There are thousands of medical apps available out there. But most doctors are reluctant to prescribe them to patients because so little is known yet about their efficacy. A new website tackles this issue by steering Canadian doctors to peer-reviewed apps that may benefit patients. Called Practical Apps, the site was launched in September, 2016 by Dr. Ed Brown (pictured), CEO of the Ontario Telemedicine Network (OTN) and his team of experts. Brown hopes doctors who recommend apps from the site will provide feedback about their experience.
There are over 165,000 healthcare apps in the app stores, says Brown, explaining the impetus for starting up the site. “Only a tiny percentage are associated with credible healthcare organizations. There are lots of good ones but there are also some really dangerous ones – we call them digital snake oil. Doctors don’t know what to do.”
Because of this, only a small percentage of doctors recommend apps to their patients. “They’re not Luddites, they just don’t know what to recommend. Most doctors have smartphones and they know all about apps. We just don’t know how to apply them to healthcare. It’s a new skill that isn’t being taught in med school yet.”
The site was designed to be as easy to use as possible. “We wanted to make it really simple for primary care providers to be able to make credible suggestions and we wanted to do it in a very practical way. We decided we would look at a common medical condition every couple of weeks and review the best apps to support that condition. There are some good sites like iMedicalApps out there that already review apps, but they aren’t in a Canadian context and they generally don’t take our single-condition practical approach. They just review apps as they’re released.”
The Practial Apps team has made some good app recommendations for conditions such as migraine, insomnia, hypertension, alcohol consumption and smoking cessation. “We’ve got a pretty good lineup for the year. When we feel like we’ve got a whole good list of common conditions, we’re going to go back to the beginning and start again to see if anything new and better has been developed.”
Brown says his team is considering adding consumer-oriented medical devices to the line-up.
“We’ve also tried to add extra value to our reviews by getting medical specialists to provide a short video clip touching on information that primary care providers should be aware of when looking at these particular health issues.”
A rigorous evaluation process has been developed to bring consistency to the way apps are reviewed on Practical Apps, he says. Dr. Payal Agarwal, who is a physician and an engineer at Women’s College Hospital Institute for Health System Solutions and Virtual Care (WIHV), was recruited to help develop a scientific approach.
“The team there came up with a process. I wouldn’t call it evidence-based because we’re not doing clinical trials on it, but they use a combination of reviewing academic literature, looking at what the most downloaded apps are in the app store, and scouring the Web to find the best apps. Then the researchers identify four or five apps that meet the criteria and ask the reviewer to go through them based on a detailed framework. They rank the apps in seven different categories. Then they roll that all up into an overall rating.”
About a dozen medical experts, many with backgrounds in both medicine and engineering, will be conducting the evaluations in the coming year. “We have a list of conditions we’re planning to review for all of 2017.
We haven’t published that because we’ve assigned them to the doctors doing the reviews, but we don’t know what the delivery dates will be from them – they’re all doing this on top of their day jobs.”
Brown believes it’s important to evaluate these medical apps from a Canadian perspective. “I think healthcare is always local no matter where you are. I think it’s important to get these apps reviewed by people who are in our health system. Our units and guidelines are different. The way we deliver care is different in different jurisdictions. We haven’t found any app review sites out there that we could put in front of physicians in Canada and tell them, ‘Just use this U.S. website.’ We looked around and we couldn’t find anything like that. That’s part of the reason we did this.”
Brown is eager to receive input from doctors who use the site to find out if the apps work as intended to benefit their patients, and if the evaluation process or some other aspect needs to be tweaked. “I’d love it if doctors took a look at Practical Apps and gave us some feedback, tell us whether it’s working or not. It’s really just meant to be another useful tool that providers can use when they’re looking after their patients.”
For more information, visit https://practicalapps.ca/