Mobile Apps in Clinical Practice: Powerful Tools, With Pitfalls

March 4, 2017
Steven Chan

SAN FRANCISCO—Mobile apps have an array of potential uses in mental health treatment, but clinicians need to be aware of possible pitfalls in using them, Steven Chan, MD, MBA, told attendees at Elevate by Psych Congress 2017.

 “There’s a rich source of technologies that you can use to see how your patients are doing from afar,” said Dr. Chan, Clinical Informatics Fellow, University of California San Francisco School of Medicine.

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Digital tools may be cost-effective and could help clinicians revamp their operations, improve their quality of care, and overcome barriers such as location and transportation, he said. For example, interventions can be delivered immediately—such as when an app detects that an alcoholic is near a bar—instead of the patient needing to wait for a clinical visit.

More than 71% of psychiatric outpatients like the idea of using smartphones as a mental health tool, Dr. Chan said, noting that younger patients and those with private insurance are more likely to own smartphones and favor mobile apps.

“Patients are going to start demanding these,” he said.

To get started in using apps, Dr. Chan recommended thinking about typical clinical workflows and how apps can be used in each step. For example, patients could log symptoms or record videos while waiting for an appointment, and apps can deliver ongoing education after a treatment plan is formulated.

Before “prescribing” an app to a patient, clinicians should assess it using a rating system developed by the American Psychiatric Association, Dr. Chan said. That model evaluates a set of basic characteristics, privacy, safety, efficacy, ease of use, and data sharing capabilities.

Apps from established entities, such as government and nonprofit agencies, are more likely to have been vetted in areas such as privacy and security, compared with those from amateur developers, according to Dr. Chan. Further, apps often get outdated or disappear quickly.

 “You want to go with the well-known brand,” he said.

For example, the U.S. Department of Veterans Affairs has a suite of free apps for conditions such as mood disorders, addiction and post-traumatic stress disorder. Other mental health-related apps or app groups include Intellicare, SAM, and MindShift.

Dr. Chan also noted that most mobile apps are not approved by the US Food and Drug Administration, and no mobile devices are, and encouraged clinicians to keep that in mind when discussing them with patients.

When communicating with patients or dealing with patient information, it is important for clinicians to use enterprise systems they have agreements with, rather than free tools available to consumers, Dr. Chan said. He cited a study published in 2015 showing that 35 of 70 consumer apps included strong identifiers in transmitted information, and two-thirds of those did not use encryption.

—Terri Airov

References

“Connected Health Technologies and Mobile Apps for Mental Health.” Presented at Elevate by Psych Congress 2017; March 4, 2017; San Francisco, CA.