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THE QUESTION
As my New Year's resolution, I plan to pay more attention to my health. I must admit I am a bit of a techno geek. Can you recommend any apps that can help me achieve my goal?
THE ANSWER
There are literally tens of thousands of health-related smartphone apps. But identifying the good ones can be a lot like finding the proverbial needle in a haystack. The vast majority of health apps are downloaded, used maybe once or twice, and then abandoned.
Even so, some apps can be extremely effective in helping people take charge of their own health, says Dr. Edward Brown, CEO of Ontario Telemedicine Network (OTN), a non-profit organization funded by the provincial and federal governments.
Dr. Brown is a big believer in the power of technology to solve many of the challenges facing our health-care system.
OTN, which he founded, created a video-conferencing network that enables Ontario patients who live in remote locations to have virtual doctor appointments in their own communities or homes.
Dr. Brown sees apps as cost-effective and readily available tools for aiding patients. They let people keep track of their medical condition on a daily basis. That kind of information can help them stay motivated between doctor appointments.
Yet only about 15 per cent of family physicians recommend apps to their patients, Brown says. Maybe they just don't know what to suggest – given a large number of apps are of questionable value.
To take the guesswork out of the selection process, OTN has begun a new service to review and rate health-related apps so physicians can feel comfortable recommending them.
A team of nine family doctors and one pediatrician will take turns evaluating apps, based on their background and interests.
The review method was designed by Dr. Payal Agarwal, a family physician and Innovation Fellow at Women's College Hospital Institute for Health System Solutions and Virtual Care (WIHV).
The reviewers will look at four or five of the most popular apps for a particular health area and provide ratings based on various features including clinical effectiveness, usability, reliability, as well as privacy and security.
Although the primary target audience is family doctors, patients can also see the ratings online at practicalapps.ca.
"Our goal is to use everyday language so that this is accessible to anyone in the general public," Agarwal says.
So far, they have rated apps for migraine headaches, high blood pressure, insomnia, alcohol consumption and quitting smoking. The team plans to issue a new review every two weeks.
The reviews tend to be focused on chronic illnesses. But the team wants to branch into apps for helping healthy people stay healthy.
So, what makes a good app? Ease of use is certainly important.
Agarwal points to the example of apps for managing high blood pressure. Some blood-pressure cuffs, she notes, can use Bluetooth technology to transmit readings directly to a smartphone or other electronic device, and the app then records the information. In the past, patients might have been asked to keep a paper diary of their blood-pressure readings. Now that can be done electronically. "It certainly makes the entire process a lot easier," Agarwal says.
Good apps can also provide clues to the things that might improve a patient's well-being. For instance, certain migraine apps can help identify the triggers that bring on the debilitating headaches. "If you can find patterns, you might be able to avoid them – and that can help you better manage your own condition," Agarwal says. Furthermore, feedback is key to a successful app. In some cases, an app will warn when a vital health indicator, such as blood pressure, is starting to creep outside the normal range. "This might be the time to see your family doctor again," Agarwal says.
Dr. Sharon Domb, division director of family practice at Sunnybrook Health Sciences Centre, says OTN's effort to evaluate apps is a "worthwhile endeavour."
She routinely recommends apps to her patients. However, they are not suitable for everyone. "People operate differently," Domb says. "Some patients like apps, others still prefer information on a piece of paper."
But possibly the biggest obstacle to the full utilization of apps is the health-care system itself.
The electronic medical records used by many doctors' offices are not able to collect and store information from apps in a useful format, Domb says.
Ideally, you would want to share the data with members of your health-care team, so you could benefit from their input and expertise. Many apps, of course, allow patients to create and print summaries of clinically useful information. As a general rule, though, "we don't have the electronic integration at this point," she says. Until that happens, you may not get the most out of an app.
Still, if you feel an app can motivate you, OTN's ratings may help you find one that suits your needs.
Paul Taylor is a patient navigation adviser at Sunnybrook Health Sciences Centre. He is a former Health Editor of The Globe and Mail. You can find him on Twitter @epaultaylor and online at Sunnybrook's Your Health Matters