Ensuring the safety of digital healthcare

20170616160000, Zayani Bhatt
Maintaining patient safety requires bringing technology out of the phone – and into the world.
Maintaining patient safety requires bringing technology out of the phone – and into the world.
Over the past decade, an entire industry has emerged to create mobile health technology. Today, there are a quarter of a million apps to help people manage stress and anxiety, monitor vitals such as blood sugar levels and present exercise routines for those with back pain.

Unfortunately, researchers are increasingly finding that these tools focus on how technology can solve healthcare problems, instead of what healthcare or patient challenges need to be solved. Can the narrative of patient safety from both apps and devices be reclaimed from digitised healthcare?

Apps without a medical purpose


Researchers at the University of Sydney have found that smartphone apps for treating back pain are usually poor quality and not rigorously evaluated. The study, published in Best Practice & Research: Clinical Rheumatology, reviewed 61 back-pain apps evaluating their content, functionality, quality, and whether they recommended evidence-based interventions or not.

Lead researcher Gustavo Machado said that although "millions of people worldwide use these apps,” there is “no independent guidance to help consumers identify which ones are safe and of high quality.” According to him, without rigorous testing, “it is not clear whether any of them are really effective in improving symptoms in people with back pain.”

Another of the paper’s authors, Associate Professor Steven Kamper from Sydney Medical School believes “app developers need to work closely with healthcare professionals, researchers, and patients to ensure the app content is accurate, evidence based, and engaging to improve the quality of existing apps.”

It is not just apps; medical devices need to be questioned, too


For several years, the medical manufacturer Olympus, produced a widely used medical device – the duodenoscope, a flexible tube inserted in the mouth in order to reach the small intestine. However, its usage coincided with a number of outbreaks of multidrug-resistant infections in hospitalised patients, from the Netherlands to America.

It was discovered that the duodenoscope caused the infection because its design made it impossible to completely disinfect. It was only when the hospitals complained in 2013 that the FDA realised the problem. By then though, a year had already passed.

The FDA currently employs a system of passive reporting which requests medics to identify risks associated with a new device and report them. However, this is time-consuming for healthcare professionals and the FDA, which receives several hundred thousand medical device safety reports each year.

To increase efficiency, they are piloting a technology called the National Evaluation System for health Technology (NEST). It aims to rapidly identify safety issues by collating data from electronic health records, existing registries, and other sources.

The future demands direction


Implementing this, however, will prove tricky. The FDA will have to ensure different electronic data sources can work together and collect information even during routine appointments. It will also be a challenge to add all devices currently in use and the many new ones that are approved each year.

However, identifying healthcare and patient safety problems and incorporating the physical environment like this can make mobile technologies a success. Tracking the outcome of using a certain medical device can increase patient safety.

In the same way, adjusting environmental factors such as sound, temperature, smell and light in the home, office and certain outdoor spaces can promote positive health habits. For example, instead of an app that notifies the user when it is time to sleep, it can dim the lights in the room as a behavioral nudge to head to bed.

This is more likely to work than current technologies such as mindfulness apps that keep buzzing until the user tells it they took the time to relax. MIMS

Read more:
The need for a different healthcare system for Generation H
Digital healthcare necessitates improved cyber security and a prepared society
The converging lines between tech giants and healthcare

Sources:
https://medicalxpress.com/news/2017-06-dont-smartphone-apps-pain.html
https://www.statnews.com/2017/06/07/medical-device-monitoring/
https://www.statnews.com/2017/05/24/digital-health-smartphones/