July 28, 2016
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Review: Mobile health holds promise for early diagnosis, prevention of CVD

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Mobile health has the potential for a great role in the early diagnosis and prevention of CVD, according to authors of a contemporary review published in the Journal of the American Heart Association.

Zubin J. Eapen, MD, MHS, and colleagues “outlined specific opportunities for [mobile health]; potential challenges to the development and adoption of solutions; and a framework for developing safe, effective and evidence-based [mobile health] solutions for CVD.”

According to the authors, mobile health tools like wearable activity trackers and mobile ECG platforms can provide health behavior and physiological data to improve early disease detection, outpatient monitoring, and health promotion and disease prevention, but there are some hurdles that have to be crossed before these tools can be implemented into clinical practice, including:

  • risks of misuse and false results;
  • long-term durability and customer engagement of product;
  • better access for elderly and lower-income patients; and
  • privacy of patient data.

Eapen, from Duke Clinical Research Institute, and colleagues also wrote that payers must start implementing health care incentives and reimbursements to motivate providers to purchase mobile health tools because many clinicians are still wary of adopting them.

“Clinicians may be frustrated with current health information technologies, particularly [electronic health records],” the authors wrote. “Poor workflow integration, detraction from time spent with patients and lack of interoperability may all contribute to providers’ reluctance to accept newer forms of health information technology.”

Currently, only certain devices have the compatibility to integrate into a patient’s health records, and concerns persist about who manages all the data and whether patients will have access to their electronic health records so they can participate in their own care.

Another issue is the lack of high-quality evidence that these tools work, according to the review. Some developers of direct-to-consumer apps have received fines from the FDA for “making unsubstantiated health claims,” the authors wrote.

“A recent [American Health Association] scientific statement on the use of [mobile health] for CVD prevention found that very few applications have undergone rigorous study; among those that have, many lack a randomized comparator,” the authors wrote.

To find effective solutions to these issues, Eapen and colleagues recommended that besides conducting more evidence-based research, mobile health developers must create partnerships with providers, payers and professional societies such as the AHA.

“The evolution of [mobile health] is still in the beginning stages, but is a burgeoning field that represents the promising convergence of health care and mobile technologies,” the authors wrote. by Tracey Romero

Disclosure: The manuscript was supported by the AHA. Eapen reports serving on the advisory boards of Amgen, Cytokinetics and Novartis; serving as a consultant for Amgen, Novartis, and SHL Telemedicine; receiving honoraria from Janssen; and holding equity in Pattern Health Technologies. Please see the full review for a list of the other authors’ relevant financial disclosures.