in particular, and, if they could have a mobile device that would help address their health care needs, what are those needs they'd like addressed," she said.

The questionnaires yielded promising results. Participants were responsive to the idea of mHealth and were intrigued by the possibilities. "We got some interesting feedback about managing prescription refills, taking medications and tracking mental health status," said Laing.

The next phase of the project is currently underway. Laing is surveying healthcare providers to determine the feasibility of using mHealth in their practices. The overall goal is to improve communication between patients and providers. "We want to get the two groups to understand what the other is doing and to see the challenges that each side faces," said Laing.

Having instantaneous, unbridled access to information has always been one allure of the internet and related technologies like apps. Laing sees apps as having the potential to help produce better outcomes for patients. "This technology bridges the gap that occurs between patient visits when we can lose that motivation of the patient to stay on top of their regimen," says Laing.

More research needs to be done into apps and mHealth to determine their effectiveness. Early research into a text-based message system between doctors and patients highlights work that needs to be done. "How do we make sure we're giving people just enough to keep them interested in what it is we want them do but not too little whereby we lose them," said Laing.

One major piece that needs to be addressed is credibility and that's where Laing hopes she can make an impact. Besides her research, Laing also teaches a class at UW Tacoma that deals with mHealth. The course involves rigorously evaluating health care related apps to determine the benefits and risks. "I recognize there is a responsibility that I have in terms of not just doing the research, but also bringing it into the classroom to make our students aware of what's out there and hopefully creating researchers who will continue the work we're starting," said Laing.

The final course project involves creating a blueprint for an app. Students are evaluated on different criteria including ease of use and intended outcome. "I taught this class for the first time last year and my students came up with some fantastic apps," said Laing. "I loved that it wasn't just bells and whistles, they had to explain why each feature was there and why they felt it made a difference."

Maybe there is an app that evaluates other medical apps. If there's not an "app for that" there's always Sharon Laing and her work. "If we're going to provide support to physicians to work with patients when they're using this technology then they need to know that this technology is tried, tested and true."