Clinical management apps hold promise for managing asthma, diabetes

A new report from The Commonwealth Fund finds that clinical management apps have the potential to improve health outcomes, reduce health disparities and control costs.

According to the report, clinical management apps enable patients and providers to work together to manage chronic conditions such as diabetes and asthma, and are mostly used by health plans and large healthcare organizations with an interest in improving outcomes and controlling costs. In addition, some of these apps offer access to patients' electronic health records (EHRs), while others send data to physicians wirelessly or involve text messaging or secure emailing between patients and providers.

"Clinical management apps may be especially beneficial for low-income and minority patients, who are disproportionately affected by chronic disease and face barriers to accessing and managing their care," states the report. "In fact, safety-net populations appear to have better-than-expected access to mobile devices, often relying on cell phones for internet access in lieu of home-based computers."

Survey results released last year by the Pew Research Center's Internet & American Life Project indicate that African Americans and Hispanics are more likely than whites to own a smartphone, with 49 percent of Hispanics, 47 percent of African Americans, and 42 percent of whites owning these mobile devices. In particular, the Commonwealth Fund report highlights two specific types of clinical management apps--diabetes management apps and asthma management apps--that "have the potential to improve care and clinical outcomes for conditions for which there are racial and socioeconomic disparities."

An asthma management app that the report says holds promise is from Asthmapolis, which designed a mobile device with Bluetooth-enabled sensors that snaps onto rescue inhalers to track how often people are using them, their location, and the time of day.

However, as the report points out, there are challenges to the broader adoption of these apps including the lack of objective research to evaluate outcomes, uncertainty about how to pay for and encourage the use of cost-effective apps and the absence of a regulatory framework that standardizes development to ensure performance.

"To date, there is little robust utilization and outcomes data on the effects of clinical management mobile technologies, with systematic reviews finding limited evidence of their benefits or mixed results," states the report. "Some studies have found early indications of added value from use of clinical management apps, but final results are still a few years away."

In addition, for the widespread adoption of clinical management apps to occur, the report concludes that these apps will need to be incorporated into provider reimbursement schemes and integrated into EHR systems and other health information technologies. These apps will also need to be rigorously evaluated and regulated to ensure their safety, performance and effectiveness.

To learn more:
- read the report from the Commonwealth Fund 

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