Use of mobile medical apps in clinical settings risky

The lack of governance and regulatory guidelines relating to the use of mobile devices in medical workplaces have serious implications for clinical care, professional practice and the education of healthcare professionals, according to results of a study announced by researchers at Australia's Monash University.

"There is a need for regulatory guidelines for use in clinical care, particularly beyond the concept of mobile devices used to mediate a 'face-to-face' consultation or even a clinical 'toolkit' managed by an enthusiastic end-user," the authors write. "This raises significant issues for professionalism in patient care, making imperative a more considered and comprehensive approach to the use of mobile devices and medical apps in healthcare."

In an article in the European Journal of ePractice, the authors explore the disadvantages and risks attached to healthcare apps, and how best to educate healthcare professionals in their use. "While mobile devices provide many benefits to medical, nursing and allied health practitioners and their patients, mobile digital technologies in healthcare (mHealth) also has identifiable disadvantages and risks," states Jennifer Lindley, senior lecturer in the Faculty of Medicine, Nursing and Health Sciences at Monash University, in the announcement.

According to the authors, some of the benefits of mHealth include more convenient access to patient records through mobility of devices, improved communication between health professionals as well as improved efficiency and decision making. However, at the same time, they assert that the potential risks include infrastructure constraints such as bandwidth availability, distracters including email alerts and advertising banners and privacy and security issues. 

"On mobile devices, icon badges, notifications, 'pop-up' alerts and constant availability of emails and internet access lead to distraction," Juanita Fernando, also of Monash University, writes. "Privacy and security issues in health care contexts are of particular concern to all stakeholders because of the sensitive nature of the data stored on the many mobile devices."

A report released in June 2013 from the mHealth Alliance, Thomson Reuters Foundation, Merck and Baker & McKenzie identified the policy gaps and legal and technological changes that need to be addressed in order to strengthen privacy laws that relate to mobile healthcare. With an overview of the current state of mHealth privacy and security laws, the report provided a "functional framework" for addressing worldwide mHealth privacy law issues, which the authors say can be applied to analyze existing privacy law systems and proposals for new privacy laws and regulation.

Monash University's Lindley also makes the case that the development of apps is often ad hoc and frequently undertaken without input or critical appraisal by end-users. "This can result in either variability of features or an app that does not perform the expected function," she said.

As a remedy, Fernando advises that best practices for use of mHealth need to be incorporated into the education of healthcare professionals, and curricula is required to provide the appropriate knowledge, skills and attitudes for future professional practice. "In the case of an adverse event, who precisely is responsible--the app developer, the individual clinician user, the health care provider organization or the government regulators?," she asks.

To learn more:
- read the announcement

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