How should digital health apps be rated?

 In Medical Product Design

No matter the product market, it's important to determine efficacy. A product's ability to meet a desired effect for the target audience needs to be rated, but in a relatively new market those standards are often vague. Is the success or failure of a digital health app determined by its total downloads? Or is there a target outcome among the end users? 

The market is currently flush with health apps, fitness trackers and other data-heavy digital tools. While the ease of use and access certainly benefit end users, how does the medical industry validate these tools if they're seen as disposable commodities? Doctors will use or prescribe a digital health app if it's proven effective, but this measure of  effectiveness can be quite vague. 

HealthTap and IMS Health have established their own rating systems for digital health products, as reported by mHealth Intelligence. These lists are compiled by doctors, who rate the apps based on their perceived success. However, this solution does not take the patient's point of view into consideration, leaving out a valuable success factor. 

"A product's ability to meet a desired effect needs to be rated."

One MIT and Harvard-based nonprofit believes that it's the consumer who will determine the success or failure of a digital health app. The Hacking Medicine Institute has made it its mission to measure the outcomes of digital health care products. According to the Hacking Medicine Institute's mission statement, "Medical and health technologies — for decades derided as the driver of increased health costs — are now the key enabler of new products." 

Collecting and applying right kind of data
Capturing user data is not a problem when it comes to digital health apps. These tools are collecting vast amounts of information on user ailments, symptoms, daily habits and progress. The challenge is collecting trusted data and applying it to prove or disprove effectiveness. 

The Hacking Medicine Institute believes that the end users will determine the efficacy of digital health tools, and they've developed a platform for it which will collect the trusted data to show this. Launched in December, the group has created a forum for consumer reviews of digital health apps. These apps have been vetted by Harvard University doctors, but the main focus is on the user reviews.

Co-founder Zen Chu told mHealth Intelligence that user reviews are paramount because it stresses the importance of a keeping the patient in the design of medical products. One of the important factors in these user ratings is what's become known as "digiceuticals" in the digital health world. In an article for Fortune, Chu described digiceuticals as a set of opportunities that arise when digital tools and social behavior change a user's health and environment. Chu believes that using clinical approval as a baseline and focusing on end-user {hyphenating here only to indicate modifier – otherwise "end user" should always be two words} ratings will help to narrow down the thousands of digital health apps to the most effective. 

"Any ratings have to take intended usage into consideration."

Function and intended usage
First and foremost, the product must perform the service for which it's intended. As digital products are always evolving to add more capabilities, this becomes surprisingly difficult, as apps pivot to seek new opportunities. The technology needs to be used in the right way. This is easier in a clinical environment, where medical professionals are often monitoring usage. With consumers this can be more difficult, because they can choose to download apps they hardly use, or use with limited motivation. 

Any ratings have to take the overall intended usage of the digital health product into consideration, because an app that is supposed to treat a specific ailment will have a different use than one intended to lower medical costs. If the app is meant to be part of a larger treatment program, then that needs to be taking into consideration, rather than rating the app on its own. If another component of this broader treatment plan is unsuccessful, then it's not fair to give the digital health app a poor rating if the overall goals weren't met. 

The large amount of digital health apps on the market and their ever-evolving nature makes efficacy complicated. As these solutions gain traction and continue to become accepted by the clinical community, new standards will be developed, albeit deliberately. It's important to remember that in order to design medical products for successful patient outcomes, keeping the patient needs in mind is critical. 

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